Post-Abortion Concerns: Pain and Bleeding on Day Five

Fifth day post-abortion: issues with cramping and bleeding?

After the abortion procedure on February 29, 2016, I continued taking uterotonics, anti-inflammatory medication, and pain relievers four times a day.
The doctor mentioned during the surgery that my uterus was positioned deeper, which could lead to more prolonged bleeding.
At home, I experienced light bleeding for the first three days, but it wasn't very painful.
I followed up with my doctor as scheduled, and they indicated that my uterus wasn't completely cleared, so I should continue taking the medication four times a day.
However, on the fourth day, I started to have bright red and dark blood clots, accompanied by abdominal pain (which is tolerable).
Since last night, I have been passing a lot of blood clots.
Today is Sunday, and the clinic is closed.
I'm unsure if I should go to the emergency room for the ongoing bleeding or if I should continue taking the medication.
Thank you, doctor.

Lynn, 20~29 year old female. Ask Date: 2016/03/06

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, please continue taking your medication and return for a follow-up appointment.
Wishing you good health.

Reply Date: 2016/03/06

More Info

After an abortion, it is not uncommon to experience some bleeding and cramping as your body begins to heal. The fact that you are on medication for uterine contractions, anti-inflammatories, and pain relief suggests that your healthcare provider is actively managing your recovery. However, your current symptoms raise some important considerations.

On day five post-abortion, experiencing bright red bleeding with clots can be concerning, especially if it resembles a menstrual flow. This could indicate that your body is expelling remaining tissue, which can happen if the uterus did not fully clear during the procedure. The presence of clots is not unusual, but the amount and consistency of the bleeding are critical factors to monitor.

Here are some key points to consider regarding your situation:
1. Bleeding Patterns: Light spotting is typical in the first few days after an abortion, but if you notice a significant increase in bleeding (soaking through a pad in an hour or less), it may indicate a complication such as retained products of conception or an infection.

2. Pain Management: Mild to moderate cramping can be expected as your uterus contracts back to its normal size. However, if the pain becomes severe or is accompanied by other symptoms like fever, chills, or foul-smelling discharge, it is essential to seek medical attention.

3. Medication: Since you are on medications to help with contractions and inflammation, it is crucial to continue taking them as prescribed unless directed otherwise by your healthcare provider. These medications can help your body expel any remaining tissue and reduce the risk of infection.

4. When to Seek Emergency Care: If you experience heavy bleeding (more than a pad per hour), severe abdominal pain, or any signs of infection (fever, chills, or foul-smelling discharge), you should seek emergency medical care immediately. Given that today is Sunday and your clinic is closed, it is advisable to go to the emergency room if your symptoms worsen.

5. Follow-Up Care: It is essential to have a follow-up appointment with your healthcare provider to ensure that your recovery is on track. They may perform an ultrasound to check for any retained tissue if your bleeding continues or if you have persistent pain.

In conclusion, while some bleeding and cramping are normal after an abortion, the specifics of your situation warrant careful monitoring. If you feel uncertain or if your symptoms escalate, do not hesitate to seek emergency care. Your health and safety are the top priority, and it is always better to err on the side of caution when it comes to post-abortion care.

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