Medical Abortion Care - Topic Overview
Care after a medical abortion continued...
Normal symptoms that most women will
experience after a medical abortion include:
- Bleeding or spotting for up to 14 days.
Bleeding may last longer for pregnancies of more than 7
- Cramping for the first 2 weeks. Some women may have
cramping (like menstrual cramps) for as long as 6 weeks.
- Emotional reactions
for 2 to 3 weeks, often influenced by changes in pregnancy hormones. It's
normal to feel one or more emotions such as relief, guilt, sadness, and/or grief.
Call your doctor immediately if you have any of these symptoms
after an abortion:
- Severe bleeding. Both medical and surgical
abortions usually cause bleeding that is different from a normal menstrual
period. Severe bleeding can mean:
- Passing clots that are bigger than a golf
ball, lasting 2 or more hours.
- Soaking more than 2 large sanitary
pads in an hour, for 2 hours in a row.
- Bleeding heavily for 12
hours in a row.
- Signs of infection in your whole body, such as
headache, muscle aches, dizziness, or a general feeling of illness. Severe
infection is possible without fever.
- Severe pain in the belly
that is not relieved by pain medicine, rest, or heat
- Hot flushes or a fever of
100.4°F (38°C) or higher that
lasts longer than 4 hours
- Vomiting lasting more than 4 to 6
- Sudden belly swelling or rapid heart
- Vaginal discharge that has increased in amount or smells
- Pain, swelling, or redness in the genital area
Call your doctor for an appointment
if you have had any of these symptoms after a recent abortion:
- No bleeding. If bleeding does not occur, then
the medicines may not be working. A second dose of misoprostol may be needed.
Methotrexate and misoprostol may take up to 3 weeks to be
- Bleeding (not spotting) for longer than 2
- New, unexplained symptoms that may be caused by medicines
used in your treatment
- No menstrual period within 6 weeks after the
- Signs and symptoms of
depression. Hormonal changes after a pregnancy can
cause depression that requires treatment.
Complications that can occur include:
- Tissue remaining in the uterus (retained
products of conception). Cramping belly pain and bleeding will occur again within
a week of the procedure.
- Infection. Symptoms of fever of
100.4°F (38°C) or higher, pain,
and belly tenderness will usually start within 2 to 3 days of the
procedure. But you can have a serious infection without
- Blood clots blocking the cervix (hematometra). If the uterus
doesn't contract to pass all of the tissue, the cervical opening can become
blocked. This prevents blood from leaving the uterus. The uterus will become
enlarged and tender. Belly pain, cramping, and nausea may be
- Moderate to severe bleeding (hemorrhage). Bleeding may be
more than normal if:
- Products of conception are retained in the
- The uterus has not contracted toward its prepregnancy size
- Uterine muscle rupture has occurred. In rare cases, a
uterine incision scar tears open when a medicine is used to induce
When a medical abortion fails, a surgical abortion must
be done as follow-up to prevent complications or development of a fetus with