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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 weeks.
  • 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 hours
  • Sudden belly swelling or rapid heart rate
  • Vaginal discharge that has increased in amount or smells bad
  • 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 effective.
  • Bleeding (not spotting) for longer than 2 weeks
  • New, unexplained symptoms that may be caused by medicines used in your treatment
  • No menstrual period within 6 weeks after the procedure
  • 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 fever.
  • 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 present.
  • Moderate to severe bleeding (hemorrhage). Bleeding may be more than normal if:
    • Products of conception are retained in the uterus.
    • The uterus has not contracted toward its prepregnancy size (atony).
    • Uterine muscle rupture has occurred. In rare cases, a uterine incision scar tears open when a medicine is used to induce contractions.

When a medical abortion fails, a surgical abortion must be done as follow-up to prevent complications or development of a fetus with abnormalities.

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WebMD Medical Reference from Healthwise

Last Updated: August 31, 2012
This information is not intended to replace the advice of a doctor. Healthwise disclaims any liability for the decisions you make based on this information.
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