Causes of Post-Abortion Bleeding
No matter which abortion method you undergo, your chance of bleeding afterward is very high and completely normal. The specific causes of bleeding after a medical vs. surgical abortion are as follows:
- Medical abortion: Mifepristone, the first pill you take while at the clinic, in the care and presence of your doctor, blocks progestin. Progestin is needed for the fetus to continue growing and without it, the lining of the uterus begins to break down as it would during menstruation.
- Surgical abortion: While a medical abortion empties your uterus with the use of medication, a surgical abortion empties it via suction or curette.
Normal Bleeding After An Abortion
The bleeding you can experience post-abortion differs from that of menstruation. The volume, duration, color, and timing can vary and while you may notice some similarities between the two, you should expect some deviance.
Medical abortions can produce a heavier amount of blood flow than you’re used to, which may also include blood clots. Make sure you have an extra supply of menstrual pads made for heavy periods on hand and keep track of the number you go through and the frequency in which you change them. If the blood flow does not decrease or you’re bleeding too much (you’re soaking more than two maxi pads per hour for over two hours), reach out to your doctor.
Surgical abortions often produce less blood flow, however, it’s a good idea to keep pads on hand afterward and contact your doctor if the amount of blood loss concerns you.
Cramping, bleeding and spotting are common to experience for a few weeks post-abortion no matter which method you undergo, but if you feel too uncomfortable or anxious about your symptoms, you have a fever above 100.4°F or stomach cramps that don’t improve with medication, it’s best to call your doctor.
Warning: Do not use tampons or menstrual cups during or after an abortion. Also avoid sex and birth control methods that involve insertion for at least a week following an abortion, as you are at higher risk for infection.
After a medical abortion, you could bleed anywhere from one day to an entire month. The timing of the abortion (how far into the pregnancy you were) can affect the length of time you bleed, as generally the earlier the procedure, the less bleeding experienced.
Whether it be a medical or surgical abortion, most women experience bleeding for 1-3 weeks following the procedure, though it should decrease in volume the longer it continues (certain activities, such as running or lifting, may cause you to bleed longer or heavier). Spotting and cramping are also common, but belly pain that isn’t relieved by medication should be brought up to your doctor.
It is sometimes difficult to discern the color of menstrual blood from that of post-abortion bleeding since the color is fairly close. Generally, post-abortion bleeding will be darker and possibly even slightly brown. You also may notice blood clots, which tend to be much darker since the concentration is denser.
Spotting may be tinged brown from the old blood which is completely normal. If your discharge has a yellow or green tint and/or has a foul odor, it’s not normal and a sign of infection. If you notice these symptoms, you should call your doctor.
Some women won’t bleed until a few days after the abortion, while others won’t bleed until their next period a month after the procedure. These variations shouldn’t cause concern unless you notice blood clots larger than a lemon or the bleeding continues too heavily for more than 4 hours after the fetus has been expelled from the uterus (soaking two maxi pads per hour for over two hours is a good indication of too much bleeding).
Your Period After Abortion
“When do you get your period after abortion?” is a common question but not so simple to answer.
An abortion resets your menstrual clock. Thus, you should expect your first period after an abortion to start approximately 4 weeks from that point. However, because each woman bleeds differently after an abortion, it can be difficult to distinguish between a period, spotting, or abnormal bleeding. Read on for some clarity on how to recognize your period (or lack of) post-procedure.
A Lighter or Heavier First Period After Abortion
After an abortion, you may experience a change in the length and strength of your normal period. It could be shorter, longer, lighter or heavier. In any case, it should return to normal the following month.
Post-Medical Abortion: A heavy period after a medical abortion is common. It could extend beyond your normal cycle length or fall short of it. A heavy period after abortion is not anything to be concerned about, as long as you’re not bleeding too much for too long (a good rule of thumb is no more than soaking two maxi pads per hour for over two hours), have abnormal belly pain or a fever.
Post-Surgical Abortion: A lighter flow or spotting is commonly experienced with the first period after a surgical abortion. Light flow is usually associated with a shorter cycle and can quickly dissipate to spotting, which could last longer and come and go.
An Irregular Period After Abortion
Your body works to bring your hormones back to normal levels following an abortion and can take some time to do so, which of course affects your menstrual cycle. When your body takes a little longer to regulate remaining pregnancy hormones, an irregular period can occur. Keep track of your period or any bleeding you experience post-abortion and call your doctor if you suspect your cycle may be off or not “bouncing back” as you expect.
No Period After Abortion
Maybe you got your first period but missed your second period after abortion. Or perhaps you’re cramping and spotting, but beyond that, your period is non-existent after 4-8 weeks post-procedure. In either case, you may want to take a pregnancy test.
While it is rare, having no period about 4-8 weeks after an abortion may indicate:
- You are still pregnant
- You are newly pregnant
- An underlying medical condition brought about as a result of the abortion, such as Asherman’s Syndrome, a rare condition in which scar tissue interrupts ovulation
Signs of Pregnancy After Abortion
Having no period after 4-8 weeks from your abortion procedure is one of the first signs that indicate you could either still be pregnant or became newly pregnant. You may also experience some of the following symptoms:
- Sore breasts
- Spotting or brown discharge
- Cramps without bleeding
Ovulation After Abortion
Women can become pregnant relatively quickly after having an abortion thanks to ovulation, which can return to normal within 2-3 weeks post-procedure. Even if you do have sex before two weeks out, it is possible the sperm can live and remain in the uterus for up to 5-7 days with the possibility of fertilization.
If you are experiencing any symptoms of pregnancy, speak with your doctor.
Using Birth Control After Abortion
To protect against an unwanted pregnancy after you’ve had an abortion, it is recommended that you implement a birth control method immediately.
The clinic where you received your abortion will likely be able to provide you with some form of birth control to be used right away or help you decide what is the best option for you.
Birth control pills can be used in conjunction with abortion medication. Other methods (such as the birth control ring or IUD) may require you wait at least a week following the abortion for recovery purposes.
When to See A Doctor
While bleeding may be the most common side effect of abortion, it isn’t the only one. Other symptoms you may experience include:
- Low-Grade Fever
Seek Medical Attention If You Experience:
- Any of the above symptoms for more than a few hours
- Intense pelvic pain and/or increased bleeding that doesn’t pass or gets worse
- Fever (a sign of infection)
- Continued heavy bleeding (soaking two or more maxi pads per hour for over two hours)
- Blood clots larger than the size of a lemon
- Vaginal discharge tinted green or yellow, or has a foul smell
- No period within 4-8 weeks post-abortion
- Pregnancy symptoms
Abortion Services and Aftercare
It’s important to always speak with a licensed physician about which abortion method is right for you. Eastside Gynecology strives to ensure the utmost comfort, privacy, and safety, and we understand the importance of appropriate abortion aftercare.
Call or visit us to set up an appointment today!