How Long Can You Bleed After an Abortion?

Approximately one million abortion procedures are performed in the United States each year.

Although generally considered a safe procedure when performed by a licensed provider (or using prescribed medications), there are potential side effects of surgical and medical abortions. One common example is post-procedure bleeding.

Bleeding after an abortion

There is more than one type of abortion procedure. The best option for you will depend on various factors, and your provider can help you decide. The two common types of abortion are a medication abortion (using a pill, generally at home) and a surgical abortion. The side effects of each procedure differ. One such side effect is post-abortion bleeding.

After taking the Abortion Pill

There are several steps to abortion using a medication, and two different medicines are required. The first pill is called mifepristone. The purpose of the first meditation is to stop embryo growth. Depending on your body's reaction to mifepristone, you may feel nauseous or experience mild bleeding. The second medication is called misoprostol. Your provider will explain how and when to take your second pill. Misoprostol will cause cramping and bleeding as it triggers the body to empty the uterus.

Most people will begin bleeding within one to four hours after taking misoprostol. Cramping and bleeding from a medication abortion typically last between four and five hours, although it can last longer. Cramping may last between 24 and 48 hours after the bleeding subsides. If you do not start bleeding within 24 hours of taking the second pill, you must contact your provider immediately.

There are instances where one may have second thoughts after taking the first pill or choose not to take the second pill. It is essential to remember that the first pill is designed to stop embryo growth. Therefore, if someone takes the first pill but not the second, there may be a significant chance of harm to the embryo. However, there are options for reversing medical abortion. Studies show that using progesterone within 24-48 hours after taking the first pill may improve one’s ability to “reverse” a medical abortion and carry a healthy pregnancy to term.

When having a surgical abortion

A surgical or "in-clinic" abortion uses surgical intervention to end a pregnancy. There are a couple of different surgical procedures, and your provider will help you understand which type is right for you. In general, the procedure is called a Suction Dilatation and Curettage (D&C) or a Dilatation and Evacuation (D&E). The procedures are named the same for either a miscarriage or an elective abortion. Unlike a medication abortion, a surgical abortion takes between five and twenty minutes, depending on the procedure type.

Bleeding after a surgical abortion is not uncommon; however, the type of bleeding differs from medical abortion. After a surgical abortion, one is unlikely to bleed as heavily or for as long as after a medication abortion. Bleeding will range from mild to moderate bleeding and small clots for a few days to light spotting for a few weeks.

How to know if the abortion worked

Both abortion methods are generally considered safe and effective. Again, the best choice for you depends on factors specific to your needs, including the stage of your pregnancy. Surgical abortions are approximately 98% successful, and medication abortions are between 91% and 98% effective, depending on the stage of pregnancy.

There are several ways to check for signs of incomplete abortion. Surgical abortions are only performed if there is proof of pregnancy by ultrasound and the contents are analyzed by a pathologist to confirm that products of conception were obtained. Sometimes, a blood test will be performed to confirm if the procedure was successful. Other options include a home pregnancy test or a follow-up ultrasound.

An incomplete abortion requires follow-up care from a medical provider. To ensure prompt care, it helps to know the signs of an incomplete abortion after misoprostol. Examples of incomplete abortion symptoms include:

• Fever.
• Lower abdominal pain.
• Pain in the perineum, back, buttocks, or genitalia.
• Continued passing of blood clots.
• Moderate to severe (more than one pad per hour) vaginal bleeding that persists after symptoms of a medication abortion should resolve.
  

What will your period be like after an abortion?

Most women do not have monthly periods when they are pregnant. An abortion begins a new menstrual cycle, so most people notice their periods will return to normal within four to eight weeks of their procedure. The exact date one's period begins after abortion will depend on the woman’s normal cycle or the type of birth control one uses after the procedure.

First period

The first period after a medical abortion may be longer or heavier than usual. This is because the medication used to cause the abortion affects hormone levels and, therefore, cycle duration and length.

Second and subsequent periods

The second period generally returns to what the individual's periods were before their procedure. However, it is not uncommon for it to take between two and three cycles for periods to regulate. If this does not occur or more than eight weeks pass and your period do not start, you must contact your provider.

How long after abortion can you get pregnant?

One's monthly period will return within a month or two of their abortion; however, it is not necessary to have your period to get pregnant. It is possible to get pregnant within a few weeks after an abortion. This is because ovulation, the process of an ovary releasing an egg, occurs approximately 14 days into a 28-day menstrual cycle. This means ovulation occurs just a couple of weeks after a surgical or medical abortion procedure. If you are trying to avoid pregnancy, it is good to talk to your provider about starting birth control immediately after the abortion.

Post-abortion care

As previously mentioned, more than one million abortion procedures are reported each year in the US. Statistics suggest the overall complication rate is around 2%, with most complications and side effects considered minor. However, there is a risk of major side effects as well. Although serious complications are rare, it is important to know what to look for and to contact your provider immediately if you experience any of the following:

• Signs of infection.
• Fever (temperature above 100.4 degrees).
• Chills.
• Foul-smelling vaginal discharge.
• Fainting.
• Flu-like symptoms that persist for more than 24 hours.
• Heavy vaginal bleeding (soaking through 2 or more pads per hour for more than 2 hours in a row).
• Severe back or abdominal pain that does not subside with medication.

Abortion performed under the supervision of a medical professional is a safe way to end a pregnancy. Understanding each procedure, the potential side effects, and your options is essential before deciding which procedure is best for you.