Bleeding after an abortion: what is normal and abnormal

  • You are likely to experience heavy bleeding for several hours after a medical or surgical abortion.
  • You may continue spotting for a couple of weeks afterward, depending on how many weeks you were pregnant.
  • But if you pass large clots and soak through two or more sanitary pads an hour, contact a doctor.

Abortion is a safe and effective way to end a pregnancy when performed legally and by a trained physician who follows the methods outlined by the World Health Organization.

But it can be helpful to know what physical symptoms to expect before you have one.

According to Dr. Lisa Masterson, an OB/GYN in private practice, one of the most common side effects of medical and surgical abortions is bleeding.

It’s also common to experience painful cramping after an abortion, says Dr. Monica Grover, a board-certified OB-GYN and medical director of VSPOT.

Grover says that the cramping may be intermittent for the first few days and then increase along with the bleeding around the third to fifth day after the procedure.

The severity and duration of these symptoms are different for each person and may depend on the type of abortion you had and how far along you are in your pregnancy.

Some people experience light bleeding and spotting for two weeks after the procedure, while others experience an episode of heavy bleeding immediately afterward.

Below, OB-GYNs share exactly what to expect when it comes to bleeding and your period after an abortion.

bleeding after abortion

The amount and duration of post-abortion bleeding can vary from person to person: It is normal to experience light, moderate, or heavy discharge, as well as blood clots or blood-tinged vaginal discharge.

In addition, the type of abortion you have will also be a factor:

  1. medical abortions they involve a combination of two drugs that cause the lining of the uterus to shed, preventing the pregnancy from progressing.
  2. Surgical abortionsalso known as in-clinic abortions, they usually involve local anesthesia before a medical professional inserts a device through the vagina to empty the uterus of any fetal or uterine tissue.

This is the amount of bleeding that can be expected from each procedure.

medical abortion

After a medical abortion, bleeding usually starts one to four hours after taking the second medication. For some, however, the bleeding will start between taking the first and second medication.

Heavy bleeding should only last for a few hours shortly after taking the second pill, and you may experience clots, which can range from the size of a dime to the size of an orange. In rare cases, heavy bleeding may not start until a few days after taking the medication.

As your body passes the pregnancy tissue, the bleeding will decrease but may last 10 to 18 days.

surgical abortion

It is common to bleed for up to a week after a surgical abortion, according to Dr. Kim Langdon, an obstetrician and gynecologist at the

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Medzino platform. She says the blood can be deep red to brownish in color and can also sometimes include small clots that appear red to dark purple. The clots should be no larger than the size of a lemon.

After about a week as the bleeding eases, you can expect to have a pink or brown-tinged discharge. However, the duration of the bleeding depends on how long you have been pregnant.

The longer you’re pregnant, the longer the lining of your uterus has had to thicken, which means there’s more tissue to shed, Langdon says. So, for example, a surgical abortion performed at 16 weeks gestation may cause heavier bleeding than one performed at 10 weeks.

Also, bleeding may decrease when you rest and increase when you exercise.

Sometimes, Langdon says her doctor may prescribe methylergometrine, a vasoconstrictor drug, to control bleeding after a surgical abortion. However, in most cases, Grover says you’ll have to wait.

Post-abortion period

Pregnancy hormones interrupt your menstrual cycle, so you may not get your period at the usual time after the procedure, Langdon says.

Grover says that you can expect your next period to start four to seven weeks after having an abortion.

It may take some time for your hormones to regulate and your body to readjust, but according to Grover, your periods should become regular within two to three cycles.

When to see a doctor

If you experience any of the following symptoms, OB/GYNs say you should contact your doctor right away:

  • Heavy bleeding that lasts 12 hours or more
  • Heavy bleeding that soaks through more than two pads in an hour
  • Severe cramping that doesn’t get better with over-the-counter pain relievers
  • Fever and/or chills
  • smelly discharge

You should also contact your doctor if you don’t bleed at all after a medical abortion, because that may mean the medications didn’t work and you’re still pregnant.

According to Langdon, the most common cause of excessive bleeding is incomplete abortion. If that’s the case, the bleeding will usually be accompanied by abdominal or pelvic pain.

An incomplete abortion means there is still tissue from the pregnancy in the womb. In rare cases, an incomplete abortion can cause other complications, including:

  • Sepsis: an immune response that can cause tissue damage and organ failure
  • Hemorrhagic shock from severe blood loss
  • uterine rupture

Less commonly, excessive bleeding can also indicate uterine injury that occurred during the abortion procedure.

Both incomplete abortion and uterine injury can increase the risk of infection, which, if left untreated, can spread to the fallopian tubes and cause infertility.

Insider Takeaway

“It’s normal and common to have some bleeding after an abortion,” says Grover.

The later in the pregnancy you miscarry, the more bleeding you are likely to experience. Bleeding will usually be heaviest within 24 hours after a medical abortion, and then you may experience light bleeding and/or spotting for up to 18 days.

In general, bleeding tends to be lighter after a surgical abortion, but it usually lasts from several days to several weeks. The bleeding may also be accompanied by clots and cramps.

If you are ever concerned about the amount of blood or how long the bleeding has lasted, contact your doctor.

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