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Many people experience some bleeding after having an abortion. Doctors call this postabortion bleeding. It is a good idea to use pads after an abortion to track how much blood is resulting.
The two main types of abortion are medical and surgical. Here, we discuss these types of abortion and bleeding that women may experience afterward.
Bleeding after a medical abortion
A medical abortion is when the doctor gives a woman abortion pills to end her pregnancy. This type of abortion is available in the first 10 weeks of pregnancy.
During a medical abortion, the doctor gives a woman two pills:
- mifepristone to stop the pregnancy developing
- misoprostol to trigger the uterus to expel the pregnancy tissue
Misoprostol causes the uterus to contract, which forces the pregnancy tissue to pass out through the vagina. This treatment results in bleeding, which can be similar to having a heavy period. Some people experience heavier bleeding than others, and it may contain large blood clots.
A woman may then experience spotting or light bleeding for up to 2 weeks after the pregnancy tissue passes out.
Bleeding after a surgical abortion
Surgical abortions typically take place after week 10 of pregnancy. There are two types of surgical abortion:
- vacuum aspiration, which involves removing the pregnancy by the use of suction
- dilation and evacuation, which involves dilating the cervix with forceps and removing the pregnancy with suction
Doctors usually use vacuum aspiration up to around 14–16 weeks after a woman’s last period. After a longer time, they will generally recommend dilation and evacuation.
Surgical abortions can also cause postabortion bleeding, which may be similar to a normal period. Bleeding after a surgical abortion usually lasts around 1–2 weeks. Some women may experience spotting up until their next period.
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Does it cause irregular periods?
Some birth control methods may affect the regularity of periods after an abortion. If a person typically has irregular periods, they may continue to experience these after an abortion.
Having an abortion can lead to emotional stress, which may also affect someone’s menstrual cycle. Experiencing stress can change the regularity of periods.
If a woman has irregular periods after an abortion and did not previously, she should speak to her doctor.
Post-abortion bleeding is different from menstruation
It’s normal to bleed after an abortion. This bleeding might look like your monthly period, but it isn’t the same. It’s the result of your uterus expelling tissue from the pregnancy.
Some people don’t bleed at all after an abortion. They won’t start to bleed until their next period.
The timing of your bleeding depends on whether you had a medical or surgical abortion.
During a medical abortion, you’ll get two pills. Your doctor or other healthcare professional will administer the first pill. It breaks down the lining of your uterus so that a pregnancy can no longer grow. Some people start to bleed after this first pill.
You’ll take the second pill after you leave the hospital or clinic. This pill causes your uterus to release its contents. You may start to bleed within 30 minutes to 4 hours after you take it.
The bleeding will get increasingly more intense until you’ve passed the pregnancy. This should happen 4 to 5 hours after you take the second pill, but it can take longer in some people. There will likely be a window of 1 to 2 hours where you notice heavier flow and possible clots passing. This increase in flow should lessen after a couple of hours. Afterward, the bleeding should look more like a normal period.
If you have a surgical abortion you might bleed immediately after. Or, you may not start bleeding until 3 to 5 days afterward. In general, the flow is lighter than a period-like flow.
The bleeding may stop or continue until your next period. It if continues, it should get lighter over time.
It’s common to bleed for 1 to 2 weeks after either type of abortion. Some people find that the blood flow will stop and then start again.
The bleeding should taper off after a week or two. You may continue to have some light bleeding or spotting for a few weeks afterward, or until your next period.
The bleeding should look similar to your periods, except the color may be more brown than red. Blood flow is typically heavier with a medical abortion than a surgical abortion.
Certain activities can increase or decrease the amount of bleeding. You may bleed more when you exercise and less when you’re at rest.
You may notice blood clots. This typically isn’t anything to worry about. The clots can range in size from small to large. Some may be as big as a lemon. If clots are occurring with heavy bleeding and last more than two hours, you should call your healthcare provider to discuss whether you need evaluation.
There may be blood-tinged discharge, too. The discharge may be stringy like mucus, but it shouldn’t be foul-smelling, yellow, or green. These are signs of an infection.
Other side effects depend on the type of abortion you’ve had.
Side effects of a medical abortion include:
Because fever can also be a sign of infection, you should call your healthcare provider if you notice a fever, body aches, or increased bleeding or pelvic pain.
Side effects from a surgical abortion include:
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