Understanding the typical bleeding patterns after taking the abortion pill can help manage expectations during this process. Bleeding is a normal and expected part of medication abortion, indicating that the process is progressing. Knowing what to anticipate regarding the duration and characteristics of bleeding can provide reassurance and help identify when medical attention might be needed.
How the Abortion Pill Works
Medication abortion involves two medicines: mifepristone and misoprostol. Mifepristone works by blocking the hormone progesterone, essential for maintaining a pregnancy. Without progesterone, the uterine lining thins, and the pregnancy cannot continue. Most individuals do not experience significant effects immediately after taking mifepristone.
Misoprostol is usually taken 24 to 48 hours after mifepristone. It causes the uterus to contract and the cervix to soften, leading to cramping and bleeding that expels pregnancy tissue. This process is similar to a natural miscarriage.
Typical Bleeding Expectations
After misoprostol, bleeding and cramping generally begin within 1 to 4 hours. This initial bleeding is often heavier than a regular menstrual period and may include blood clots and tissue. Heavy bleeding typically lasts for one to two days, with the heaviest phase often occurring for 4 to 6 hours as tissue is expelled.
Following this heavy phase, bleeding gradually lessens over days to weeks. Light to moderate bleeding or spotting is common for up to two to four weeks, sometimes continuing for up to eight weeks. This bleeding may be irregular, stopping and starting, and can include small clots. The amount of bleeding varies with pregnancy stage. Associated symptoms like cramping, low-grade fever, chills, nausea, dizziness, or diarrhea usually subside within a day or two.
Signs Requiring Medical Attention
While heavy bleeding is normal, certain signs indicate a need for immediate medical attention. Contact a healthcare provider if you soak through two or more maxi pads in an hour for two consecutive hours. Passing blood clots larger than a lemon also warrants medical consultation.
Other symptoms requiring prompt medical evaluation include:
Severe, unmanageable pain not relieved by medication.
Fever lasting more than 24 hours after misoprostol, signaling infection.
Unusual or foul-smelling vaginal discharge, another potential sign of infection.
No bleeding within 24 hours after misoprostol, indicating ongoing or ectopic pregnancy.
Feeling lightheaded, dizzy, or faint, a sign of excessive blood loss.
After the Bleeding Stops
After the heavy bleeding subsides, light bleeding or spotting is common for several more weeks. This lighter bleeding may be intermittent and can continue until the next menstrual period. The uterus returns to its pre-pregnancy size during recovery.
Regular menstruation typically returns within four to eight weeks. The first period may be heavier or longer than usual, and it might take a few cycles to return to a typical pattern. A follow-up appointment, often within two to five weeks, is usually recommended to confirm the abortion’s completion, potentially involving a urine pregnancy test, blood work, or ultrasound. During recovery, avoid inserting anything into the vagina, such as tampons, or engaging in sexual intercourse for at least two to three weeks to prevent infection.