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Medical Abortion Care

Overview

A medical abortion is the use of medicines to end a pregnancy. Depending on the medicine used, a medical abortion can be done up to about 10 weeks of pregnancy.

After a medical abortion, you may have:

  • Bleeding and cramping that start within a few hours after you take the second medicine.
    • Cramps may be intense. You can take ibuprofen (such as Advil or Motrin) to help with pain.
    • Bleeding may be heavier than a regular period and may have some clots until the pregnancy has passed. The heaviest bleeding should stop 1 to 2 hours after you pass the pregnancy tissue.
  • Bleeding or spotting for up to 2 weeks.
  • Cramping for the first 2 weeks. Some women may have cramping (like menstrual cramps) for as long as 6 weeks.

Caring for yourself after a medical abortion

Carefully follow all of your doctor's instructions after you have had a medical abortion.

If you did not get instructions, follow this general advice.

  • Do not rinse the vagina with fluids (douche).

    This could increase your risk of infections that can lead to pelvic inflammatory disease.

  • Take any medicines your doctor has prescribed.

    Take them exactly as instructed.

  • Try returning to normal activities after 1 to 2 days.

    Most women can return to normal activities during this time.

  • Ask your doctor when it's okay to have sexual intercourse.
  • If you don't want to get pregnant, use birth control when you start having sex again.

Your health professional will give you information about what to expect after an abortion. Normal symptoms that most often occur include:

  • Irregular bleeding or spotting for as long as the first few weeks.
  • Cramping for the first 2 weeks. Cramping (like menstrual cramps) may last for as long as 6 weeks.

Follow your doctor's instructions on what to do at home.

Call your doctor now if you have any of these symptoms after an abortion:

  • Severe bleeding. Both medical and surgical abortions usually cause bleeding that is different from a normal menstrual period. Severe bleeding can mean:
    • Passing clots that are bigger than a golf ball, lasting 2 or more hours.
    • Soaking more than 2 large pads in an hour, for 2 hours in a row.
    • Bleeding heavily for 12 hours in a row.
  • Signs of infection in your whole body, such as headache, muscle aches, dizziness, or a general feeling of illness. Severe infection is possible without fever.
  • Severe pain in the belly that isn't relieved by pain medicine, rest, or heat
  • Hot flushes or a fever that lasts longer than 4 hours
  • Vomiting lasting more than 4 to 6 hours
  • Sudden belly swelling or rapid heart rate
  • Vaginal discharge that has increased in amount or smells bad
  • Pain, swelling, or redness in the genital area

Call your doctor for an appointment if you have had any of these symptoms after a recent abortion:

  • Bleeding (not spotting) for longer than 2 weeks
  • New, unexplained symptoms that may be caused by medicines used in your treatment
  • No menstrual period within 6 weeks after the procedure
  • Signs of depression. Hormonal changes after a pregnancy can cause depression that requires treatment.

It's possible to become pregnant in the weeks right after an abortion procedure.

  • Ask your doctor when it's okay to have sexual intercourse.
  • To prevent infection and pregnancy, make sure to use condoms as directed by your doctor when you start to have intercourse again. This is a good time to also start a highly effective birth control method that fits your lifestyle.

The risk of problems from medical abortion is rare. But some problems may include:

  • Failure to end the pregnancy.
  • Tissue remaining in the uterus (retained products of conception).
  • Moderate to severe bleeding (hemorrhage).
  • Infection.

Follow-up exam

A lab test or follow-up exam is done within 14 days after you take the medicine for a medical abortion. The exam may include:

  • A physical exam.
  • A lab test. This is to check for a low human chorionic gonadotropin (hCG) level, which means that the pregnancy has ended.
  • A blood test. This is to check for anemia.
  • An ultrasound. This is to confirm that the uterus is empty.
  • Information about birth control, if you don't want to get pregnant.

Related Information

Credits

Current as of: November 22, 2021

Author: Healthwise Staff
Medical Review:
Sarah Marshall MD - Family Medicine
Adam Husney MD - Family Medicine
Kathleen Romito MD - Family Medicine
Rebecca H. Allen MD, MPH - Obstetrics and Gynecology
Kirtly Jones MD - Obstetrics and Gynecology