Understanding Prolonged Bleeding After Medical Abortion: A Case Study

Question
Hello i am from India. my wife had 1 medical abortion in 2003, then we had 2 children in 2004 & 2007. in 2008 or so there was a continuous period and D&C was done by the doc. In may 11 pregnancy was positive and Medical abortion was done in may 11 end, the bleeding lasted for around 15 days. doc confirmed the successful termination of pregnancey after sonogarphy in follow up visit. on 6th july 11 first period started, first 2 days only spotting then bleeding with small to medium clots, sometimes the blood was bright red too but mostly on darker side, the bleeding was continuous some times and sometimes intermittent. on 15th july doc gave some medicine (meftal spas/dysmen, dexorange and metolar) for 5 days but the bleeding reduced and again started medium to high. we went to other doc on 20th july & this doc gave regulate medicine for 20 days but advised that if the bleeding does not stop in next 5 days they would do D&C and that should close the matter.  After taking 5 tabs of regulate (2.5 days) the bleeding has reduced considerably and we hope that it may end. however we have been told that there might be some tissue remaining in the uterus due to which this is happening, please guide us on the following :-

In case the bleeding continues -

should we go for D&C after 5 days dosage of regulate (starting 20th july night) as told by one doc (another doc told us that since we had used regulate the D&C can be done only after full dosage of regulate i.e. 20 days)

In case the bleeding stops -

should D&C still be done (since the tissue might still be there) or ultrasound should be done to see if the tissue is there and D&C be done only if the tissue is present?

What is the recovery time after D&C and is there any after effect of D&C?

Please answer to all queries. we are really worried. please advise. Thanks in advance.

Answer
Dear Akbabaj,

In case the bleeding stops there is no need for a D&C.
The ultrasound does not reveal the presence of a tiny bit of rests.
Remember that the uterus is a self-cleaning organ, and these rests - IF any - will be removed at
next periods.

Periods after an abortion are ALWAYS irregular and unpredictable, even for some months.
What you need is patience. If there are no serious problems, just wait.
In the meantime do not have unprotected sex as there are no safe days either.
This I think answers your question....if not, feel free to mail me again.
Bests, and good luck,

Dr Shan.