Post-Medical Abortion Bleeding: What to Expect & When to Worry

Question
I had a medical abortion 5 weeks ago 1/12/10 today..everything went according to how it was supposed to go. ie..took the pills 4 hours later cramping then bleeding with the passing of clots. I bled for 2 more weeks had my follow up and then no more bleeding. On 2/5/10 I was walking and had a decent amount of bleeding start..I assumed it was my normal period but now almost 10 days later I am still bleeding (my normal periods lasted 4 days) then this morning 1/16/10 I woke up to having completely soaked through my tampon and had blood all over my pants i have never bled that much on my period ever. when i removed the tampon i had huge clots..is this normal should i still be bleeding and bleeding for this long should i be worried...

Answer
Dear Courtney,
Thank you for your question about heavy bleeding one month after a medical abortion.  The bleeding you are describing with the abortion pill is typically normal.  It is common to have delayed heavy bleeding for weeks to months after a medical abortion. Sometimes this bleeding is even heavier than when you first went through the initial miscarriage.  Passing large clots can be frightening, but it doesn't mean there is a problem.  It simply means that the blood sat in the uterus before it came out, so it formed itelf into a clot.  This heavy bleeding should only last a few days before it starts to be more like a period.  

Reasons to see a doctor include: if you are having strong abdominal cramping with the bleeding; if you have a strong foul odor; if you were anemic before the medical abortion; if the bleeding does not start to get lighter in 3-4 days; if you are gushing blood - 2 maxipads/hour for more than 2 hours.

There is more information on bleeding and medical abortion on my website: http://www.earlyabortionoptions.com

I hope this is reassuring and that the bleeding starts to get lighter.

Doctor Joan