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

Question
I had a surgical abortion about three weeks ago.  I've stopped bleeding for about a week now, and I was told at the clinic that I would start my period 3 to 4 weeks after the procedure.  I began bleeding yesterday (nothing heavy or strange), and I assumed it was my period.  I've started taking birth control pills very recently as well.  Today, I'm not bleeding at all.  Do you think this is a side effect of the birth control, just normal spotting from the abortion, or something else?  I'm not extremely worried, but my period has never been regular (I've bled for 3 to 4 weeks straight before, and it's also not uncommon for me to be 2 weeks late either.), so it's so hard for me to tell what this could be from.

Answer
Dear Sarah,
It is common and normal to have irregular bleeding and spotting for weeks to months after a surgical abortion.  It can also be caused by starting birth control pills.  It can also be your usual irregular periods.  There is no way to know.  The most important thing is to remain on the birth control pills, and take them as directed.  This is important so that you are sure to not get pregnant again.  Many women are under the false impression that if they are bleeding they cannot get pregnant.  If the irregular bleeding is from the abortion it should resolve on its own in the next month. If it continues after that, you may ask your doctor to try a different brand of birth control pills.
There is more information on birth control, bleeding and spotting after abortion on my website: http://www.earlyabortionoptions.com
I hope this is helpful,
Doctor Joan
New York City