Heavy Bleeding and Clots After Medical Abortion: What to Expect

Question
QUESTION: I had a medical abortion Sept 22nd. I have had consistent but irregular bleeding. I went to my follow up apt last week and the doctor said my uterus was empty. I started taking birth control (ortho trcyclin low) that day. Two days ago I started bleeding heavily and passing large clots(golf size or better) I even bled through a pad and had a large clot over night. I am concerned by the clots. I have three children and have never experienced passing clots this large. I do not have a fever or even any cramping. A little fatigue and minor mood swings which I figure is normal. Should I be concerned?

ANSWER: Dear Emily,
Passing large clots(even larger than golf ball size) is typically completely normal after the abortion pill, or a medical abortion.  Intermittent irregular bleeding for a month after taking the abortion pill is also normal.  However, the heavy clotting should only last 24-48 hours.  If it lasts longer, you should call the doctor and have a second check up.  

While frightening, clots are completely normal.  Clots are simply blood that has sat in the uterus or vagina and was exposed to air (so it clots) before it comes out.  You can help your uterus to pass these clots by taking a bath and massaging your lower belly.  Sex can also help your uterus to contract and expel them, though sex may be unappealing while you're bleeding so much.  Also, low impact exercise at your home can help.  

There is more information on bleeding after the abortion pill or medical abortion at my website: http://www.earlyabortionoptions.com (Making your Decision, After Care).


I hope this is helpful and reassuring.  
Doctor Joan
http:www.earlyabortionoptions.com
New York City

---------- FOLLOW-UP ----------

QUESTION: Thank you very much. I feel better. Since I didnt have a fever or any pain, I figured it may be normal, I was just supprised by the size of the clots. I still have some sensitivity and swelling in my breasts so I figure my body is still in the process of getting back to normal. I may call planned parenthood and see if they think a second visit is necessary just to be sure.

Answer
As long as you are not having fever or pain, or heavy bleeding that lasts for more than a few days, you should be fine.  It is normal to have sensitivity in your breasts for weeks to months after ending a pregnancy.  It is best not to stimulate them, if possible.
Doctor Joan
http://www.earlyabortionoptions.com
New York City