Post Operative Instructions For Abortion Patients

Abortion procedures performed at the Women’s Centers require a high level of skill. Termination procedures are one of the most frequently performed medical procedures in the United States.

However, as with any medical procedure, complications can occur. It is important that you know how to take care of yourself after the abortion procedure.

The instructions below are meant to reduce your chance of complications. Identify complications that can occur as early as possible. Take all medications that you have been given as directed.

If you begin to have cramping, performing a uterine massage may help to decrease cramping. To perform the uterine massage, use the palm of your hand and push down firmly from your navel to the top of your pubic hair line.

This helps to make your uterus contract in order to push out blood and clots through your vagina which will decrease or stop the cramps.

Get a thermometer if you do not already one! Take your temperature two (2) times per day for the next two days. Elevated temperature may be a sign of infection which requires additional treatment.

For first and second trimester patients, call our office immediately if your temperature is over 100.4F at any time.

For Chemical Abortion patients, call our office immediately if your temperature is over 100.4F for more than 4 hours on the day of Misoprostol use or above 100.4F on any day after Misoprostol use.

Do not put anything into your vagina for two weeks or until after your post-abortion check-up.

This includes intercourse, fingers, diaphragms, tampons, douching, tub baths, hot tubs, and swimming (showers are ok). Any introduction of bacteria into the vagina can increase your chances of getting an infection.

Also remember that women can become pregnant again following an abortion, some within two weeks. For patients less than 6 weeks pregnant, one can engage in sexual intercourse within 24 hours of the surgical procedure or anytime the patient is comfortable after the non-surgical procedure.

Use maxi pads and monitor how much bleeding you are experiencing. If you begin bleeding more than two pads an hour for two hours in a row, please call our offices immediately.

Surgical Abortion Patients

In the absence of an elevated temperature after an abortion, it is normal to:

-Bleed on and off with a flow like your normal period or heavier for up 2 to 6 weeks, you may not have any bleeding or just have spotting which is also considered normal.

-Pass clots less than a fifty cent piece. You may have increased cramping immediately prior to and during the passing of clots.

-Have cramps on and off for 7 to 10 days, worsening with activity. Avoid strenuous exercise aerobics, running) and heavy lifting (over 15 pounds) for a week.

-You may not to have your next period for up to 12 weeks and sometimes longer after your procedure, but on average 4-6 weeks after your abortion.

Avoid aspiring, alcohol and marijuana which may cause heavier bleeding.

For Non-Surgical Abortion Patients

In the absence of an elevated temperature after an abortion, it is normal to:

-Have nausea and vomiting or diarrhea with Mifeprex or Misoprostol use.

-Pass several blood clots ranging in size from a dime to a large lemon. The embryo may be embedded in a blood clot and not seen at all or may be seen as a grape size, gray to white form.

-Have heavy cramping starting within 2 hours of Misoprostol use and lasting 7 to 14 hours. The cramps can last up to 48 hours.

-Have bleeding lasting from 1-60 days, but on average 14-17 days. For patients 6 weeks or less, the bleeding normally lasts for less than 7 days.

You may go back to your normal light activities within a day or two, but need to rest at least the remainder of the day of your abortion whether it is an aspiration or chemical process.

Strenuous activity too soon can increase the likelihood of heavy cramping and bleeding. You should refrain from strenuous activity; lifting small children, strenuous work, standing all day, etc. for at least 7 days.

If anything you do increases your cramping, bleeding, or clotting please stop what you are doing and monitor the problem. Generally the cramping, bleeding, or clotting will stop within a half hour. If it does not, please call our office emergency number.

Post Abortion Exam 

An appointment for your post abortion exam will be made prior to your procedure. This exam is free of charge for up to six 8 weeks after your abortion.

The purpose of this exam is to confirm that the abortion was successful and that your uterus is back to normal. If you have had the vacuum aspiration procedure, a uterine exam and a pregnancy test will be done.

If you have utilized the chemical process, an ultrasound will be done. If you have started on birth control with us and wish to continue receiving your birth control prescriptions, then you will need to have a birth control exam (Pap Smear, breast exam, and other minor laboratory testing) in addition to your post-abortion check-up. There is an additional fee for this expanded visit.

Post Abortion Emotional Health

You may experience a variety of feelings after an abortion, this is normal. You may have feelings of guilt, relief, sadness, happiness, grief, or anxiety. There is no right or wrong way to feel after an abortion.

Most women feel a big moment of relief. If you are having trouble coping with your feelings, you are welcome to call our offices. You may also find support by calling Exhale, a free national talk line that provides emotional support, resources and information at 1-866-4-EXHALE or visiting www.4exhale.org.

Peace After Abortion is another site that helps women cope with their emotions after having an abortion. The site address is www.peaceafterabortion.com

CALL US IMMEDIATELY IF YOU HAVE ANY OF THE FOLLOWING: 

Surgical Abortion Patients

  • Heavy bleeding which totally saturates one full-sized maxi-pad within an hour.
  • Constant severe headache not relieved with Tylenol
  • Passing clots larger than a 50 cent piece
  • Temperature greater than or equal to 100.4F for more than 24 hours
  • Persistent weakness and chills for more than 24 hours.
  • Lightheadedness or dizziness lasting for more than 4 hours.
  • Sudden lack of consciousness or unable to walk.
  • Persistent nausea and vomiting for more than 4 hours.
  • Diarrhea lasting for more than 4 hours.
  • Persistent lower abdominal pain for more than 24 hours.
  • Severe cramping, pain, or anything that is making you uncomfortable.

Vaginal bleeding may last for 7 to 14 days. In some cases it may last from 30 to 60 days. Nausea and vomiting generally diminishes within 2 to 3 hours after a first trimester procedure.

Chemical Abortion Patients

  • Nausea and vomiting for more than 4 hours after taking medication.
  • No bleeding started after 24 hours of inserting Misoprostol.
  • Temperature greater than or equal to 100.4F for more than 3 hours on the day of Misoprostol use or greater than or equal to 100.4F any day after Misoprostol use.
  • Heavy bleeding which saturates one full-sized maxi-pad every 30 minutes for two hours in a row.
  • Abdominal pain, discomfort, tiredness, weakness, nausea, vomiting or diarrhea for more than 24 hours after using Misoprostol.
  • Persistent low back or lower abdominal discomfort after 4 hours of passing tissue.

With the abortion pill procedure, nausea may become worse after taking the first medication. The nausea and vomiting should diminish significantly after taking the second set of medication within 2 to 4 days.

If this does not occur, it may be a sign of a failed abortion procedure and a follow up exam must be scheduled as soon as possible. Bleeding at times does not begin until 2 to 4 days after taking the second set of medications.

Remember that we are available 24 hours a day to serve you. Do not hesitate to call with any questions you may have.

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