Expert: Doctor Early Options - 10/23/2008

Question
Hi Dr. Joan,

I had a medical abortion at 7 weeks and everything checked out fine at the 1 week follow-up exam. I bled for about 30 days until it finally seemed to be reaching an end (very, very light; similar to the end of a period). But then after 4 days of being very light, the bleeding quickly started up again (back to being bright red). I thought maybe it was my period beginning. I called the clinic and they agreed that it sounded like my period and prepared me (i.e. much heavier than normal, painful cramps).

Today, after exactly a week of this medium bleeding, it suddenly got extremely heavier within a day (much, much heavier than even right after the abortion), and I've been passing large clots (at least one every other hour) since. I'm soaking through one thick pad within an hour and half to two hours, though I'm in no pain of any sort.

I don't know what's going on and I'm worried. I'm going to call the clinic as soon as it opens in the morning to see what they think, but I'd really appreciate another opinion. I don't even know if this second round of bleeding is actually my period or not. Is it possible to have your period while you're still bleeding a bit?

I didn't really pass any clots after the abortion, so I'm wondering if maybe my "period" triggered it to finally happen..? At my 1 week follow-up, the clinician mentioned that my uterus lining was very thick so maybe this is all that finally coming out?

Thank you so much for your time.

Answer
Dear Elle,
The bleeding you are having can be very frightening, but it is  probably normal.  It is fairly common to have a second heavy bleed weeks after the medical abortion.  Most likely it is a clot that has been sitting there, and is finally passing.  Usually a heavy bleed like this lasts less than 24 hours, and then goes back to normal (like a period).  If it does not stop after 24 hours, you will need to get a procedure to stop the bleeding, as that would indicate that you have active bleeding going on (not just an old clot).  
I hope this is helpful,
Doctor Joan
Early Abortion Specialist
EarlyAbortionOptions
New York City