Expert: Doctor Early Options - 2/16/2008

Question
I had a surgical abortion 6 weeks ago, when I was 7 weeks along. Immediately after the procedure, I started bleeding, and it has not stopped. Though it is light bleeding, spotting, I am still very concerned. I went 2 weeks after the abortion to my personal doctor for the follow up. He said that my pregnancy test came back positive and when asked about the bleeding, he too said this is normal. He instructed me to take another home pregnancy test within the next few weeks, and if positive, I would need to come in for a sonogram. Last night, I took 2 pregnancy tests, and both were positive. I am also very concerned about my bleeding. I am not sure if it should have lasted this long?? I do not think it is my period, because the blood itself is more a brownish color, rather than red. I made an appointment to go get a sonogram and run some blood work this coming week. I am just scared that I may have to endure the process all over again. Could I still be pregnant?!?! And is this bleeding ever going to stop?!? Please help! I would like to get on with my life but am plagued with this decision everyday.

Answer
Dear Maggie,
It can be normal to have a positive pregnancy test at four weeks.  However, it is definitely time for you to have a follow up appointment.  The most likely scenario from everything you have described is that you have "retained prodcuts."  This means that a small part of the lining, or "decidua" did not come out after the procedure.  This can cause a persistent positive pregnancy test and persistent bleeding. This is not necessarily the doctor's fault - it can be a normal problem that happens after any miscarriage, surgical abortion, or pill abortion.  
The good news is that if this is the case, there are no long term consequences, and it can be treated.  You will have a choice to do nothing, and let it resolve on its own, or to repeat a procedure, in which case the bleeding will stop within a few days.  
For you, it would be important to make the decision by what is best for you emotionally.  If the bleeding is reminding you of a difficult decision and makes you upset, it is probably worth doing the procedure again.  If you are scared, and that is why you are upset, then maybe just some reassurance that everything is fine will help you to move on and be able to handle the daily bleeding until it stops.
Either way, you should get an evaluation and make sure that the pregancy is over, and have an ultrasound so the doctor can determine whether they think it will resolve on its own.  
I hope this is helpful,
Doctor Joan