Expert: Doctor Early Options - 7/1/2008

Question
QUESTION: Hi, i had a medical abortion exactly a month ago (5/14/08). on my 2 week follow up, the nurse gave me an ultral sound and told me the medicine worked.  the next day my light bleeding got heavy again and it feels like i m having my period, could i be having my period 2 weeks after the medical abortion?  as of today, my bleeding has stopped completely.  my tender breast has gotten less sore over time but recently it seems to stop getting better, i still fell the soreness when i touch my breast though its not severe.  it has been feeling like this for quite a while now, is it normal?  nurse said the breast tenderness should go away a few days after the procedure.

ANSWER: Dear Mandy,
Everything you are describing sounds normal.  Bleeding after a medical abortion can be intermittent, with heavier bleeding or spotting, or clots.  It can come and go, just as you're describing it, so that it is hard to know if you are having a period or are having bleeding from the pregnancy.  It is common, and normal.  The breast tenderness also sounds normal.  It takes longer for pregnancy symptoms to go away with a medical abortion - sometimes more than a month.  If the pregnancy symptoms get worse, make sure to get checked.  
I hope this is helpful,
Doctor Joan

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

QUESTION: Dear Doctor Joan
After my bleeding stopped, i been having deep brown discharges on my panties. the color looks like old blood but its not jsut blood by itself, its as if my discharge has been dyed with that color.  but when i wipe myself, i see clear discharge on the toilet paper.  is that normal?  my breast is still hurting and these few days it has gotten worse.  hurts when i turn around in bed, hurts when i walk.  they seemed to be gotten bigger too...  how long does the pregnancy symptons usually takes to go away with medical abortion?  i have had sex the past few days for the first time after the abortion procedure(nothing rough or crazy), my uterus have a little of sharp pain from time to time, it doesnt last, just comes and goes, and not very often.  is that normal too?  i been under some stress lately,  could that be part of the reason too?  thanks.

ANSWER: Dear Mandy,
If you have pregnancy symptoms, like breast tenderness, that is getting worse, you should definitely get checked.  Go back to the office where you were given the medical abortion.  Otherwise, the discharge sounds normal.  It is probably blood that has not come out of your uterus quickly, so it becomes brown.  Unless it has a foul odor, there is nothing to be concerned about.  I am not sure about the pain during sex - make sure when you go back to the doctor that they check your cervix and make sure there is not some tissue sitting in the cervix.  This could cause all of your symptoms.
I hope this is helpful,
Doctor Joan

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

QUESTION: Dear Doctor Joan
I am sorry to bother u again...today my bleeding got heavy, exactly a month away from last time i was bleeding liek this.  tonight when i was watching tv, i felt something passed out of my vagina...so i went to bathroom and check...it was an egg shaped bottle cap size tissue...i m 100% sure its not a blood clot.  the ousid eis half clear white and i can see theres something blood color tissue inside, its kidna of heavy consider its size...much heavier than blood clot that size.   i also see some vine on it, i could be wrong but thats wat it looked like to me.  what is that thing?  i never seen something liek that.  i have schedual with the clinit for a follow up but its still some days before the appoitment.  i am confused and little disturbed by this thing, please help.  thanks.

Answer
Mandy,
It is good that you passed this.  It is probably the reason you were having brown discharge.  In an early pregnancy, the tissue that lines the uterus is a thick lining, getting ready for the pregnancy.  It is white and tan colored.  If the tissue is not completely removed, it can form what you are decribing - a very firm, formed clot-sized object.  It probably was stuck at your cervix to get this shape.  There is nothing wrong, and again, it is good that you passed this.  Everything may have passed, or they may find more at your check-up.  Make sure they do an examination and look in your cervix, and check your cervix on ultrasound. There are ways that you can facilitate passing it yourself - sex is the best way, otherwise you can take a bath and massage your lower belly.  
I hope this is helpful,
Doctor Joan
earlyabortion.com
New York City