Expert: Doctor Early Options - 1/25/2009

Question
QUESTION: Hi Doctor,  I had an surgical abortion one week ago today at 5 weeks pregnant.  However, I had sex with my boyfriend 4 days after with a condom with spermicide.  We have had sex about 5 times since then and used a condom every time.  I have not bled at all except the day of mildly.  It hurt a lot the first time, but not so much anymore.  I have a post-op follow up on Feb 9th.  I had an abortion 7 months prior at 3 weeks pregnant and bled for 3 days 3 days after the abortion, then for 7 days about 24 days after that.  I am still not bleeding.  Is this because I had sex so soon after?  And is it only for risk of infection and/or pregnancy that you cannot have sex for 4 weeks after?

ANSWER: Hello Diana,
You have a few good questions: One about sex after an abortion and another about bleeding after abortion.
Doctors vary a lot about what they advise about sex, or anything in your vagina, after an abortion. Many say to wait weeks. There is not good evidence for this advice.  In fact the internal opening in the uterus is pretty much closed after 24 hours for an abotion between 5 and 10 weeks. We advise women not to put anything in their vagina (which doesn't necessarily mean no sex :-) ) for 24 hours for abortions 5-10 weeks. It is protection for preventing infection.
Women can get pregnant as soon as ONE WEEK after an abortion, so it is good you are using condoms and spermicide.
Bleeding after an abortion varies A LOT!! Having sex will not change the bleeding pattern.  Every pregnancy is different and every post abortion bleeding pattern is different.  Sometimes women don't bleed at all, expecially with early terminations.  Other times it can stop and start, sometimes light/sometimes like a period.
Go to your check-up, but everything sounds fine.
Dr. C.
earlyabortions.com
New York City

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

QUESTION: Dr. C,
Thank You so much for responding to my concerns.  So even though my body is not responding the way it did (as far as bleeding) after my last abortion, doesn't mean that anything is wrong since it is not responding the same this time?  And if I am not even as much as spotting, for how long after is that normal not bleed at all?

Answer
Dear Diana,
Dr. C was covering me for a day. I agree with everything she wrote to you.
Everything you describe is completely normal.  It is normal and common to have different experiences with bleeding patterns after ending a pregnancy.  It all sounds completely normal.  It is also common not to bleed at all, or it may stop and start, which is also normal.
I hope this is helpful,
Doctor Joan,
Earlyabortionoptions.com
New York City