Expert: Pat G - 6/13/2009

Question
Why is there spotting of blood versus heavy bleeding after taking the last dosage of the medical abortion pill 12 hours later?does that indicate an incomplete abortion?

Answer
Hello, Brooke,

The pills used in a medical abortion are powerful drugs. Since in most instances, the pregnancy is a normal situation, there is no balancing medical condition.

I assume that you have taken the last dosage within the past day. It is too early to tell how this will turn out. One thing you didn't tell me is how far along you are. You also didn't tell me if you took two different medications, or only one. Generally speaking, for the second course of pills, the drug Cytotec is used. This is actually a drug intended to treat stomach ulcers, and the manufacturer says it is NOT to be used by pregnant women. This is because it can cause contractions so severe they can rupture a woman's uterus. And there is no way to control the strength of the contractions. If used vaginally, they can also cause toxic shock syndrome. You are looking at life-threatening conditions. Toxic shock syndrome usually kills before the problem can even be diagnosed. If you just took the last pills, you are still very much at risk. At the first sign of difficulty, please go immediately to the emergency room and mention these possibilities. You should be experiencing contractions. In order to have a successful abortion, you will have to go through labor. There should also be significant bleeding. If you were more than six weeks along, it is unlikely the pills will even work. If you were more than seven weeks along, they probably won't. In addition, it is fairly common for a woman to start to bleed uncontrollably, and to bleed like this for weeks. That also can kill a woman, and if proper medical care is not sought, that's highly likely. A lot of women in India who don't have access to medical care are dying this way. In my opinion, any doctor who would provide these medications for the purpose of abortion is committing malpractice.

If you have an incomplete abortion, most likely, they will want to follow up with a surgical abortion. In a few rare cases, a woman can have a normal baby, but this requires regular doses of progesterone. She will need to see a doctor immediately. There is also the possibility, if all she took was Cytotec, that the baby could have microcephaly or shortened limbs. But if she first took the other drug, it is my understanding this is unlikely.

The situation you are describing, to make a long story short, is dangerous. Please find a decent doctor and go see him right away. Don't go back to the one who provided the pills. Please do this right away! Your life and health could depend on it.

Please take care of yourself, and don't take any more chances! Let me know how you do.