Expert: Doctor Early Options - 2/15/2010

Question
I decided to have an abortion on the 6th week of my pregnancy. I was given the abortion pill at the clinic which was one by mouth In front of the doctor and 4 tiny pills to be inserted by hand. The doctor told me that It would be ok for me to Insert the pill after 24 hours and i did. I had heavy clotting the first day, The color was red and white, the bleeding was average like that of a normal period. it continued to be this way for a week and then the bleeding stopped. I thought I was clear and had protected intercourse with my boyfriend.  two days after the bleeding stopped It began again. this time with huge clots. Every time went to urine at least one or two would come out. the bleeding was heavier than my first week when the actual abortion was happening. I don't bleed constantly to the point where I fill out pads to quickly, but when I do It feels like my body pumps out plenty of blood, when this happens I wonder If I messed my pants. Please let me know If this Is normal. Should I go to the emergency room?

Answer
Dear Jessica,
Thank you for your question about the abortion pills, blood clots, and heavy bleeding.  Typically what you are describing with the abortion pills is completely normal.  It is common and normal to have large blood clots.  Passing blood clots can be frightening, but they generally do not indicate that there is a problem.  It just indicates that the blood sat in the uterus before it came down, so it formed a clot.  It is also common and normal to bleed heavier the second week, than at the time of the actual abortion.  Usually this type of heavy bleeding you are describing only lasts days.  

I usually do not recommend going to the emergency room when you have bleeding from the abortion pills.  It is much better to go back to the doctor who prescribed the pills.  Doctors in the emergency room are not trained in medical abortion, and they will usually recommend a D&C surgical procedure, which is usually unnecessary.  

Reasons to go back to your doctor would be: the bleeding continues for more than a few days as you are describing that does not start to get lighter; you start to get strong lower abdominal cramping; or you had anemia before you took the abortion pills.  

There is more information on bleeding and abortion pills on my website:  http://www.earlyabortionoptions.com

I hope this is helpful and that the bleeding slows down,

Dr. Joan
New York City