Complete "Aftercare" Instructions
Aftercare
Instructions for Patients:
For
recent surgery patients experiencing post-abortion emergencies,
call 24 hours a day. For all
other questions and appointments, call Monday-Friday 9 am- 5pm
or Saturday 10 am - 2pm
What to Expect
Now that the procedure is over, you should eat as soon
as you feel up to it. You may eat or drink
anything you like. You may return to normal activities, but you
should not "overdo it." Most
women find it best to avoid strenuous activities and heavy lifting.
If you need a note excusing you
from strenuous activities at work or school, the Recovery Room
Nurse can write you a note.
Post abortion problems are rare, but we do want to protect you
from the possibility of an infection
or too much bleeding, which can possibly be serious. Please follow
our instructions carefully. If you
are having problems, please re-read this information, and then
call us. A staff member is on call
for emergencies through our Answering Service. If you have routine
questions, or questions about
scheduling or birth control, please call during regular office
hours, weekdays, 9-5 and Saturdays
10-2, except holidays.
Bleeding
and Cramping: What is Normal Bleeding?
Most women have some bleeding off and on for a week or two. Bleeding
varies from woman to
woman. You may bleed for a full two weeks or have no bleeding
at all. For many women, the
bleeding stops and starts for a few days at a time. There may
even be spotting until your next
period. You may also find that you pass some large blood clots
and have mild to moderate, or
even heavy cramping. All of this is normal.
What is Problem Bleeding
Please call us if your bleeding is more than 1 maxi-pad (full,
soaked through) in an hour, for two or
more hours. (See Medicine to Control Bleeding) If you have many
large clots for more than a day,
please call us.
Be sure to take your methergine as directed.
If you have chosen a Medical Abortion with the medication Mifeprex,
please read special
instructions, as you may have much heavier bleeding than described
above.
Medicine to Control Bleeding
We will give you (or prescribe for you) a medication to control
bleeding called Methergine (also
known as Ergonovine or Ergotrate). This will minimize your bleeding
and help bring your uterus
back to its normal size. These pills are usually taken at night
and in the morning, about 12 hours
apart. If you are bleeding heavily you can take 3 per day, every
8 hours. Follow the instructions on
the pack of pills. Start TONIGHT. Don't be alarmed if you start
bleeding or clotting heavily when
you stop taking the methergine. This is a normal reaction when
the uterus relaxes.
If we give you a Methergine pack marked "Take as Needed"
and you are bleeding like a normal
period, please save the pack for 3 weeks in case you need it.
If you are bleeding more than a
period or more than is comfortable for you, take a methergine
pill and complete the medication as
directed or have the prescription filled as soon as possible.
Cramps and Pain Medication
Please be sure you have pain medication on hand. Let us know if
you need some medicine to take
with you. We encourage you to take pain medication at the first
sign of cramps to control
unnecessary pain. You should take either Ibuprofen (like Advil,
Motrin IB or other Ibuprofen product)
up to 800 mg. every 4 to 6 hours, OR Aleve, two pills every 6-8
hours. Extra Strength Tylenol
(2 tabs) every 4-6 hours can be substituted but we do not recommend
aspirin.
Your Period
If you are not going on hormonal birth control or the Depo shot,
your first normal period should
begin in about 4-6 weeks. The first period may be heavier than
before. If you have been given the
Depo Provera shot you may have bleeding off and on or your period
may not come at all. If you are
not on a hormonal birth control, you can get pregnant again before
your next period, so follow-up on
your birth control plan. Do not have intercourse for 2 weeks.
If you do not get a period after 6 weeks,
please get a pregnancy test and call us. Please keep your follow-up
appointment.
If you are going to use the birth control pill or patch, begin
taking it on SUNDAY. You will get your
period during the "reminder pills" or during the last
week of the cycle. Continue taking them
according to the instructions we give you (on the green sheet).
Call during our regular hours if
you don't get your period as expected.
Infection Precautions: Do's and Don'ts
Because the cervix has been opened (dilated) you are at greater
risk for infection. We want you to
take some precautions for the next two weeks. Do not put anything
in the vagina for two weeks. Do
not have intercourse for the next two weeks. Do not use tampons.
Do not take tub baths, douche, or
go swimming for the next two weeks. Showers and sponge baths are
fine. You can resume your
normal routine after two weeks as long as there are no problems.
Fever
Take your temperature each morning and evening for the next week
or if you are feeling flushed. If
you don't have a thermometer please pick one up at the nearest
pharmacy. (If you are taking pain
medication, take your temperature before or 4 hours after taking
pain medication to get an accurate
reading.)
If your temperature is ever 100.4 degrees or more, call us immediately.
Please read the
thermometer accurately; if you have a digital thermometer check
that it is working properly.
If your temperature is more than100 degrees, and you are experiencing
abdominal tenderness,
chills, etc., check your temperature every hour and drink lots
of water/liquids. Call us if your fever
ever reaches 100.4 degrees and we will order additional antibiotics.
Have the number of a
pharmacy ready when you call.
Antibiotic Instructions
We will give you antibiotics to prevent infections. We usually
give Doxycycline 100 mg. twice a day
for 5 days. You can take it with food or between meals. It works
fine either way, but if the
Doxycycline upsets your stomach take it with a small amount of
food. Please let us know before
you leave if you think you are allergic to the antibiotics we
give you.
Antacids (like Tums or Maalox) and iron tablets decrease the effectiveness
of antibiotics. These
products should not be taken at the sametime as antibiotics; wait
at least two hours.Rarely, a
person can have a sensitivity to the sun while on antibiotics.
You should avoid unnecessary
prolonged exposure to the sun or tanning beds for ten days.
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Follow-up Exam
A follow-up exam is very important to be sure you are completely
healed and no longer pregnant. If
you were early (less than 9 weeks) your follow-up visit should
include a pregnancy test. At the
follow-up exam you can continue your birth control plan. If there
is a problem call us immediately and
we will treat you at no extra charge.
There is no fee for your follow-up visit if you return here within
6 weeks. Make an appointment here
or with your own doctor or clinic 2-3 weeks from today. We will
give you a summary of your records
if you are not returning here.
Other Concerns
Call during office hours if heavy bleeding continues more than
2 weeks or if you don't get a period
when you should. If your nausea/morning sickness or pregnancy
symptoms do not go away within
a few days, call us during office hours. Some women may have some
breast discharge. If this
happens to you, do not stimulate breasts, wear a tight bra even
when sleeping, and apply cold
packs for 10 minutes at a time.
Contacting Us
Post-abortion problems are rare but require prompt medical attention.
Please consult us before
going to an emergency room; you may incur unnecessary expense
and/or treatment. We are the
experts in this procedure, please call us if you need us.
After office hours (9 am-5 pm weekdays) our answering service
will take your name, phone number
and symptoms. A staff member will get back to you within 10-20
minutes. If the service does not
answer, wait a minute and call back. Sorry, after office hours,
we can only take calls about post-
abortion emergencies. Call during regular office hours about birth
control problems, scheduling,
and other questions.
CALL (607) 785-4171 or 1-800-676-9011
Emotional Aftercare
Ending a pregnancy is an important life decision and it is completely
normal to have feelings about
it. Most women are relieved that the abortion is over, but some
may also have other feelings.
Problem signs includecrying a lot, having trouble concentrating
at work or school, trouble sleeping
or eating. If you find that you are sad or guilty and it is not
getting better, you may want further help.
If you want to talk to us, or if you want a referral, please make
an appointment to talk either in
person or over the phone. There is no charge for any additional
counseling sessions. See also,
www.pregnancyoptions.info.
Other suggestions:
1. If you are feeling alone in this experience it is important
to find someone to talk to, either a
trusted friend or family member, clergy, or a professional counselor.
Call us during office hours
for a referral or to schedule a counseling appointment.
2. If there are people who oppose your decision or if you are
worried about regretting it later, take
some time to write down your reasons and how you felt about ending
the pregnancy. Save this to
read at a later date if you need to.
3. There is written material on dealing with your feelings after
an abortion. You can take a copy of
the Pregnancy Options Workbook, especially the "healing after"
section today, or look at it on the
internet (www.pregnancyoptions.info). Other books and literature
are also available tohelp you.
4. Whatever you were feeling before your abortion will likely
continue afterwards. If you are having problems in a relationship
or with a family member, you
should try to resolve that, perhaps with the help of a counselor
or trusted advisor. If you have been
prescribed medication for depression or other mood problems, continue
it as directed.
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