Post abortion care

Aftercare Instructions for Patients:

Please read the following carefully before calling. 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

When 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. You may want to ask your employer whether you can get “light duty” or what kind of excuse you might need.

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?

If your bleeding is more than 1 maxi-pad (full, soaked through) in an hour, for two or more hours you should take the medicine we gave you to control bleeding. (See Medicine to Control Bleeding) If that is not working or you need more medication, please call us and have the number of a pharmacy that is open. If you have many large clots for more than a day, please call us. Be sure to take your methergine as directed. Call us if you are bleeding heavily beyond the two weeks. Go for your follow up exam whether you are bleeding or not.

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 usually give you one pill called Methergine which is medication to control bleeding (also known as Ergonovine or Ergotrate). In some cases, we will give you more methergine pills with instructions. If you are bleeding more than you are comfortable with, heavier than your period, or saturating a pad an hour, take this pill and have the prescription filled as soon as you can. 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. Don't be alarmed if you start bleeding or clotting more heavily when you stop taking the methergine. This is a normal reaction when the uterus relaxes.

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. Call us if you needed.

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. (4 200 mg. pills of any over-the-counter Ibuprofen product) 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 the SUNDAY after the abortion. 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). You can start the Nuva Ring, a vaginal contraceptive at the first period. Call during our regular hours if you don't get your period as expected.

Infection Precautions: Dos 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 than 100 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 for two more doses. 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 if you think you are allergic to the antibiotics we offer.

Antacids (like Tums or Maalox) and iron tablets decrease the effectiveness of antibiotics. These products should not be taken at the same time 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.

Follow-up Exam

A follow-up exam is very important to be sure you are completely healed and no longer pregnant. Keep your appointment even if you are bleeding. Your follow-up visit here will include a pregnancy test. At the follow-up exam you can continue your birth control plan. If there is a post abortion 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 your appointment here. 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 10-30 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, emergency contraception,  scheduling, and other questions.

CALL (607) 785-4171 or 1-800-676-9011