Post Abortion Care Instructions

Post Abortion Aftercare

What to Expect

When the procedure is over, you may eat or drink anything you like as soon as you feel up to it. You may return to normal activities, but you should not "overdo it"--avoid strenuous activities and heavy lifting. If you had narcotic pain relievers or sedation, allow 12 hours to get them out of your system--do not drive.

Post abortion problems are rare but, as with all medical procedures, we are concerned about infection and too much bleeding. Please follow our instructions carefully.

Post Abortion Aftercare Instructions [pdf]
Having a problem?
  • Re-read all instructions.
  • Take your temperature
  • How many maxi-pads are you soaking in one hour?
  • What pain medications are you taking? When?
  • Have the phone number of a pharmacy that is open now.
  • Call us at 1-800-676-9011 or 607 785-4171

Bleeding and Cramping

What is Normal Bleeding?

Bleeding varies from woman to woman. You may bleed for the full two weeks or have little or no bleeding. 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 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 consecutive hours, you should take the medicine we prescribed for you to control bleeding. If you have many large clots for more than a day, take the medicine. (See Medicine to Control Bleeding below).  Call us if you are bleeding heavily beyond two weeks. Go for your follow up exam whether you are bleeding or not.
If you have chosen a Medication Abortion with the abortion pill Mifeprex, please read the special instructions we gave you, as you may have much heavier bleeding than described above.

Medicine to Control Heavy Bleeding

Methergine (Methyl Ergonovine) is a medication that tones up the uterine muscle and slows bleeding. We will give you a prescription for Methergine to be filled and taken ONLY IF NEEDED. If you are bleeding much heavier than your period, or saturating a pad an hour for two hours, take the medication. Call us if this pill does not resolve the heavy bleeding after 2 hours. You may have cramping so be sure you have taken some pain medication. Remember, some clots and bleeding are normal. Saturating a pad an hour for two hours or passing many large clots in a few hours means you should take the medication.

Cramps and Pain Medication


Please be sure you have over-the-counter pain medication on hand. 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) up to 800 mg. (4 -200 mg pills of any over-the-counter Ibuprofen product) every 4- 6 hours. Or take Aleve or Naproxen, two pills every 6-8 hours. Extra Strength Tylenol, 2 pills every 4-6 hours can be substituted but we do not recommend aspirin.

Your menstrual period

If you are not going on birth control pills or the 3 month 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 on and off 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 and do use condoms. Do not have intercourse for two weeks to prevent infection. 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 unless otherwise directed. You will get your period during the reminder pills or during the last week of the cycle. Continue taking them according to the directions we gave you on the green sheet. You can start the Nuva Ring, a vaginal contraceptive ring at the first period. 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 infections. 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 for two weeks
    Do not douche for the next two weeks.

Studies suggest that swimming and tub baths are probably OK, but Dr. Cousins prefers that you wait for one week. 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 or feverish. If you don't have a thermometer please pick one up at the pharmacy. If you are taking pain medication, take your temperature before, or after 4 hours taking pain medication to get an accurate reading.

If your temperature is 100.4 degrees or more for more than an hour 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.

Follow-up Exam

A follow-up exam is available to be sure you are completely healed and no longer pregnant. Keep your appointment even if you are bleeding. NOTE that sensitive home pregnancy tests can show positive for 2-3 weeks. At the follow-up you can continue or change your birth control plan. If there is a post abortion problem call us immediately; there is no extra cost to you for follow-up appointments if you return within 6 weeks. Make an appointment with Dr. Cousins or with your own doctor and clinic 2-3 weeks from your appointment. We will give you a summary of your records if you are not returning here. If you had a medication abortion, the follow up exam 1- 2 weeks later is essential. You can still come back, at no cost, up to 6 weeks later.

Other Concerns

If your nausea/morning sickness or other 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 touch or stimulate breasts, wear a tight bra even when sleeping, and apply cold packs for up to 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 hours (9 am to 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 no one gets back to you in 30 minutes, call the service again. Sorry, we can only take calls about post abortion emergencies after hours. Call during regular office hours about birth control problems, scheduling, emergency contraception, and other questions. (607) 785-4171  or toll free 1 (800) 676-9011.
 
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