Making the decision to have an abortion is always difficult, regardless of the circumstances. The days after making a decision like this can bring up all sorts of feelings, and it’s normal for your mind to be as busy as your body right now. Alongside everything else you might be feeling, it’s natural to find yourself paying close attention to every twinge and change, wondering what’s part of recovering and what might need a closer look.
Cramping, bleeding and a whole mix of emotions are all part of the process of a medical abortion, but we understand that knowing where the line sits between “this is normal” and “I should call someone” can be hard to judge on your own, especially without a nurse in the room. Please be reassured that whatever you’re feeling right now, you don’t have to work it out alone.
This guide walks through normal vs concerning symptoms during a medical abortion, including what to expect after a medical abortion, the warning signs that mean you should get in touch with us, and what an incomplete or failed abortion can look like. Please read it as a general guide rather than a diagnosis. If anything feels wrong to you, trust that instinct and call us. We would always rather hear from you and put your mind at ease than have you sit with worry at home.
What’s normal after a medical abortion
If you’ve used our Abortion Pills by Post service, you’ll already have talked through what to expect with one of our consultants, but it’s still worth having a clear picture to refer back to now that you’re going through it. Cramping and bleeding are expected parts of a medical abortion, and for most women they’re the most intense in the first few hours after taking Misoprostol, the second of the two medications. Cramps are often described as stronger than a typical period, and many women find over-the-counter painkillers like ibuprofen or paracetamol helpful. It’s common to pass clots, sometimes fairly large ones, during this stage.
So, how long do you bleed after a medical abortion? As NHS Inform states, bleeding usually continues, on and off, for one to two weeks, though light spotting can carry on for up to three or four weeks in some cases. The pattern to look out for is a gradual easing off. Heavy bleeding in the first day or two should start tapering to something closer to a normal period, and then to lighter spotting, as the days go on. Every woman’s timeline looks slightly different, so try not to compare your experience too closely with what a friend or a forum post describes.
As for how long it takes to feel normal after a medical abortion, most women find their energy and mood settle within a week or two, though this varies depending on how far along the pregnancy was and how your body responds to the medication. Your period should return within four to six weeks. Feeling tearful, tired or a bit flat in the days afterwards is common too, and doesn’t necessarily mean anything is wrong physically. If low mood lingers well beyond this, we’d encourage you to talk to your GP or reach out to us for support.
How do you know if something is wrong after an abortion?
Most women recover without complications, but it helps to know the specific signs that mean it’s time to get medical advice rather than wait and see.
- Heavy bleeding: Soaking through two or more maxi pads an hour for two hours in a row is a sign to seek urgent help. So is passing very large clots repeatedly or feeling lightheaded, dizzy or faint alongside heavy bleeding.
- Fever or flu-like symptoms: A temperature, chills, or feeling generally unwell more than 24 hours after taking Misoprostol can point to infection and should be checked promptly. In some cases, this can be a sign of an infection.
- Severe or worsening pain: Some cramping is expected, but pain that keeps getting worse rather than easing, or pain that isn’t helped at all by painkillers, is worth flagging to us.
- Unusual discharge: Vaginal discharge with a strong, unpleasant smell, or discharge that looks different from what you’d normally expect, can also be a sign of infection.
If you notice any of these, please don’t wait to see if things improve on their own. Call our 24-hour support line straight away, and if your symptoms feel severe or are getting rapidly worse, go to your nearest A&E.
As Mr Alex Steshenko, Consultant Gynaecologist at The Gynae Centre explains: “Most women go through a medical abortion at home without any complications, and the symptoms they experience, cramping, bleeding, some tiredness, are simply the body doing what it’s meant to do. But we would always rather a patient calls us with a question that turns out to be nothing than stays quiet about something that needs attention. There’s no such thing as a silly question when it comes to your health.”
Signs of a failed or incomplete medical abortion
Medical abortion is effective in the vast majority of cases, but it isn’t guaranteed to work every time, and a small number of women will need further treatment. There are a few signs that can point to the pregnancy not having ended, or not having passed completely.
Continuing to feel pregnant a week or more after the procedure, with symptoms like nausea or breast tenderness persisting rather than easing, can be one indicator. Very light bleeding, or bleeding that stops almost immediately, can sometimes suggest the process hasn’t fully taken effect, though this isn’t always the case, so it’s worth getting checked rather than making any assumptions.
An incomplete abortion, where some pregnancy tissue remains in the womb, can cause bleeding that continues heavily, persistent pain, or the infection symptoms described above. This is one of the reasons follow-up matters so much. We usually recommend a pregnancy test around three weeks after treatment, and a scan if there’s any doubt about whether the abortion was complete. If your test is still positive at that point, please contact us so we can arrange the right next steps, which may include a further dose of medication or a short surgical procedure.
When in doubt, get in touch
Working out what’s normal and what isn’t during something as personal as this can feel overwhelming, particularly if you’re going through it without anyone else in the house. You don’t need to have a textbook list of symptoms memorised. If something feels off to you, that’s reason enough to call.
Our team is here around the clock for exactly this reason, and getting in touch costs you nothing but a phone call. For more on what to expect from the process as a whole, our guide on whether abortion pills are safe covers the wider picture in more detail. However you’re feeling right now, physically or emotionally, please know that support is only a phone call away.
