What to expect after an abortion

Nearly one million abortions happen every year in the U.S., so if you’re seeking more information about what to expect after an abortion, you are not alone. About 1 in 4 people who can become pregnant will have an abortion by the time they’re 45. Some will have more than one. Whatever your circumstances, let’s talk about what to anticipate in the days and weeks after your abortion.

The first days

The type of care you will receive and what you can expect after an abortion depends on how far along your pregnancy is and if you plan to have a medical abortion (taking pills) or a surgical abortion. Surgical abortions are also called D&C or D&E. D&C is dilation and curettage, D&E is dilation and evacuation. They are two distinct procedures done depending upon gestation age at the time of termination.

Surgical abortions take place at a hospital or clinic, while the abortion pill can be taken at home (though some people will take part of the treatment with a provider). As you plan, make sure to pick up pads in various absorbencies (including the heaviest flow), Ibuprofen, and a heating pad.

Most people who take pills for an abortion will have 1-2 days of heavy bleeding and cramping. This may be accompanied by nausea, vomiting and/or diarrhea. It’s likely you’ll pass tissue and clots in addition to bleeding during this time.

The day of a surgical abortion, you will need a ride home because the sedation you’ll receive will make it unsafe to drive. Most people feel sleepy and some feel nauseous. A few hours after, most of the sedation will have worn off, and you’ll feel tired and crampy. 

After the first 1-2 days, most recoveries look similar whether you had a medical or surgical abortion. Most people describe bleeding like a period, with cramping that is usually managed well by medications like Ibuprofen and warmth (warm drinks and a heating pad both help). Try to rest for 1-2 days if possible, as lots of activity will generally cause heavier bleeding and cramping. 

Weeks one-two

Expect bleeding to slow down over about 1 week, with some discharge or spotting lasting 1 week more. This discharge can be black, brown, pink or mucousy. Sometimes discharge or spotting can last for a few weeks, although this is less common.

If your abortion was performed later in pregnancy, you may have breast/chest changes — this can range from soreness to severe engorgement and milk production. Wearing a supportive bra and icing your chest will help (so will the Ibuprofen you’re already taking for cramps). Some people also add Cabocreme or cabbage leaves to their care. If you are having pain for more than 1-2 days, reach out to your provider for support. If you can’t talk to your provider, monitor for signs of a breast infection. 

After week two

Many people find their menstrual cycle takes 1-3 months to get back to their normal, though it is possible to ovulate right away (before your next period), so take steps to prevent pregnancy or try again depending on your situation. 

If your abortion happened later in pregnancy, then it’s more common to experience longer amounts of bleeding, discharge and cramping. 

Your emotions

The range of emotions after abortion varies as much as the reasons for needing one. You could be feeling immense relief, sadness or just be ready to move on. Whatever your experience is, your feelings are valid. There are also significant hormonal changes at play, knowing that you can expect some ups and downs can help you prepare for them. 

It may feel taboo to talk about your abortion and — depending on where you live — it may not feel like a safe option. If you’re able, talking to a trusted partner or friend can be validating and can help you process your experience. If you’re unable to talk to someone, writing in a journal or doing other activities like meditation can help.

If you need some more support, there are after-abortion hotlines to call, including https://exhaleprovoice.org/resources/

What to avoid after an abortion

Until you stop bleeding, you should generally avoid:

  • Tampons or anything else in the vagina (if you took pills, you can use tampons or a menstrual cup after the first few days when you’re sure your bleeding has slowed down)
  • Swimming or baths
  • Intercourse 
  • Vigorous exercise
  • Breast/nipple stimulation like touch or warm water (for abortions that happened later in pregnancy)

Your provider may have given you more relaxed instructions, and that’s okay too! Be sure to follow their recommendations and take medication they may have prescribed for you.

Warning signs

Be on the lookout for any of these symptoms, each of which are a reason to call your provider right away.

  • Heavy bleeding that soaks through a pad in one hour. If you’ve been very active, try rest and a heating pad to see if this helps slow the flow, but continued heavy bleeding needs attention.
  • Fever over 100.3F
  • Pain that doesn’t get better with medication, warmth and rest
  • Clots larger than a lemon 
  • Fainting
  • Discharge that smells bad or looks like pus
  • Still feeling pregnant 2 weeks after your abortion
  • Nausea, vomiting or diarrhea that lasts more than 1-2 days

It’s not common to have a complication after an abortion, but watching for warning signs and getting medical help if needed is important to take care of yourself. 

Make a plan that includes where you’ll get care if you need it and who you can rely on for support and transportation. Remember that if you need to seek urgent care for bleeding, or any of the other warning signs above, you do not need to tell medical providers that you had an abortion. The medical care for complications after an abortion is the same as after a miscarriage. 

Reviewed by the Ovia Health Clinical Team

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Ovia’s goal is to support the health and wellness of our members throughout their reproductive health journeys. Ovia cannot, however, encourage or discourage the very personal decision of whether to have an abortion or counsel on whether and how an abortion may be performed in a particular case. Abortion may or may not be legal in your state and in your particular personal situation. None of the information made available through Ovia is intended to provide you with legal advice regarding abortion. Ovia may refer you to third-party websites or publications for additional information on reproductive health issues, including abortion. Ovia is not affiliated with these third parties and is not responsible for any information that they make available to you.

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