Post-Abortion Care Guide : Managing Physical and Emotional Health

For someone considering an abortion, it is important to have knowledge and understand what happens after getting this procedure done. Abortion is ending a pregnancy and it can be medical, spontaneous or surgical and is safe most of the times.⁽¹⁾ The care involved after the abortion usually involves lots of rest, good diet and being comfortable. Side effects of abortion are often mild and of short duration; however, in some cases, there may be some complications.

Cramps and bleeding are to be expected after any kind of abortion. Other than this, other side effects experienced are nausea, soreness in the tissue of chest/breast area and vaginal discharge.

Bleeding Post Abortion: The amount of bleeding experienced after abortion differs from person to person. In case of medical abortion, the bleeding is most on the day the medicine misoprostol is taken. There is more bleeding after medical abortion than surgical abortion and it can last for about nine days on an average.^{(2, 3)} After a surgical abortion, there is not much bleeding, and the patient can start to experience bleeding about 3 to five 5 days after.

There can be light bleeding for around 15 days after any type of abortion. Some patients can also experience bleeding on and off. According to some, spotting can occur for even about a month post-abortion and even longer in some patients.

Post Abortion Cramps and Pain: Cramping is to be expected after an abortion, and it indicates that the body is getting rid of the pregnancy and the uterus is returning to its size which was before the pregnancy. The pain felt after abortion is usually intense than the regular menstrual cramps. In case of surgical abortion, the cramping can initially feel like period pain after which the severity increases after 3 to 5 days of the procedure.

The most commonly reported side effect of medical abortion is pain with around 78.4% of women in a study done in 2012 experiencing moderate to severe cramping.⁽⁴⁾

A study from 2019 showed that cramps from a medical abortion were often less painful when compared to cramps after surgical abortion; however, the pain after the medical abortion was more.⁽⁵⁾ Pain post abortion also differs from patient to patient.

Patients who experience more pain than others can consist of:

• Younger people can experience more pain after abortion.
• Women who were pregnant for longer duration before opting for abortion can have more pain.
• Women having dysmenorrhea or having a history of painful periods.
• Women who have not given birth vaginally previously.
• People without a good support system and who are not sure how they feel about getting abortion.

Each body is different and not everyone is going to experience all these side effects.

Breast/Chest Pain: Tenderness in the chest or breast can occur before getting abortion and can persist for some time after having the abortion. In some cases, this is the symptom which is the last to go.

Vaginal Discharge: After abortion, it is normal to experience mucus-type of discharge, which can be red to purple to blackish-brownish color.

Chills: Chills and shivering can be felt after getting an abortion and fever can also be present, in which case it is recommended to consult your doctor.

Nausea, Vomiting or Diarrhea: GI symptoms can be felt for about a day after the surgical abortion or for some days after taking abortion pills. If these symptoms persist longer, then it is better to consult your doctor.

Fatigue: After any medical procedure, fatigue is felt as the body needs rest and some downtime to get back to normal. Patient can feel sleepy and feel tired all the time.

Complications post abortion are rare, and only about 2% of women feel these complications after abortion.⁽⁶⁾ Infection and incomplete abortions are the commonest complications experienced. Signs which indicate serious problem post abortion are:

• Heavy bleeding for long period of time.
• Passage of blood clots, which are bigger than lemon in size.
• Severe cramps or pain; and if the pain worsens with time or doesn’t dissipate even after taking a pain killer, then consult your doctor ASAP.
• Vaginal discharge which has a bad or strong smell.
• Acute pain in the abdomen, which doesn’t feel like cramps.
• Having a fever of 38ºC (10 0.4ºF) or higher.

If any of you are having the above symptoms after getting an abortion, then please consult your healthcare professional immediately. If the symptoms of pregnancy persist for greater than 2 weeks after getting the abortion or if there is no bleeding after taking the abortion medication, then it is highly advisable to consult your doctor, as all these can indicate an incomplete abortion.

If the abortion had been done in a clinic, then your doctor will give you some pointers for managing the potential side effects before getting the abortion. Antibiotics can also be prescribed to prevent infection and painkillers for the pain. Always take medication as told by your doctor and if in any doubts, then don’t hesitate to ask your provider.

In case of surgical abortion, the patient will need someone to take them home, more so if the patient has been given a sedative. It is also highly recommended to take a few days off from work/school/college and rest at home irrespective of the type of abortion done.

To relieve the pain and cramps after abortion the following measures are beneficial:

Painkillers: Taking OTC pain medication, such as acetaminophen or ibuprofen for alleviating pain and cramps.

Hot Water Bottle: Using a hot water bottle or a heating pad on your abdomen to help reduce pain and cramps associated with abortion.

Wear Tight-Fitting Bra: Wearing a compression top or tight-fitting bra can help in alleviating breast/chest tenderness.

Massage: Try massaging your abdomen where cramping is felt by firmly pressing with your fingertips and gently massaging in circles from the belly button to the pubic bone for some minutes.

Stay Hydrated: Drink lot of water as it is important to stay hydrated, more so when having diarrhea or vomiting. Drinking warm beverages, such as tea, soups can help in relaxing and also in easing the post abortion symptoms.

A good support system in the form of family and friends is hugely beneficial in rapid and easy recovery after abortion.

What not to take: Never take aspirin or medications which have aspirin in them for pain relief, as it can increase bleeding post abortion.

Your periods will get back to normal after the abortion. However, there are many myths surrounding abortion that it will change the menstrual cycle, which is not true. However, it is common for the first few cycles to be somewhat irregular.

If the patient usually has predictable or regular monthly periods, then the next period most likely will start within 4 to 7 weeks after getting the abortion. However, it is not a cause for worry if they take longer to start, more so for someone with irregular periods previously.

Putting anything inside the vagina carries a risk of vaginal infection and it includes tampons also. With a tampon, the risk is not that much; however, as infections are one of common complications occurring after abortions; especially surgical abortions, so it is highly recommended to avoid inserting anything within the vagina as it increases the risk of infection.

Your doctor is the best person to advise you when to start using tampons post abortion. In any case, it is recommended to use menstrual pads for the bleeding occurring after abortion. Pads carry lesser risk of infection and also one can track better the amount of bleeding one has after abortion.

What not to do: douching has extremely high risk of infections⁽⁷⁾ irrespective of abortion and one should stay away from doing it at any point in time.

Not a lot of research or studies are there when it comes to the length of time one has to wait to have sex post abortion. Many experts say one can proceed with sex after the bleeding stops.  It is also advised by some to wait for at least a couple of weeks before having penetrative sex to prevent infection.

If one wants to prevent pregnancy after the abortion, then you should start birth control immediately or as per your doctor’s instructions. Birth control can be started on the same day as the abortion by using the following methods: hormonal birth control and barrier methods.

Using intrauterine devices (IUDs) as birth control immediately after any abortion is not recommended as it increases the risk of complications.⁽⁸⁾

One can feel extremely strong feelings or a gamut of different emotions after abortion which is completely normal.  A study showed that round 17% of women experienced mostly negative feelings after getting abortion and around 12% had mix of positive and negative emotions, even though they all understood that this was right decision for them.⁽⁹⁾

Go easy on yourself and give yourself a lot of time and space for healing and processing your feelings. Make use of your support system and spend time in activities which you enjoy, such as reading, painting or even watching television.

It is important to remember that whatever emotions one is experiencing, getting an abortion is not associated with development or worsening of any type of mental health problem.

Studies show that people who got abortions are not an increased risk for having mental health challenges than people who did not have had an abortion.⁽¹⁰⁾ Research says that if a person is denied of an abortion then it can affect their mental health in the long run.⁽¹¹⁾

Abortion, which can be medical or surgical, is a safe procedure with very less side effects and even lesser or rare complications. The most common thing one can expect after abortion is cramping and bleeding, which is stronger in nature and lasts longer than regular periods. These symptoms can be managed with over-the-counter pain medications for pain relief and simple measures like using heating pads. Other symptoms which can occur after the abortion are nausea, vomiting, breast pain and diarrhea. Post abortion care includes taking it easy, taking lot of rest for few days and prioritizing self-care. Many of the normal activities, including tampon use and penetrative sex can be used a fortnight after the abortion.

At the end of the day, everyone’s post abortion recovery is different and one should always follow doctor’s instructions and listen to what your body says and rest and relax. In case of any alarming symptoms, never hesitate to get help and ask your doctor anything you want.

References:

Also Read:

• Kinds Of Abortions & The Pros And Cons Of Legalizing Abortion
• How to Take Care of Yourself After Abortion?
• Risks of Home Remedies for Abortion
• 4 Different Types of Abortion
• What is Post-Abortion Syndrome?
• What are the After Effects of Surgical Abortion? | What To Eat and What To Avoid After Surgical Abortion?
• How to Care for Yourself Post Abortion?