Abortion is said to be incomplete (in common medical terms known as an incomplete abortion) when your uterus has not expelled all the products of conception (embryo, gestational sac, and other pregnancy tissue).
When you have an abortion using medical abortion pills, you need to make sure that your abortion is complete. If it is an incomplete abortion, there are high chances that you will develop infection later on.
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What happens when you take medical abortion pills?
In India, two medications Mifepristone and Misoprostol are used for medical abortion.
Mifepristone stops the embryo (a sperm fuses with an egg to form a fertilized egg and it grows to become an embryo and later a foetus) from growing inside the uterus. This is achieved when Mifepristone blocks a hormone called Progesterone which results in the thinning of the uterus lining, thereby making it impossible for the embryo to implant further and grow
Misoprostol causes the uterus to expel out all the products of conception through the vagina. This is achieved when Misoprostol causes the uterus to contract.
Usually Mifepristone is taken under the supervision of the doctor in the clinic. But some doctors are all right with you taking it later at home. Misoprostol is taken after a few hours or a day or two later. Your doctor will advise you when to take it.
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How much pain & cramps are normal?
Within a few hours after taking Misoprostol, you will start experiencing pain and cramps. This is a sign that your uterus has started to respond to the medication. However, if you do not feel any pain or cramps within 24 hours, then you must consult your doctor.
Since pain and cramps are part and parcel of the medical abortion, doctors also give you pain killers which you can take according to their advice.
Once the medicines start to work, you will start bleeding. Unlike the menstrual bleeding, here you will find that the blood has clumpy masses, some even the size of a small gooseberry. This is perfectly normal. It is advisable to use sanitary napkins to keep a track of the bleeding.
You will continue to bleed and have cramps for the next few hours. Once the pregnancy tissue has been expelled from the uterus, the bleeding and cramping become less intense and start decreasing. However, for the next one or two days, you will have occasional cramps and spotting.
For some people, nausea and vomiting can happen during all this while. It is nothing abnormal. But to manage them, some doctors also give you medications for that.
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Signs that are abnormal:
- When your bleeding is so heavy that you have to change your sanitary napkins every hour.
- The cramps are very strong that you have severe abdominal pain and back ache
- You have a fever wherein the temperature does not come down for more than 24 hours
- Your vagina gives a strong, smelly discharge
The importance of follow up:
Abortion does not end with you taking all the medications that the doctor prescribed and having the expected bleeding, cramps and pain. It is highly important that you follow up with your doctor. For those who have had abnormal signs during an abortion, you must reach out to your doctor as soon as possible, rather than waiting for the follow-up appointment slot given by your doctor.
The doctor will assess whether your abortion is complete, even if you feel that your abortion went well and did not experience any abnormalities. A blood test and ultrasound scan will be done to ascertain that you are not pregnant and that your uterus has completely expelled all the pregnancy tissue.
However, if the findings show that you have an incomplete abortion, then the doctor will either give you another round of medications or will suggest a surgical abortion. Depending on the severity of your case the needed decision will be made.
An incomplete abortion is not your fault. You do not have to feel that you are to be blamed for the incomplete abortion or that you are being punished for having an abortion! Incomplete abortion happens to many. It is normal. Different bodies react differently to abortion pills. Some have a complete abortion and some don’t. What is important is you heed the signs shown by your body and take medical help the moment you realize something is off.
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