After Visit Questions

Preguntas después de la visita en español AQUI

Here are answers to the most common questions from our patients. Please see if your question is already answered before you call us. The emergency phone line is on the card in your bag.

How-to instruction cards
4-8 weeks

9-11 weeks

12 Weeks

Bleeding Questions

  • We are only worried if you are soaking (front-to-back, no white patches left) two extra large pads an hour for two hours in a row. There is very, very wide range of normal bleeding patterns. Anywhere from 4 days to 4 weeks is normal. It can stop and start up again; that’s okay.

    Do not gauge your bleeding by what you see in water. Clots expand in water by up to 5 times.

  • There is very, very wide range of normal bleeding patterns. Anywhere from 4 days to 4 weeks is normal and expected. It can stop and start up again; that’s okay. Some people bleed a small amount over many weeks. Some people bleed heavily for a shorter time. Bleeding may not follow an exact pattern. Bleeding may increase with exercise and decrease with rest.

    You may bleed less if your pregnancy is very early, and more if your pregnancy is further along. Pregnancy symptoms going away is the best measure that the pills worked.

  • If you only have light spotting or no bleeding for 24 hours after taking misoprostol, then repeat the dose. Just like the first time: first, take 4 tablets of ibuprofen (200 mg each) and 1-2 meclizine (25mg each). After 30 minutes, use 4 tablets of misoprostol; (in between cheek and gum, two each side). If you do not experience any bleeding in the 24 hours after the second round of misoprostol, call the clinic.

  • Your next period may come anytime in the next 2 weeks to 2 months. It is normal and common for your first period after an abortion to be much heavier than usual. Call us if you have not have your menstrual period yet after 6 weeks.

    It is possible to get pregnant again 7 days after an abortion, before your pregnancy test turns negative and before your next period. Your periods may be irregular for several months after a pregnancy. We do not recommend using menstrual cycle tracking as your primary method of birth control.

  • Bleeding can last for days or weeks after an abortion or miscarriage.

    Sometimes the blood can cause an odor.

    If you feel well with no fever, an odor is not a concern. You can wait to see if it goes away on its own.

    If you are worried, you can call our doctor’s line, or go to a clinic to get an exam.

Pain/Cramping Questions

  • The uterus is strong muscle and can cause intense cramping as it squeezes. Misoprostol will make your uterus squeeze very hard. Cramping pain is a good sign that the medications are working as expected. The pain is usually in your lower stomach, hips and can radiate into your legs. This is all normal and expected. Pain typically lasts 2-6 hours but can last for a few days.

    Use FOUR ibuprofen tablets up to every 8 hours for pain. Please take the FOUR ibuprofen pills 30 minutes before you use misoprostol so it will be in your blood stream ahead of time.

    Other things you can also do for pain:

    • Add Tylenol (acetaminophen) up to 2 tablets every 6 hours.

    • Use a heating pad or hot water bottle

    • Take a hot bath or hot shower

    • Go on a gentle walk. Moving your body helps the pain.

    • Massage your lower belly, legs and low back.

  • Cramping and pain can be very intense. Sometimes it is barely noticeable. Pain can come and go over hours to days.

    Misoprostol will make your uterus squeeze very hard. Cramping pain is a good sign that the medications are working as expected. The pain is usually in your lower stomach, hips and can radiate into your legs. This is all normal and expected. Pain typically lasts 2-6 hours but can last for a few days.

    Use FOUR ibuprofen tablets up to every 8 hours for pain. Please take the FOUR ibuprofen pills 30 minutes before you use misoprostol so it will be in your blood stream ahead of time.

    Other things you can also do for pain:

    • Add Tylenol (acetaminophen) up to 2 tablets every 6 hours.

    • Use a heating pad or hot water bottle

    • Take a hot bath or hot shower

    • Go on a gentle walk. Moving your body helps the pain.

    • Massage your lower belly, legs and low back.

    Call us at the urgent line provided if you have severe pain that does not improve with any of these measures.

  • Usually cramping and pain is the most intense in the first day after using the misoprostol pills. Pain can come and go over hours to days.

    Sometimes people can have reduced bleeding but then an increase in cramping. This can happen when blood clots in the uterus. It is not dangerous - blood is meant to clot when it is sitting still. A clot in the uterus just means you are not bleeding fast.

    You can use deep massage to your low belly to help dislodge the clot. Using ibuprofen FOUR pills every 8 hours also helps.

Nausea Questions

  • Nausea is a common and expected side effect of misoprostol. It also is a pregnancy symptom. Take meclizine from your kit 30 min BEFORE using misoprostol and up to every 6 hours as needed.

    Pregnancy-related nausea is the first pregnancy symptom to go away after an abortion. Please call us if pregnancy nausea is not gone after a week.

    Keep up with small sips of fluids often. Large gulps might make you vomit. Call us if you are unable to keep down any fluids or have severe dizziness.

  • Misoprostol is absorbed through the cheeks. Nausea is a common and expected side effect. Nausea often means the misoprostol was absorbed and is working.

    Sometimes the pills do not fully dissolve. That’s okay. We know they are working if they were in your cheeks for 30 minutes. It is not at all concerning to have vomiting after misoprostol so long as the pills were in your cheeks for 30 minutes.

    If you vomited before the 30 minutes were done, please take the nausea medication (meclizine), wait 30 minutes, then repeat the misoprostol by placing 4 pills in your cheeks again. You may place the the misoprostol pills in your vagina if you are too nauseated to keep them in your cheeks.

Follow-up Questions

  • Please do NOT take a pregnancy test for at least 4 weeks. It can take up to 6 weeks for a pregnancy test to turn completely negative, even when everything worked. This is based on how long it take the hcg hormone to clear your system. The best early measure to know that it worked is pregnancy symptoms going away and bleeding/cramping/passing clots.

    Do not arrange an ultrasound (sonogram) or blood test unless we advise it. Most doctors do not know what a normal after-abortion ultrasound looks like and will often tell you incorrectly that you need a procedure. One time blood tests are not useful. Blood tests require two readings spaced at a specific time frame.

    If you have continuing pregnancy symptoms after a week or a positive urine test after 4 weeks then please call us first. Our team has decades of experience to guide you.

  • Please do NOT take a pregnancy test for at least 4 weeks. It can take up to 6 weeks for a pregnancy test to turn completely negative, even when everything worked. This is based on how long it take the hcg hormone to clear your system. The best early measure to know that it worked is pregnancy symptoms going away and bleeding/cramping/passing clots.

    Do not arrange an ultrasound (sonogram) or blood test unless we advise it. Most doctors do not know what a normal after-abortion ultrasound looks like and will often tell you incorrectly that you need a procedure. One time blood tests are not useful as it requires two readings spaced at a specific time.

    If you have continuing pregnancy symptoms after a week or a positive urine test after 4 weeks then please call us first.

  • It is not necessary to have another ultrasound if you have bleeding/cramping/passing clots and your pregnancy symptoms are going away.

    We urge that you not arrange an ultrasound (sonogram) or blood test unless we advise it. Most doctors do not know what a normal after-abortion ultrasound looks like and will often tell you incorrectly that you need a procedure. One time blood tests are not useful as they require two tests spaced at a specific time.

    If you have continuing pregnancy symptoms after a week or a positive urine test after 4 weeks then please call us first. The best early measure to know that it worked is pregnancy symptoms going away and bleeding/cramping/passing clots.

  • Mifepristone is considered irreversible. There are a lot of anti-abortion activists pushing “abortion pill reversal” regimens with high dose progesterone. We agree with the American College of Obstetrics and Gynecology that claims regarding abortion “reversal” treatment are not based on science and do not meet clinical standards.

    There is not reliable science showing damage to a developing fetus from mifepristone - that’s just not how it works. But there is a risk of later miscarriage and heavy bleeding if you take mifepristone alone without misoprostol. If you do not wish to continue with the the abortion after taking mifepristone in clinic, please start a prenatal vitamin and establish care with a family doctor or OBGYN as soon as possible to manage your pregnancy.

  • There are no food restrictions with a medication abortion-- you can eat or drink what you like. Alcohol may make nausea worse and may affect your ability to cope with pain, but it does not affect the abortion process. THC or cannabis does not affect your medication abortion.

  • Other than the IUD, birth control can be started at any time. IUDs can be used after the pregnancy is expelled.

  • The treatment of miscarriage is not really different, whether the miscarriage is caused by abortion pills or happens naturally. If you seek medical care, it is your decision about whether you share that you took pills. You will be able to get appropriate medical care even if you choose to keep the abortion pills private.