Warning Signs After an Abortion: When to Call Your Doctor | Dr. Emily Women's Health Center

Abortion Is Very Safe — But Knowing the Warning Signs Matters

Both surgical abortion and medication abortion (the abortion pill) are among the safest medical procedures available. Serious complications are rare — occurring in less than 1% of cases. However, like any medical procedure, it is important to know what is normal during recovery and what symptoms warrant a call to your doctor.

This guide covers the most common warning signs after an abortion and what to do if you experience them. If you had your procedure at Dr. Emily Women's Health Center and have concerns, call us at 718-585-1010 — we are available to answer your questions.

What Is Normal After an Abortion

Before covering warning signs, it helps to know what to expect as part of normal recovery. Light to moderate cramping for several days is normal, as is spotting or light bleeding for up to two weeks. Mild nausea, fatigue, or breast tenderness may persist for one to two weeks as pregnancy hormones leave your body. A positive home pregnancy test for up to four to six weeks after the procedure is also normal — this does not mean the abortion failed. It simply reflects lingering pregnancy hormones.

Warning Sign #1: Heavy Bleeding

In rare cases, some patients bleed more than expected after an abortion. The most reliable way to assess whether bleeding is excessive is to count how many pads you are going through per hour.

Call your doctor immediately if you are soaking more than two maxi pads per hour for two consecutive hours, if you are passing large clots, or if you feel dizzy or lightheaded — these are signs of significant blood loss that require prompt attention.

Heavy bleeding after an abortion can occur for a few reasons. The most common is uterine atony — when the uterus relaxes too much rather than contracting to control bleeding — which can be treated with medication. Another cause is retained tissue (incomplete abortion), where some pregnancy tissue remains in the uterus. In very rare cases, heavy bleeding may indicate a uterine perforation that occurred during the procedure.

Warning Sign #2: Severe or Persistent Pain

Some cramping is normal after an abortion, but severe or persistent pelvic pain is not.

Call your doctor if you have persistent, severe pelvic or abdominal pain that is not relieved by over-the-counter pain medication such as ibuprofen, acetaminophen, or naproxen.

The most common cause of pain after an abortion is a bacterial infection. Most infections are mild and respond well to oral antibiotics. Pain can also be caused by retained tissue or blood clots that have not passed on their own — in these cases, oral misoprostol or a vacuum aspiration procedure may be needed to empty the uterus and relieve the pain.

In rare cases, persistent pain may indicate an ectopic pregnancy — a pregnancy that implanted outside the uterus, most often in a fallopian tube. An ectopic pregnancy that ruptures can cause severe abdominal pain and heavy internal bleeding and is a medical emergency. If you have severe one-sided pelvic pain, shoulder pain, or feel faint, seek emergency care immediately.

Warning Sign #3: Fever

A low-grade fever immediately after taking misoprostol (the second medication in the abortion pill regimen) is a known and temporary side effect. However, a persistent fever is a warning sign.

Call your doctor if you have a fever of 100.4°F (38°C) or higher that lasts more than two hours, especially if accompanied by severe pain, foul-smelling discharge, or chills. These can be signs of infection that requires treatment.

Warning Sign #4: Continued Pregnancy Symptoms

Symptoms such as nausea, breast tenderness, and fatigue typically resolve within one to two weeks after an abortion as hormone levels return to normal.

Contact our office if these symptoms persist beyond two weeks, as this may indicate that the pregnancy has continued — particularly after a medication abortion. Do not rely on a home pregnancy test to determine this, since tests can remain positive for four to six weeks after an abortion due to lingering HCG hormone. An ultrasound at our clinic is the most reliable way to confirm the abortion is complete.

Note: if you started hormonal birth control (the pill, patch, or vaginal ring) immediately after your abortion, be aware that these can also cause nausea, breast tenderness, and other pregnancy-like symptoms, especially during the first month of use.

Warning Sign #5: Signs of Infection

Beyond fever and pain, other signs of infection include a foul-smelling vaginal discharge, unusual discharge that is yellow or green, chills or body aches, and feeling generally unwell several days after the procedure when you should be feeling better.

Call your doctor promptly if you notice any of these symptoms. Most post-abortion infections are mild and easily treated with antibiotics when caught early.

When to Go to the Emergency Room

Go to the nearest emergency room or call 911 immediately if you experience any of the following: heavy bleeding that soaks more than two pads per hour for two hours, fainting or loss of consciousness, severe abdominal pain that is sudden and worsening, high fever with severe pain, or signs of shock such as rapid heartbeat, pale skin, or confusion.

We Are Here for You After Your Procedure

At Dr. Emily Women's Health Center, our care does not end when you leave the office. If you have any concerns during your recovery — no matter how small they seem — we encourage you to call us. Our staff can help you determine whether what you are experiencing is normal or whether you need to be seen.

Call 718-585-1010. We are located at 642 Southern Blvd, Bronx, NY — one block from the 6 train.