After Abortion Care: What To Expect After Your Abortion

Bleeding and cramps are typical after a medical or surgical abortion. Many people experience additional side effects, including nausea, sore breast or chest tissue, and vaginal discharge.

Bleeding

Everyone experiences different amounts of bleeding following their abortion.

If you’ve chosen a medical abortion, you’ll probably experience most of the bleeding the day you take misoprostol. Medical abortion appears to cause more bleeding than surgical abortion, lasting an average of nine days.

Following a surgical abortion, you may not bleed much — or at all — the first few days. You may begin to bleed 3 to five 5 after, about as much as your usual menstrual period.

Light bleeding may last anywhere from a few days to around 2 weeks, whether you’ve had a medical or surgical abortion. For some, bleeding may be off and on.

Some sources suggest that spotting could last up to four weeks post-abortion or even longer for some people.

Pain and cramps

Cramping is to be expected. It’s a sign that your body is expelling the pregnancy and returning your uterus to its prepregnancy size. Post-abortion pain is often stronger than typical menstrual cramps.

If you’ve had a surgical abortion, your cramping may initially feel like menstrual pain before increasing in severity 3 to 5 days after the procedure.

Pain is the most commonly reported side effect of medical abortion, with 78.4% of people in a 2012 study reporting moderate or severe cramping.

According to a 2019 study, cramps from a medical abortion were generally considered less painful than cramps from surgical abortion, however, the pain from the medical abortion lasted longer.

Some people report more pain than others following an abortion.

People who appear likely to experience more pain may include:

• those who were pregnant for longer before getting their abortion
• younger people
• those who have not given vaginal birth before
• people with a history of painful periods (dysmenorrhea)
• people who feel conflicting emotions about their abortion or lack social support

Other side effects

Everyone’s body is different, and you may experience some, all, or none of these symptoms after your abortion:

• Breast or chest pain: Breast or chest tenderness may have begun before your abortion and may continue for a while after your abortion. For many people, it is the last symptom to go away.
• Discharge: It’s not unusual to experience a bit of mucus-like discharge ranging from red or purple to brown or blackish in color. Some blood may be apparent in the discharge.
• Nausea, vomiting, or diarrhea: Gastrointestinal symptoms may last for about 24 hours following a surgical abortion or for a few days after taking abortion pills. If GI trouble lasts longer than that, you may want to follow up with an abortion-informed healthcare professional, but it’s likely not a sign of an emergency.
• Chills: Some people experience chills and shivering. If accompanied by a fever, it’s a good idea to contact a healthcare professional.
• Fatigue. As with any medical procedure, your body will probably require a little extra rest and downtime to recover. You may feel sleepy or have less energy than you usually do.

Severe complications from abortion are extremely rare, affecting no more than 2% of people who have abortions. The most common complications include incomplete abortions and infections.

Here are some symptoms to watch out for:

• Prolonged heavy bleeding (defined as bleeding through two maxi pads per hour for two hours in a row, or one pad per hour for three hours in a row)
• Passing blood clots larger than the size of a lemon
• Severe pain or cramps, especially if the pain increases over time or doesn’t go away after taking pain medication
• Severe abdominal pain that doesn’t feel like uterine cramps
• Fever of 100.4ºF (38ºC) or higher
• Strong-smelling vaginal discharge

Be sure to contact a healthcare professional immediately if you experience any of the above.

If you still feel any side effects associated with pregnancy more than 2 weeks after your abortion, or if you didn’t bleed at all after taking abortion medication, follow up with a healthcare professional. These could be signs of an incomplete abortion.

If you had your abortion in a clinic, your provider will likely give you tips for managing potential side effects before you leave.

They may also prescribe antibiotics to help prevent infection or medications to help relieve pain. Be sure to take medication as directed and ask your provider any questions you have.

If you had a surgical abortion, you’ll likely need someone to drive you home, especially if you received sedating medication. It’s best to be picked up by someone you trust and who supports your decision, if possible.

Afterward, whether your medical was surgical or medical, it’s a good idea to take a day or two off work or school if you can. Try to rest somewhere comfortable and limit exposure to anything that triggers stress.

You may also find it helpful to:

• Use a heating pad or hot water bottle on your stomach to help reduce cramps.
• Take medication like ibuprofen or acetaminophen (Tylenol) to lessen cramps and pain.
• Massage your abdomen at the site of the cramps. A uterine massage involves firmly pressing down with your fingertips and rubbing in circles from your belly button to your pubic bone for 10 minutes or longer.
• Wear a tight-fitting bra or compression top to help relieve tenderness.
• Stay hydrated, and be especially conscious of your hydration levels if you’re experiencing vomiting or diarrhea.
• Drink warm liquids like tea, which can help manage stress, keep you hydrated, and ease GI symptoms.
• Have a support system in place. Friends and family who are there for you can be immensely helpful as you recover.

Despite some myths that abortion alters your menstrual cycle, your periods will return to usual — whatever that means for you — after your abortion.

However, it isn’t unusual for the first few periods to be somewhat irregular.

When will your periods come back?

If you typically have regular, predictable monthly periods, your next period will likely start within 4 to 7 weeks post-abortion. However, it’s OK if it takes slightly longer to return, especially if your periods can be irregular.

Still, you may want to consider scheduling a follow-up if your period hasn’t come back after eight weeks, just to be safe.

Learn more about what to expect from your period after an abortion here.

Can you use tampons after an abortion?

Inserting anything into the vagina, including tampons, runs the risk of a vaginal infection.

The risk is typically low, but since infections are one of the most common complications following abortions — particularly surgical abortions — it’s best to limit anything that could elevate the risk. That includes using tampons.

If you saw or connected with a clinician for your abortion, they will probably tell you when it’s OK to use tampons again. If they didn’t, it’s a good idea to reach back out and ask them.

Some experts suggest waiting 1-2 weeks to use tampons if you had a surgical abortion.

After a medical abortion, it’s OK to use them as soon as you feel ready. Just make sure any heavy bleeding has stopped first.

Ultimately, opting for menstrual pads during the first few days is a good idea. Pads can help you track how much bleeding you’re experiencing and lower the risk of infection compared to tampons.

We don’t recommend douching because it’s linked to a high risk of infections — even when you haven’t recently had an abortion — but if you’re going to douche, you should hold off until heavy bleeding stops.

There isn’t a lot of research into how long you should wait to have sex after an abortion.

Many providers say you can have sex whenever you and your partner(s) feel ready, as long as you wait until heavy bleeding stops to have penetrative sex (when a penis, toy, or fingers enter your vagina).

Some sources suggest waiting at least 2 weeks to have penetrative sex.

Holding off on penetrative sex for a while can help prevent infection, which you may be more susceptible to following an abortion.

You can get pregnant immediately after having an abortion. If you want to use birth control to prevent pregnancy, you’ll need to resume or start using your preferred method immediately.

Generally, you can start birth control the same day as your abortion:

• Barrier methods: You can use barrier methods like condoms immediately after an abortion.
• Hormonal birth control: You can start hormonal birth control — including oral contraceptives (pills), injections, implants, patches, and the ring — immediately after your abortion. It’s often a good idea to start hormonal birth control the same day as your abortion. It may help your periods resume and regulate faster.
• Intrauterine devices (IUDs): You can have an IUD inserted immediately after a medical abortion or after a surgical abortion in the first or second trimester. However, some research suggests that getting an IUD immediately after an abortion may slightly increase your risk of rare complications like the IUD being expelled. This is especially true after a second-trimester surgical abortion. Still, the risk remains low.

If you’re seeing a clinician in person for your abortion, they may be able to insert an IUD or prescribe birth control right after your procedure while you’re still in their office or clinic. Ask them about these options if you’d like to learn more.

It’s natural to feel intense emotions — or a wide range of emotions — after an abortion, even if you’re confident that it was the best choice for you.

In fact, in one study, 17% of participants reported feeling mostly negative feelings after their abortion, while 12% reported a mix of negative and positive emotions, even though nearly all participants knew that abortion was the right decision.

Give yourself as much time and space as you need to process your feelings. Lean on a support system where you can, and spend time engaging in relaxing hobbies that you enjoy.

Remember: while you may grapple with complicated emotions surrounding your abortion decision, having an abortion is not linked to the development or worsening of mental health conditions.

In fact, people who have had abortions are no more likely to experience mental health challenges than people who have not had abortions.

You may have heard about studies suggesting that abortion is linked with poor mental health outcomes.

According to the American Psychological Association (APA), many of these studies are flawed in design. Some are conducted or funded by anti-abortion organizations and may be biased.

A growing body of high quality research supports the idea that being denied an abortion harms people’s mental health in the long run — not having the abortion that they chose.

Experts argue that the overturning of Roe v. Wade will contribute to worsening mental health in the United States because being denied access to abortion is linked to social, physical, and mental health challenges. Learn more here.

Medical and surgical abortions are both very safe, but there are some side effects that you can expect and some rare complications to watch out for.

Most people will experience bleeding and cramping that is stronger and longer-lasting than their periods. You can manage these symptoms with over-the-counter or prescribed pain medications, plus home remedies like heating pads.

Some people will experience other symptoms like nausea, vomiting, diarrhea, and breast pain.

It’s a good idea to take a few days off work or school to rest and prioritize self-care if possible.

You can resume most normal activities, including penetrative sex and tampon use, within about two weeks of your abortion. You can start using most forms of birth control the same day as your abortion.

Having a support system to lean on can be helpful, as it’s normal to experience some intense emotions after an abortion — even if you feel confident that you made the right choice.

Ultimately, everyone’s abortion recovery will look a bit different. Be sure to stay tuned into your body and mind after the procedure, and don’t hesitate to seek help if you’re concerned about any of your symptoms.

Rose Thorne is an associate editor at Healthline Nutrition. A 2021 graduate of Mercer University with a degree in journalism and women’s & gender studies, Rose has bylines for Business Insider, The Washington Post, The Lily, Georgia Public Broadcasting, and more. Rose’s proudest professional accomplishments include being a college newspaper editor-in-chief and working at Fair Fight Action, the national voting rights organization. Rose covers the intersections of gender, sexuality, and health, and is a member of The Association of LGBTQ+ Journalists and the Trans Journalists Association. You can find Rose on Twitter.