Recognizing the Risks of Medical Abortion Bleeding Complications

by Monty L. Patterson on September 13, 2012

A Woman’s Abortion Pill Experience

 Women sometimes share their personal experiences as a way to empower other patients through  knowledge. This community can sometimes be found at a website or a group forum where a voice is given to a group of women known to suffer in silence as they relate to truly understand each other’s challenges.(1)

Some of the following statements are from one woman’s experience, as she describes her ordeal to others in a group forum, about her early pregnancy termination with the abortion pill.

“Almost a year ago I had a medical abortion. And not to scare you, but it was one of the worst experiences of my life.”(1)

The Pain and Bleeding

Recognizing that medical abortion experiences and bleeding complications can vary from one woman to another, she stated:

“Because of my experience with the medical abortion, I don’t think I could ever do it again (not that I plan on having an unplanned pregnancy again).”(1)

Even though she had been prescribed painkillers, the severe pain from cramping and heavy bleeding was unbearable. Bleeding was one of her biggest concerns. She feared going to the bathroom because of the resulting blood clots and blood loss associated with medical abortion. (1)

  • Most patients will initially experience moderate to heavy bleeding, with clots ranging in size from small (size of a dime) to very large (size of an orange) during medical abortion. (2)

Her first 3 or 4 days of bleeding were the worst. (1)After bleeding for over 6 weeks, she experienced further bleeding complications due to hemorrhaging which is best defined as the loss of large amounts of blood. (1) (3)

Recognizing Bleeding Complications

  • Early identification of excessive bleeding may help to prevent the risk of serious health complications. Early recognition is particularly important when the patient is at home. (4)
  • Prolonged heavy bleeding (soaking through two thick full-size sanitary pads per hour for two consecutive hours) may be a sign of incomplete abortion or other complications. (5)
  • It is important for patients to be aware of the risk of severe bleeding that may be caused by trauma (to the vagina, cervix, uterus) or retained pregnancy tissue, infection, uterine atony or rupture. (4) (6) (7)

Hemorrhaging and Medical Abortion Failure

After being admitted to the emergency room, it appears she was evaluated with bleeding complications and medical abortion failure resulting from retained pregnancy tissue that was stuck in her uterus. A surgical abortion procedure, known as vacuum aspiration, was performed on her to remove the pregnancy tissue. (1)

  • Vacuum aspiration is frequently used as the first option treatment for hemorrhage; this enables the uterus to contract and decrease bleeding. (8)
  • Severe hemorrhage and prolonged heavy bleeding require immediate attention. With significant bleeding; fluid replacement, blood transfusion and oxygen administration should be considered. (5) (8)
  • Some women may experience a heavy bleeding episode 3-5 weeks after the abortion. A curettage procedure by surgical scraping and scooping to the lining of the uterus may be required to stop heavy bleeding in about 10 per 1000 women. (9)
  • Medical abortion failure also known as incomplete abortion may increase the risk of infection and is associated with discomfort as persistent or recurrent bleeding and pain.(5)

Her Evaluation of the Abortion Pill Experience

At the end of her medical abortion pill experience, she stated:

Had I known all that was going to happen, I would have opted for the surgical abortion. Also, I had a lot of guilt during the whole process and no one to talk to about it… which I’m sure didn’t help the situation.”(1)

Understanding the Health Risks of Medical Abortion

Medical abortion may be new and unfamiliar to many women. A woman making an abortion decision needs to understand the risks, benefits, and options available that is in the best interest of her health, safety and welfare.

It is important for women to understand the warnings for serious and sometimes fatal infections and bleeding which occur following the use of Mifeprex (mifepristone) for medical abortions.

Since mifepristone’s approval in September 2000, the U.S. Food and Drug Administration (FDA) has received reports of serious adverse events, including women who have died, in the United States and other countries following medical abortion with mifepristone and misoprostol.

The most publicized medical abortion death was Holly Patterson from Livermore, California who died September 17, 2003.

To learn about the risks of the medical abortion, please visit the site http://abortionpillrisks.org/ for more information.

 

REFERENCES

1. Experience Project, pnkdi member. I Had An Abortion, Forum & Chat Board, abortion pill: what to expect. Experience Project. [Online] October 16, 2011. [Cited: September 12, 2012.] http://www.experienceproject.com/groups/Had-An-Abortion/forum/Abortion-Pill:-What-To-Expect/66199.

2. National Abortion Federation. Management of Side Effects and Complications in Medical Abortion: A Guide for Triage and On-Call Staff. Early Options, National Abortion Federation. [Online] September 2008. [Cited: August 31, 2011.] http://www.prochoice.org/pubs_research/publications/downloads/professional_education/medical_abortion/phone_triage_guide.pdf.

3. Kruse, Beth, et al., et al. Management of side effects and complications in medical abortion, Am J Obstet Gynecol. Vol 183, Number2. NCBI, PubMed. [Online] August 2000. [Cited: September 6, 2011.] http://www.ncbi.nlm.nih.gov/pubmed/10944371.

4. Lichtenberg, Steve, Grimes, David and Paul, Maureen. A Clinician’s Guide to Medical and Surgical Abortion. s.l. : A Churchill Livingstone title, 1999. ISBN # 0-443-07529-8.

5. U.S. Department of Health & Human Services. Drugs@FDA, Mifeprex (mifepristone) Label and Approval History. FDA, U.S. Food and Drug Administration. [Online] April 27, 2009. [Cited: July 12, 2011.] http://www.accessdata.fda.gov/scripts/cder/drugsatfda/index.cfm?fuseaction=Search.Label_ApprovalHistory.

6. IPPF – Marcel Vekemans. First trimester abortion guidelines and protocols. International Planned Parenthood Federation . [Online] September 2008. [Cited: June 23, 2011.] http://www.ippf.org/NR/rdonlyres/D84AFDB1-B6CC-4899-8E3C-5D3392A85F8F/0/abortion_protocol.pdf.

7. IPAS India. Refresher course for medical abortion services, Reference manual, REFMA-IND-E09. IPAS. [Online] March 15, 2009. [Cited: January 17, 2011.] http://www.ipas.org/en/Resources/Ipas%20Publications/Refresher-course-for-medical-abortion-services-Reference-manual.aspx.

8. IPAS. Medical Abortion Training Resources, Medical Abortion Study Guide, Using medicines for first-trimester pregnancy termination. IPAS. [Online] 2009. [Cited: September 8, 2011.] http://www.ipas.org/Publications/Medical_abortion_training_resources_%5BMulti-language_CD%5D.aspx. ISBN: 1-933095-46-6.

9. Medabon. Medabon Medical and Service Delivery Guidelines. Medabon. [Online] 2009. [Cited: September 9, 2011.] http://www.medabon.info/medical.php.

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Lilia Rhodes September 14, 2012

If I have to go on abortion, I would choose the surgical one. As what you have mentioned, there is a possibility that fragments will be retained in the uterus leading to bleeding and infection. These complications are life-threatening to a woman. When surgical abortion is done, you can be more confident with the result since it is a professional who is doing it. There can be lesser complications or none at all.

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