There Will Be Blood
What to know about bleeding during SMA.
The most important thing to know about bleeding during a self-managed abortion with pills is that it’s not just normal, it’s necessary. The abortion pills make the uterus cramp to push out what’s inside, which is mostly the blood-rich uterine lining. No blood? No abortion.
Everyone’s body is different, but most of the time, a person who uses mifepristone and misoprostol will start cramping and bleeding 1 to 5 hours after using the misoprostol. A person who uses misoprostol alone will start within 7 hours of the first dose.
- Use sanitary pads, not tampons or a menstrual cup. This is important both for safety and to make it easy to keep track of the bleeding.
- Wear clothes that make it easy to change pads often.
- Have easy access to a bathroom.
- Have a towel to sit or lie on, just in case.
- Get as comfortable as possible!
The bleeding will start slow and ramp up. Over time, it will probably get heavier than a menstrual period, and will often include clots. This can make some people anxious, especially if they usually have light periods! However, it’s nothing to worry about. Most of the time, the bleeding will peak after 2 to 5 hours. The point of the heaviest bleeding is usually when the abortion actually occurs. Then it tapers off by the next day.
The one thing to watch out for is blood that soaks through 2 maxi pads an hour, completely filling them up from side to side and end to end, for more than 2 hours in a row. This is rare! However, if it does happen, it requires immediate medical attention. A person need not reveal to the doctor that they used abortion pills.
After the abortion is complete, many people continue to have light bleeding or spotting afterwards for 2 or 3 weeks. Some people may also pass occasional clots for up to a month. Again, this is normal. Unless the person has also had abdominal pain or a fever for 2 days, or has vaginal discharge that’s an unusual color or smells bad, there is no need to seek medical care.
Remember: no blood, no abortion. If someone who knows they’re pregnant doesn’t bleed at all for 24 hours after using the misoprostol, or bleeds less than their normal menstrual period with no clots, they can take more misoprostol. Find more information about this – and lots more! – at AbortionPillInfo.org.