How do you know if you have complications and what should you do?

If performed in the first 10 weeks, a medical abortion carries a very small risk of complications, as she is prepared on it, while women can have a miscarriage everywhere like working in the field!. This risk is even less as when a woman has a miscarriage. A doctor can easily treat these problems. Out of every 100 women who do medical abortion, 2 or 3 women will have to go to a doctor, first aid center or hospital to receive further medical care.

These are the possible complications, their symptoms and treatment:

Heavy bleeding (occurs in less than 1% of medical abortions)

Symptom: Bleeding that lasts for more than 2 hours and soaks more than 2 maxi sanitary pads per hour. Feeling dizzy or light-headed can be a sign of too much blood loss. This is dangerous to your health and must be treated by a doctor.
Treatment: a vacuum aspiration (curettage.) Very rarely (less than 0.2%) a blood transfusion is needed. When available, a woman should start taking 2 misoprostol sublingual immediately at home. For these cases it is advisable always to have 2 extra tablets of misoprostol available at home.

Incomplete abortion

Symptoms: heavy or persistent bleeding and/or persistent severe pain.
Treatment: a vacuum aspiration (curettage)

Infection

Symptom: If you have a fever (more than 38 degrees Celsius) for more than 24 hours, or you have a fever of more than 39 degrees, there might be an infection that needs treatment.
Treatment: antibiotics and/or vacuum aspiration. or 2 tablets of misoprostol sublingual (WHO). In case of any doubts, or bad clinical signs please have a check up with a doctor.

If you think you might have a complication you should go to a doctor immediately. If you live in a place where abortion is a crime and you don’t have a doctor you trust, you can still access medical care. You do not have to tell the medical staff that you tried to induce an abortion; you can tell them that you had a spontaneous miscarriage. Doctors have the obligation to help in all cases and know how to handle a miscarriage.

The symptoms of a miscarriage and an abortion with pills are exactly the same and the doctor will not be able to see or test for any evidence of an abortion, as long as the pills have completely dissolved. If you used the misoprostol under the tongue as our protocol recommends, the pills should have dissolved within three hours after taking them. If you took the pills vaginally, you must check with your finger to make sure that they are dissolved. Traces of the pills may be found in the vagina up to four days after inserting them.

When misoprostol alone has been used, 10-20%, and when mifepristone plus misoprostol has been used, less than 1% of women experience ongoing pregnancy. This can be determined by a pregnancy test after 3 weeks or an ultrasound within a week. If the medical abortion treatment failed, there is a slight increase in the risk of birth defects such as deformities of the hands or feet and problems with the nerves of the fetus. To treat an ongoing pregnancy you must repeat a medical or surgical abortion.

More scientific information:

Research has shown that very few serious complications result from medical abortions compared to the number of women who experience successful medical abortions. ¹⁶ ¹⁷ ²⁰ ²¹ ²² ⁷⁴ ⁷⁷ ⁸¹ ⁸² ⁸⁴ ⁸⁸ ⁸⁹ ⁹¹ ⁹² ⁹³ ⁹⁵ ⁹⁶ ⁹⁹ In the few cases that a surgical intervention such as a curettage (vacuum aspiration) is needed, this can be managed by the same health care facilities that care for women who have had miscarriages.

Length of pregancy	% of women who needed further medical care
0- 49 days (0-7 weeks)	2 %
40-63 days (7-9 weeks)	2.5%
64-70 days (9-10 weeks)	2.7%
71-77 days (10-11 weeks)	3.3%
77-84 days (11-12 weeks)	5.1%
85-91 days (12-13 weeks)	8%

(Further medical care consists of vacuum aspiration for a continuing pregnancy or an incomplete abortion.)
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