What is a complete, successful abortion and how do you know you've had one?
A complete abortion means that the body has expelled all the products of pregnancy (blood, tissue, embryo) and there is no need for surgery (vacuum aspiration) afterwards. The only way to make sure that you've had a complete abortion is to have an ultrasound 10 days or a negative pregnancy test 3-4 weeks after using the medicines. You should not have extreme pain, prolonged heavy bleeding, or fever. You will bleed for 1 to 3 weeks.
More scientific information:
All women who have successful medical abortions experience vaginal bleeding 1 . The average number of days that a woman will bleed varies from study to study, but it is likely that women will bleed for one to three weeks 26 .
Many women will already know if the abortion is complete, but we advise women to have a pregnancy test 3-4 weeks after the medical abortion to be absolutely sure that the abortion succeeded. Studies do show that women can often tell if they have had a complete abortion without an ultrasound or a doctor’s examination, but she can only be absolutely certain after a negative pregnancy test. When this test is done before 3 weeks after medical abortion, often the pregnancy hormone in the blood will be still too high. When after 4 weeks the pregnancy test remains positive, it is advised to have an ultrasound.
An ultrasound has to be made in cases of ongoing severe abdominal pain, too long and too heavy blood lose and pregnancy signs, to see if the abortion was complete or if there is an ongoing pregnancy.
In case of an ongoing pregnancy the woman can redo the same procedure (within a week), or have a surgical procedure (MVA, medical vacuum aspiration).
A woman who has had a complete abortion should not have any of the symptoms of incomplete abortion or infection such as extreme pain, prolonged heavy bleeding, or fever.
Several studies suggest that women often correctly assess whether their medical abortions are complete or not, especially with protocols that include Mifepristone. One analysis used data from a clinical trial of Mifepristone-Misoprostol abortion in China, Cuba, and India. "Of 222 women, none incorrectly believed their abortions were complete when, in fact, they were not. 110 women incorrectly believed that the abortion was not yet complete, but this error would simply have led them to seek professional assistance, even if it were not routinely scheduled 1 . Another study involving women in the United States concluded, “Women and clinicians are very accurate at determining expulsion of the gestational sac during medical abortion with Mifepristone and Misoprostol without ultrasonography or a physical examination 29 .