After Care – What to Expect After An Abortion

This is a copy of the After Care Instructions provided to clients following an abortion appointment.

Cramping

It is normal to have cramping for a few days after an abortion. You can take medication such as Ibuprofen, which is normally used for period cramps. Ibuprofen, Advil, and Motrin are different names for the same medication. You may take 800 mg. of Ibuprofen every 6 hours for cramping. For example, you would take 4 of the 200-mg. tablets of Advil to get 800 mg. of Ibuprofen. If you are allergic to Ibuprofen, Tylenol may be taken. Do not take aspirin -- aspirin increases bleeding. A hot water bottle or heating pad also helps relieve cramping.

Cramping is not always a sign of a problem. Sometimes cramping can mean there are blood clots in your uterus, you have a strained muscle near your uterus, or your uterus is contracting to its normal size. Other ways to relieve cramping are:

• Massage your abdomen. Push down starting from below your belly button towards your pubic hair. You can lie down or sit on the toilet. This massage may help you to pass blood clots that might be causing your cramping.
• You can lie down on the side that hurts and pull the bottom knee up towards your chest, or put your leg on a chair and lean into the direction of the pain. If you get relief from this, the pain is most likely due to muscle strain and can be treated by resting.

Fever

If you feel hot, or have cramping, take your temperature. IF YOUR TEMPERATURE IS OVER 100.4 DEGREES, CALL THE FEMINIST WOMEN'S HEALTH CENTER’S CLIFF VALLEY CLINIC. Fever can be a sign of infection. Most infections can be treated with medication and do not require hospitalization. Early treatment is important. Cramping or tenderness of the abdomen can also be signs of infection.

Bleeding

If the amount of bleeding increases to soaking more than one maxi-pad in one hour or if you begin to pass blood clots larger than a quarter, Call the Feminist Women's Health Center.

Medications

Please take your medication as follows (unless otherwise advised):

Doxycycline is an antibiotic that protects your uterus and tubes from infection. It should be taken twice a day -- after breakfast and after dinner. Please take this medication after eating so that it will not cause stomach upset and nausea.

Methergine is used for uterine bleeding. This medication will help contract your uterus and control your bleeding after your abortion.

• 6-12 weeks LMP>1 tablet 4 times a day for 3 days
• 13-18 weeks LMP>1 tablet 4 times a day for 3 days
• Over 18 weeks LMP>1 tablet 4 times a day for 5 days

This medication may cause cramping. It is OK to take Ibuprofen or Tylenol with this medication. Once the Methergine is taken as prescribed, the uterus will relax, which may cause bleeding and which has been described as a gush of blood several hours later or the following day. This is normal.

Breast Tenderness

Following your abortion, your breasts may remain tender for as long as two weeks. It is also possible for milk to come into your breasts. This is more likely to occur if you were more than 12 weeks from your last menstrual period. If this should occur, we suggest the following:

• Place cabbage leaves on your breasts and cover with a supportive bra; cabbage leaves should be changed every 2 hours until tenderness is relieved;
• Wear a tight fitting bra (even while you sleep);
• Do not stimulate your breasts;
• Do not squeeze or express the milky fluid;
• Tylenol or Ibuprofen may be taken for discomfort; and
• Ice compresses on your breasts for ten minutes every two hours may also provide relief.

Do’s & Don’ts

From our many years of experience as an abortion provider, and from the current recommendation of the National Abortion Federation, we advise you to do the following:

To protect your uterus and tubes from infection

• You should not have sexual intercourse for two weeks. However, if you do, have your partner wear a condom. You may be more fertile after an abortion.
• Use sanitary napkins only, no tampons for two weeks.
• You may take a shower and wash your hair, but no tub bath for 2 weeks.
• No swimming for two weeks.

To make sure you heal completely:

• You may go to work or school on the day following the procedure. However, REMEMBER no strenuous exercise or heavy lifting over 10 pounds because this can cause you to bleed more.
• Be sure to take all of the medications given to you according to the directions on the label.
• No douching until after your follow-up exam.
• All of your pregnancy signs and symptoms (except breast tenderness) should decrease within 48-72 hours.
• Your next period should start four to eight weeks after your abortion. If you do not get your period after eight weeks, call the Feminist Women's Health Center.
• It is possible to get pregnant right after your abortion, so if pregnancy is not desired, a method of birth control is recommended.

Aftercare Check-Up at Feminist Women's Health Center’s
Cliff Valley Clinic

Be sure that you have a post-abortion aftercare check-up in four to six weeks after your abortion, even if you feel perfectly well. There is a modest charge for this follow-up appointment at the Feminist Women’s Health Center if you schedule within three weeks.

The follow-up visit includes a repeat non-sensitive urine pregnancy test to be sure your abortion is complete. A pelvic exam will also be done to be sure that your uterus has returned to its pre-pregnant or non-pregnant size and that there are no signs of infection. For an additional fee, birth control may be obtained at your visit.

If you think you are having a post-abortion emergency: severe cramping, heavy bleeding, or fever (see explanation), you can call the Feminist Women's Health Center’s Cliff Valley Clinic at (404) 728-7900 any time. This number enables you to reach a Feminist Women's Health Center Cliff Valley Clinic staff member.

When you call (404) 728-7900 after business hours, an answering service will accept your call and then contact us by phone or beeper. When speaking with the service explain that you had an abortion at our clinic and that you want to speak with a nurse. They will take your phone number and contact us. A nurse or on-call staff member will return your call in approximately 20 minutes.

Remember

If you have any emergency, contact the Feminist Women's Health Center ’s Cliff Valley Clinic first. Most abortion complications can be treated at the FHWC, and in many cases an appointment within 24 hours is sufficient. We cannot be medically or financially responsible for any care you receive except through our office. If you do contact your private physician, and he/she feels that treatment may be necessary, please have him/her call FWHC’s Cliff Valley Clinic for details of your procedure.

Medication Information

Drug: Doxycycline Hyclate Tablets
Generic Name: DOXYCYCLINE (dox-I-SYE-kleen)

About your Medicine:
This medicine is used to treat certain infections and to control acne. It may also be used for other conditions as determined by your doctor.

How to use this Medicine:
Use this and all medicines exactly as directed. TAKE THIS MEDICINE with a full glass (8 ounces) of water to prevent irritation of the esophagus or stomach. If this medicine upsets your stomach, it may be taken with food or milk. DO NOT GIVE THIS MEDICINE to infants or children under 8 years of age unless directed by your doctor. This medicine may cause permanently discolored teeth and other problems in this age group. TO CLEAR UP YOUR INFECTION COMPLETELY, continue taking this medicine for the full course of treatment even if you feel better in a few days. Do not miss any doses. IF YOU MISS A DOSE OF THIS MEDICINE, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

Cautions:
Check with your doctor if your symptoms become worse, or if they do not improve within a few days. Improvement may take a few weeks or months if you are taking this medicine for acne. FEMALES: ORAL CONTRACEPTIVES OR BIRTH CONTROL PILLS MAY NOT WORK AS WELL IF YOU TAKE THEM WHILE YOU ARE TAKING THIS MEDICINE. USE A DIFFERENT OR ADDITIONAL MEANS OF BIRTH CONTROL WHILE YOU ARE TAKING IT. Anyone taking this medication may become more sensitive to sunlight than you are normally, so AVOID TOO MUCH SUN AND DO NOT USE A SUNLAMP UNTIL YOU SEE HOW YOU REACT TO THE SUN. IF YOU HAVE A SEVERE REACTION, CHECK WITH YOUR DOCTOR.

Side Effects:
COMMON SIDE EFFECTS that may go away during treatment include cramps or burning of the stomach, diarrhea, nausea, or vomiting. If they continue or are bothersome, check with your doctor. In some patients, this medicine may cause the tongue to become darkened or discolored. This will go away when you stop taking this medicine. CHECK WITH YOUR DOCTOR AS SOON AS POSSIBLE if you experience increased sensitivity of your skin to sunlight. If you notice other effects not listed above, contact your doctor, nurse, or pharmacist.

Database Edition 93.3 – Expires October 1993
Copyright1993 Medi-Span, Inc. Abstracted from the USP DI ® by permission of the United States Pharmacopoeia Convention, Inc. All rights reserved.

Drug: Methergine Tablets/Ergonovine
Generic Name: METHYLERGONOVINE (meth-ill-er-goe-NOE-veen)

About your Medicine:
This medication is usually taken to stop the heavy bleeding that sometimes occurs after having a baby. It may also be used for other conditions as determined by your doctor.

How to use this Medicine:
Use this and all medicines exactly as directed. IF YOU MISS A DOSE OF THIS MEDICINE, do not take the missed dose at all. Do not take 2 doses for the next one. Instead, go back to your regular dosing schedule.

Cautions:
If you have an infection or illness of any kind, check with your doctor before taking this medicine, since you may be more sensitive to it. In addition, hypertension may be exacerbated.

Side Effects:
COMMON SIDE EFFECTS that may go away during treatment include cramping of the uterus, nausea, or vomiting. If they continue or are bothersome, check with your doctor. If you notice other effects not listed above, contact your doctor, nurse, or pharmacist.

Database Edition 93.3 – Expires October 1993
Copyright 1993 Medi-Span, Inc. Abstracted from the USP DI ® by permission of the United States Pharmacopeia Convention, Inc
All rights reserved.fwhc