Understanding When and How Medical Abortion Symptoms Manifest

In a medical abortion, several physical changes happen within the body that help the pregnancy to get expelled from the uterus. So, exactly when do these symptoms begin and the changes are noticed physically? What are the initial signs that the abortion pill MTP Kit (Mifepristone and Misoprostol) has begun working? How does the procedure proceed and when are the symptoms intense and how do they taper off?

We will discuss all the important phases of the medical abortion MTP Kit procedure in this blog below.

Phase 1: The Quiet Activity (Mifepristone)

The first step in medical abortion is to take the anti-progesterone pill Mifepristone 200mg orally with water. Misoprostol pills are only taken once 24 to 48 hours pass after the progesterone blocker pill. Misoprostol is administered buccally, sublingually, or vaginally. Mifepristone may not cause significant side effects, but performs essential action to start pregnancy termination. Some of the actions include:

➡Blocking of the progesterone hormone that helps the fertilized egg to stay attached to the endometrial lining.

➡Progesterone helps shape and thicken the uterine lining. In its absence, this lining sheds – aided by Mifepristone, and the pregnancy is no longer attached to the nutrition support it needs to advance further.

➡So, the pregnancy comes to an end. It is after Misoprostol that the activity of pregnancy expulsion begins.

➡But Mifepristone does the initial heavy lifting in ensuring the pregnancy sections come off from the uterine support and stay in the womb ready to be removed by Misoprostol prostaglandin effect.

Phase 2: The Active Process (Misoprostol)

Misoprostol administration happens 24 to 48 hours after the Mifepristone pill. The actual experiences related to a medical abortion starts thereafter. The pills soften the cervix and help with uterine contractions to remove the conception products. You may expect the initial symptoms to start in 30 minutes to 4 hours or sometimes more:

➡You may feel nauseous or vomit. So, after Misoprostol intake do take an antiemetic medicine an hour prior. This is moreover because of hormonal changes.

➡Initial cramping may feel like a dull ache, but then start to get increasingly evident and severe once the medicine begins to take effect.

➡Misoprostol works on the abdominal smooth muscles and in the uterus too. So, some gastrointestinal effects like stomach upset are common to expect. You must drink plenty of water to prevent dehydration.

The Peak (2 to 5 Hours After Misoprostol)

Here the medical abortion symptoms are intense as the body is working to eliminate pregnancy sections from the uterus. So, this is what may happen:

➡Expect strong uterine contractions, which may come in waves. The uterus is contracting often to release the pregnancy via vaginal bleeding. The cervix also softens and dilates to help with the evacuation of the womb.

➡Bleeding is heavier than a period, and you may pass large clots with pregnancy tissues and parts in them. This is a sign that the procedure is working fine.

➡It is normal to encounter temporary chills, fever, and flu-like symptoms even nausea and headache as side effects to hormonal changes, abortion effort, and Misoprostol activity. These go away soon after the uterus is vacated.

➡It is advisable to stay hydrated and drink electrolyte-based beverages, avoid junk food, alcohol, and too much caffeine. Stay in a room that has access to the bathroom. Make sure to stock with pain meds and supportive care supplies so you can manage the process well.

Phase 3: The Tapering (6 to 24 Hours)

After the pregnancy has exited the body, the increased symptoms start to reduce. It does not come to an abrupt stop but eventually begins to fade away before stopping completely. Here are the changes that may occur:

➡In 24 to 72 hours, the intense cramping may start to cease and become a manageable ache because by this time almost all the pregnancy sections have exited the uterus.

➡The bleeding is still heavy but the ‘gushing’ phase usually comes to a stop and the bleeding looks like a normal period with some clots still passing.

➡Chills, nausea, fever normally go away by this stage. Tiredness may take some time to reduce because of the physical effect and everything that goes on. But you will start to feel more energetic.

Phase 4: The Recovery (Days 2 to 14)

When the medical pregnancy termination is done with, your body is still recuperating and getting back to normalcy. Here is what to expect:

➡Light bleeding turns to spotting and then stops eventually in 2 to 4 weeks. Sometimes spotting is expected until next period.

➡As pregnancy hormones may take some time to reduce, pregnancy symptoms such as sore and tender breasts may take a few days like 7 to 10, before they go away.

➡Menstrual cycle after a successful abortion may happen in 4 to 8 weeks. But some women can ovulate as soon as in 8 to 11 days of a pregnancy termination. In this time, the endometrial lining starts to build again. You can expect a period after that as per the body’s natural cycle.

Safety Check: When to Seek Help

Now that you understand the medical abortion consequences and what is normally expected from the treatment, here are some warnings to look for in case of a medical emergency:

➡If you soak more than 2 large maxi pads per hour for the next two hours consecutively accompanied by extreme dizziness and feeling like losing your consciousness, then it may indicate excessive bleeding.

➡Ibuprofen and other pain management techniques if unable to reduce the abdominal pain, which is getting more severe, then it may indicate the pills are not giving the desired effect or an ectopic pregnancy.

➡A fever of 100.4°F (38°C) or higher that stays more than 24 hours with chills and extreme fatigue, fainting, dizziness, or foul-smelling discharge are signs of an infection.

➡In any of the above unforeseen circumstances, you need to contact an emergency care center to get help from healthcare professionals at the earliest.

Frequently Asked Questions

1. How soon will I start bleeding after taking the second pill?

Most women experience heavy vaginal bleeding starting after one to four hours, sometimes six, of using Misoprostol. If the pregnancy is around 10 to 12 weeks, it may even take up to a day before the bleeding begins.

2. Are the chills and fever I feel after Misoprostol dangerous?

A temporary rise in body temperature and some number of chills are normal and common side effects of Misoprostol. But if the fever is high and lasts over 24 hours, then seek medical help immediately.

3. How long does the most painful part of a medical abortion last?

Intense cramping and vaginal heavy bleeding can go on for 2 to 6 hours, then starting to reduce as the uterus empties. But the cramps may last until all the pregnancy tissues exit, and sometimes even thereafter mildly till the uterus resumes its pre-pregnancy size. Bleeding also tapers off eventually within a few days or weeks.

4. Can I take pain medication during the process?

You can use an over-the-counter pain medicine such as Ibuprofen to reduce the pain. It can reduce the pain intensity caused by the uterine contractions. However, avoid Aspirin as it has a blood thinning component that may increase bleeding.

5. When will I start to feel normal again after the procedure?

Usually, you may begin feeling better within a day or two of completing the medical abortion procedure. Light bleeding and fatigue may linger for some time. Once the hormones are back to normal levels, these symptoms fade away and you can go back to your regular chores in a short time.