How do you know if you have complications after an abortion and what should you do in Kenya?

If performed in the first 12 weeks, a medical abortion carries a very small risk of complications. This risk is the same as when a woman has a miscarriage and can be easily treated by a doctor or trained medical practitioner. Out of every 100 women who do a medical abortion, 2 to 3 women will seek further medical care this is normal.

Please see the list below for possible complications, 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 a serious health risk and requires medical attention.
    • Treatment: Misoprostol and/or a vacuum aspiration (curettage.) When available, a woman should start taking 2 misoprostol under the tongue immediately at home before going to the hospital. Very rarely (less than 0.2%) a blood transfusion is needed.

Incomplete abortion

    • Symptoms: heavy or persistent bleeding and/or persistent severe pain.
    • Treatment: 2 tablets of misoprostol or/ and a vacuum aspiration


    • 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.

If you think you might have a complication you should seek medical attention immediately. If you live in a place where abortion is illegal and you don’t have a doctor who 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 medical practitioner will not be able to see or test for any evidence of an abortion, as long as the pills have completely dissolved. If you took the Misoprostol under the tongue, as our protocol recommends, the pills should be spit out after 30 minutes, if not dissolved completely. 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.

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/or problems with the nerves of the fetus. To treat an ongoing pregnancy, you must repeat a medical or surgical abortion.

More information:

Research has shown that very few serious complications result from medical abortions compared to the number of women who experience successful medical abortions. In the few cases that a surgical intervention (vacuum aspiration) is needed, this can be managed by the same health care facilities that care for women who have had miscarriages

Length of pregnancy % of women who needed further medical care
0- 49 days (0-7 weeks)
40-63 days (7-9 weeks)
64-70 days (9-10 weeks)
71-77 days (10-11 weeks)
77-84 days (11-12 weeks)
85-91 days (12-13 weeks)

What if you don’t bleed after taking the medication in Kenya?

If you do not start bleeding within 4 hours of taking Misoprostol, you can take another dose of Misoprostol. If you still do not bleed within 24 hours and you are positive that you are pregnant, then you either have a continuing pregnancy or an ectopic pregnancy. In this situation, you should have an ultrasound. If you experience complications such as fever, faintness, or extreme abdominal pain, then you should seek medical help immediately, because you could have a ruptured ectopic pregnancy. If you have an ectopic pregnancy, the medical practitioner will treat it. This procedure is not considered an abortion and it is life-threatening if left untreated. If the ultrasound shows a continuing pregnancy, you can do the medical abortion again.

What is a successful abortion in Kenya and how do you know if you’ve had one?

A medical abortion is successful when the pregnancy stops developing and there is no need for additional medical care. Research has shown that 99.5 % of the women who do a medical abortion in the first 9 weeks of pregnancy with Mifepristone and Misoprostol will have an abortion that ends the pregnancy. Only 3% of women will need additional medical care. In 97% of abortions, women’s bodies will eliminate all the remains naturally and without any other medical intervention. It is important that you understand that an abortion is a process. It takes time for the uterus to empty and for the abortion to be complete. It is normal for the bleeding and clotting to continue for 1-3 weeks longer; every individual’s body is different.

If you have extreme pain, prolonged heavy bleeding, abnormal vaginal discharge, or fever, it might be a sign that you have a complication and should seek medical attention. You should have an ultrasound after taking the medicines if you have any doubts about whether the abortion has been successful.

Many women can tell when the abortion is successful. They feel the symptoms of pregnancy (nausea, tender breasts, need to urinate) going away or are aware that the embryo passed.  By having an ultrasound, you can learn whether the medicines have worked and if your pregnancy has ended within a few days after the abortion.  An early ultrasound will tell you if the pregnancy has ended, but it is best to wait for an ultrasound for 10 days after using Mifepristone, as only 23% of abortions are fully complete after 7 days.

The urine home pregnancy test can be done only 3 weeks after taking the medicines, because before 3 weeks, the pregnancy hormones are still in your body and the test might show an unreliable, falsely positive result. Your body might need several days or weeks (until your next menstrual period) to expel the tissue and blood completely. The ultrasound will show what is still in the uterus. Some medical professionals will recommend a vacuum aspiration, but if you have no pain, fever, or signs of infection, it is better to wait and let your body empty naturally.  A surgical treatment is an invasive procedure that involves risks.

More information:

Research has shown that women often correctly assess whether their medical abortions are complete or not, especially with protocols that include Mifepristone. Research comparing clinical follow up and self-assessment of outcome after medical abortion has found that self-assessment was non-inferior to routine follow-up and could therefore save resources.

What are the symptoms of an allergic reaction to the abortion medication?

An allergic reaction can cause different symptoms, from mild to severe.

A mild local reaction can be experienced as itching, small blisters or pain in or around your mouth. This will disappear by itself sometime after the medicines are dissolved.

In a mild general allergic reaction, you can get tingling hands, nose congestion and swollen eyes, a rash, and itching of your skin. It is best not to continue taking Misoprostol if you have this reaction. You can use a medicine called antihistamines (for example promethazine and clemastine) to treat these symptoms.

In very rare cases of a severe allergic reaction, you can start feeling pressure on your chest, dizziness, swelling of the face and shortage of breath. If you have these symptoms, go to a hospital or medical center immediately.

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