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Instructions After an Abortion Surgical abortion, like other surgical procedures does have a risk of side effects or complications. Although these complications are rare, it is important that you know what to expect and what to do. Infection It is important that you take your temperature with a thermometer each afternoon and evening for two days after your abortion. If it is 100.4 degrees or higher for two times in a row (taken four hours apart) or 101 degrees or higher even once, call PP/WHS immediately. The fever may indicate infection and it is URGENT that you report it at once so that you can be treated. Infection is an uncommon complication, occurring in less than % of patients. It is usually associated with fever or sometimes with abdominal cramps and foul smelling discharge. It can nearly always be treated simply and effectively with antibiotics. All patients are given an antibiotic at the time of your abortion to decrease your risk of infection. In the event of a medical emergency folowing your abortion, please contact PP/WHS immediately and one of our physicians will meet you at the emergency room. Bleeding Excessive bleeding is a rare complication of abortion. The normal amount of bleeding will vary from woman to woman. Some women may have very little bleeding or no bleeding at all for several days. Some may begin bleeding the day of procedure, bleed for 5 to 7 days, and then spot for a week. Some women can have spotting for as long as 2 weeks. You may pass small clots (approximately the size of a 50-cent piece or smalle) and bleeding may seem to increase when you get up suddenly or go to the toilet. Do not be alarmed or frightened if you pass a small clot. This is normal after having an abortion. Many women pass clots with their periods every month. If the amount of bleeding increases so that you are soaking one or more pads per hour, call PP/WHS immediately. Cramping after a surgical abortion You will probably experience cramping for a few days that is similar to cramping with a menstrual period. Clots in the uterus usully cause cramping and as soon as these clots are expelled, the cramping should cease. You should be able to obtain relief by taking Nuprin, Advil or any over the counter brand of ibuprofen and by using a heating pad or hot water bottle. Do not apply heat if bleeding is excessive. You may use Extra Strength Tylenol if you are allergic to ibuprofen or aspirin. If the cramping is severe or prolonged, and you are not getting relief from any of these methods, call PP/WHSimmediately. If you are given a drug to decrease your bleeding (Methergine), you may notice increased cramping. Take ibuprofen along with the Methergine to decrease cramping or substitute Extra Strength Tylenol if you are allergic to ibuprofen. PP/WHS number is 412-562-1900. Call IMMEDIATELY if you have any problems (fever, excessive bleeding or severe cramping) which may indicate complications. DO NOT report to an emergency room or doctor without first contacting a PP/WHS emergency call person. If you need information, or if you have questions about your abortion please call between 9:00 am and 4:45 pm daily. If you have an emergency, it is best to contact PP/WHS earlier in the day or early evening when pharmacies are still open. This may eliminate an emergency room visit. A member of PP/WHS staff is available to handle emergency calls. Cramping and Bleeding after a medical abortion Cramping and bleeding are expected and they are needed to complete the abortion. It is also possible that you may hav some nausea, vomiting, diarrhea, dizziness or mild fever and chills. Cramps: Lower abdominal cramping pain, especially in the middle of your lower abdomen, can occur anytine after you receive the mifepristone (Mifeprex). Most likely, you will not feel any cramping pain until after you put the misoprostol pills in your vagina. If you need to use pain medicine, take acetaminophen (Tylenol) or ibuprofen (Motrin IB, Advil, Nuprin). If you take Tylenol, use 2 extra strength or 3 rgular strength pills every 3 to 4 hours. If the Tylenol or ibuprofen does not help the pain, take the narcotic pain medication that was prescribed for you (2 pills every 3-4 hours). DO NOT take aspirin. Bleeding will usually start 1/2 to 10 hours after the cramping begins. If you have bleeding heavier than a period, you might be having the abortion. If you need to call PP/WHS you should know: Your temperature within the last hour. The number of pads you have soaked within the last hour. The telephone number of your drug store. Be sure it is open when you call. General Information Pad / Tampon Use Pads should be used for the first 7 days after your procedure. The rate of bleeding can be observed more easily when pads are used. Tampons can be used after the first week. Bathing You may shower or tub bathe at any time. Do not use a douche. Return of Periods For women who are not using hormonal contraception (for example, birth control pills or Depo-Provera), your first period should occur in 4-6 weeks. If you miss 2 periods, call and schedule an appointment. Intercourse It is best to avoid intercourse for one week following your abortion. You should carefully read your contraceptive sheet and begin using your contraceptive method immediately. Activity You may resume normal activity immediately. Avoid strenuous exercise for two days, especially heavy lifting and bending. Sore Breasts Wear a firm supporting bra at all times (even in bed) Apply ice bags to breasts Limit fluid intake, salt, and sexual stimulation of breasts Follow-Up Examination It is important for you to immediately make arrangements with a physician or clinic for a post-abortion check-up. At PP/WHS we schedule this appointment within 1 to 2 weeks from the date of your procedure. If you are planning to go elsewhere for your check-up you should see your doctor within 1 to 2 weeks. If you are unable to arrange an appointment with your doctor call PP/WHS as soon as possible. Our appointment counselors will be able to give you an appointment or refer you to an appropriate physician or clinic. Remember, PP/WHS emergency call is available to you for any problems or emergencies that occur after your abortion whether you are planning to return to PP/WHS or your own physician for your check-up. If you return to PP/WHS for your post-abortion check-up within 8 weeks of your procedure, there will be no charge to you for the exam. You will, however, be charged for a Pap smear. If your appointment is made after the 8 weeks period, you will be considered a gynecological patient, and there will be a charge. In either case, this will include a check-up, Pap smear and contraceptive counseling. Planned Parenthood / Women's Health Services offers complete gynecological and contraceptive care. If you are not already seeing a doctor or clinic regularly for your annual gynecological check-up, pap smear and contraceptive care, you may want to come to PP/WHS for these services. If you have any questions about our gynecological services or wish to make an appointment, please call 412-562-1900 Monday through Friday 9:00 am to 4:45 pm, or Saturday 8:00 am to 4:00 pm.