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For all you other women out there...

On 3 May 08 I had a surgical abortion at PP. I was 8 weeks.

Procedure:
After admittance and paperwork, they take some blood to test for clotting, do an ultrasound to ensure you are pregnant, and give you some painkillers to ease the body. I was not "put under". The dr uses a speculum to keep you open, and injects a painkiller to the cervix. This pinches. Then the dr inserts a tube attached to a vacuum, passed through your cervix and begins suctioning the contents of your uterus. If asleep, you feel nothing. Awake, there is a lot of poking around from the inside. Very creepy. They confirmed removal of the foetus.

Post procedure:
You recline in a chair with a heated pillow on your stomach to ease cramping. I went home with pills to shrink the uterus and antibiotics to prevent infection.

Week 1:
I felt great after the procedure, just tired, and hardly bled at all. Day 4 I was cramping pretty hard, and then passed a clot, and my "period" started. It was over by Day 5. At the end of week 1, I was again bleeding like a regular period, but only for 2 days. Tired, but took it easy.

Week 2:
Bled, but only very very lightly. End of week 2 I cramped again and slept the whole day. The next day I bled A LOT, passing clots and soaking my pads. It really worried me.

Update in the next few weeks.

I've been reading about the heavy bleeding/ long term bleeding by some women and it worries me. However, it would be more useful if you could provide detail -- such as medical or surgical abortion, and what type of activity levels/ cramps/ symptoms you may have experienced.

Thanks.

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Some specific questions regarding surgical procedures, preferably from a health care professional, are:

1. Are cramps related to uterus discharging material?

2. Are cramps related to cervix passing material/ clots?

3. Is amount/ length of bleeding associated with length of pregnancy? IE longer pregnancy means more bleeding?

4. Why does it take so long to remove all the blood/material in the uterus? Available materials state 2 weeks, up to 3 weeks, but here on this site some women have reported bleeding for 2 to 5 MONTHS.

4.1 Is the blood lining attached to the uterine walls, and it takes a while to slough off, even after the body realizes it is no longer pregnant?

4.2 Is the uterus still padding the uterine walls with blood, even after the foetus is removed?

5. Is the true sign of infection a smelly discharge? Can you have infection without smelly discharge?

6. How can you determine whether the surgical procedure was performed properly? Does properly mean -- removal of the foetus as well as most of the blood lining in the uterine wall? or simply the foetus?

7. More directly, if I feel I'm bleeding a lot, does that mean the dr did not perform the procedure well by removing much of the blood lining?
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My appt with PP is tomorrow afternoon but I started to worry bec/ I've felt lethargic since Friday. Given the little amt of bleeding for the first two weeks, and the clots being ejected yesterday night and today, she thinks I had a clot that blocked regular bleeding. With the clot largely coming out, normal bleeding resumed.

Typically she indicated it does not take two weeks to START bleeding, but I guess I was blocked up. Regarding the weakness, I've started feeling better, not great, but better. If I feel poorly later this evening, I'm going to the ER.
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I went to the ER.

By the end of Sunday, I'd bled profusely - about 10 pads from 6am to 6pm (12 hours), and passed clots every time. I was going to the restroom every 20 to 40 minutes. On the one hand, I needed to pass the tissue and rid the body of it. However, I was also feeling really tired (since Friday), lethargic -- must sleep or be horizontal, and getting dizzy and nearly fainted a few times. Every time I did any activity -- walk, laundry, get water -- I would bleed more.

So I couldn't eat or drink fast enough to replace the fluid loss and my blood pressure was going down and my heart rate up and up.

I checked into the ER at approximately 8PM. THey gave me fluids to increase my blood pressure and I felt better immediately, but the clots/blood still didn't stop. The dr examined me but I kept squishing fluid so he referred me to their gynecologist.

She ran an untrasound and still couldn't SEE in the uterus a ton of material. However, the head of the dept explained it this way: that the surgical procedure is done blind and that the D&C can be incomplete. This occurs in 3 - 5% of the cases. It happens when the uterus is folded over or twisted, and sometimes, they just miss stuff. I fell in that 5%.

They decided to go with another D&C Sunday night and put me out. The team was really great in the ER/OR and even as terrible as it is to have to undergo the procedure AGAIN, I felt I was in good hands.

Some additional thoughts:

-- The cramping was the uterus and cervix attempting to remove material from the uterus, hence flow was heavy after cramping.

-- My first/original procedure, the dr was late, an possibly rushed. Whatever the case, make sure your dr does as complete a job as possible. It does not benefit you to have to do a repeat like in my case, regardless of the reason. Get it done right. Perhaps PP is NOT the place to go, simply bec/ they have so many women to help. Perhaps a hospital is the best place. You will have to seriously consider this.

-- Speaking ONLY for surgical abortions, bleeding should not exceed two to three weeks, esp heavy bleeding. I suggest you insist with the clinic for a follow up ultrasound to ensure all the material has passed. My belief (someone pls confirm) is that material that stays too long in the uterus is NOT a good thing, and could lead to other complications. Do not allow yourself to languish.

-- The blood lining the uterus does not take two weeks to begin sloughing off.

-- The surgical procedure properly performed in ideal conditions means the foetus has been removed as well as most of the material lining the uterus. You will bleed, but follow the directions from the clinic.

-- Some clinics do ultrasounds AFTER the procedure, you may want to insist on it to ensure a clean and complete procedure. If there is tissue left over, fine, bec/ it will be passed out of the body. But you do not want to discover the dr missed most of the material, weeks later.

-- I was awake during the procedure (the first one) and the dr was indeed jabbing around with the suction device. You may want to insist on a female dr or with someone with a more delicate touch bec/ you don't want the dr to tear a hole or lacerate the uterus or any of your other internal organs. Think of the complications then!! That is very very serious, and I wished I was more forceful with the dr. I plan to bring this up with PP this afternoon during my follow up.

-- I am a smaller person with low blood pressure, but can generally take a lot of pain. In this case, it was a bad decision to wait the entire weekend to see the ER or go to the dr. I hope this was useful to you and you take immediate action on your health.
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TOday returned to PP for my two week follow up. THey determined that I was NO LONGER pregnant (duh), and were slightly appalled that I had to go to the ER. No apologies given. That's right folks. When they mess up, don't expect any love. So take your chances. It's good that they're there, but if you can, perhaps you'd be better off at a full service hospital.

Also, the woman determined that I was ANEMIC after shedding so much blood. So if you've been bleeding for a while, get your blood checked for the haemoglobin count. Bec/ your brain and muscles and everything else may not be getting enough O2, which means something shuts down suddenly. I've had headache, been pretty sleepy, and had no energy. She said it would take about a MONTH+ to recover, even with iron supplements and a good diet. I just picked up some Chromagen from CVS and will likely get some organic liquid herbal iron from Whole Foods tomorrow. Got a huge lineup of red meat and green leafy veggies.

She also told me to take the rest of the week off. Why? If I bleed any more, it would require a transfusion to put me back together.

So there you go. Bleeding? Get it fixed.
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