Bleeding During a Medical Abortion: What's Too Much, What's Too Little?

Bleeding is a natural and expected part of a medical abortion process. However, understanding what constitutes normal bleeding and identifying signs of excessive or insufficient bleeding are essential for ensuring your safety and well-being.

Expected Bleeding

• After taking misoprostol (Step 2), most people experience bleeding that is heavier than their normal first day of menstruation.
• Bleeding usually starts within a few hours of taking the second medication and may be accompanied by small to medium-sized blood clots.
• This bleeding typically lasts for 4–7 days before tapering off to lighter bleeding or spotting, which may continue for up to 4–6 weeks.

What's Too Much Bleeding?

Excessive bleeding can indicate complications and requires immediate medical attention.

Signs of Too Much Bleeding:

• Soaking a maxi pad every 30 minutes for 2 hours straight.
• Soaking 10 maxi pads in 10 hours.
• Passing blood clots larger than a tennis ball.
• Feeling dizzy, faint, or weak from blood loss.

What to Do:

• Seek immediate medical help by calling 000 or visiting your nearest Emergency Department if any of these occur.

What's Too Little Bleeding?

Insufficient bleeding may indicate that the abortion process is incomplete.

Signs of Too Little Bleeding:

• Bleeding less than your normal first day of menstruation within the first 24 hours after taking misoprostol- It can take up to 24hrs to get the full effect of misoprostol.
• No clots passing or no noticeable bleeding.

What to Do:

• Contact Aunty Jane for an urgent assessment, as this may require follow-up treatment.

Passing Clots: What’s Normal?

• Passing small to medium-sized clots is a common and expected part of the process.
• If you pass a clot larger than a tennis ball, seek emergency medical care.

When to Call Your Provider

If you experience:

• Heavy bleeding beyond the expected range.
• Ongoing light bleeding or spotting that suddenly increases weeks after the procedure.
• Symptoms of infection (fever, foul-smelling discharge, or severe abdominal pain).
• Ongoing strong pregnancy symptoms lasting more than 14 days post medication.

The information provided on this website by Aunty Jane in any format or medium, are for general information purposes only and are not intended as medical advice or as a substitute for consultation with a qualified healthcare professional. The information made available by Aunty Jane do not provide personalised medical advice, diagnosis, or treatment. To the extent permitted by law, Aunty Jane disclaims all liability for any outcomes resulting from reliance on the information provided. For specific medical concerns, please consult a qualified healthcare professional.

1. Family Planning NSW. "Medical Abortion Information." Accessed at https://www.fpnsw.org.au/factsheets/individuals/abortion/medical-abortion-information.
2. HealthDirect Australia. "Abortion – Surgical and Medical Options." Accessed at https://www.healthdirect.gov.au/abortion-surgical-and-medical-options.
3. National Abortion Federation (NAF). "Clinical Policy Guidelines for Abortion Care." Accessed at https://prochoice.org/resources/clinical-policy-guidelines/.
4. World Health Organization (WHO). "Safe Abortion: Technical and Policy Guidance for Health Systems." Accessed at https://www.who.int/publications-detail-redirect/9789241548434.