How long you're supposed to bleed after an abortion and when to see a doctor about too much blood

• You'll likely experience heavy bleeding for several hours following a medical or surgical abortion.
• You may continue to spot for a couple of weeks after depending on how many weeks you were pregnant.

Abortion is a safe and effective way to end a pregnancy when done legally and by a trained physician who follows the methods outlined by the World Health Organization.

But it can be helpful to know what physical symptoms to expect before getting one.

According to Dr. Lisa Masterson, an OB-GYN in private practice, one of the most common side effects of both medical and surgical abortions is bleeding.

It's also common to experience painful cramping after an abortion, says Dr. Monica Grover, a board-certified OB-GYN and chief medical officer of VSPOT.

Grover says that cramping may be intermittent for the first couple of days and then increase along with bleeding around the third to fifth day after the procedure.

The severity and duration of these symptoms are different for everyone and can depend on what type of abortion you had and how far into the pregnancy you were.

Some people experience light bleeding and spotting for two weeks following the procedure, while others experience one episode of heavy bleeding immediately after.

Important: If you're soaking through two or more pads an hour, or the bleeding has been consistently heavy for days at a time, that may be a sign that you're bleeding more than normal and should contact your doctor, Grover says.

Below, OB-GYNs share exactly what to expect when it comes to bleeding and your period after an abortion.

Bleeding after abortion

The amount and length of post-abortion bleeding can vary from person to person — it's normal to experience a light, moderate, or heavy flow, as well as blood clots or blood-tinged vaginal discharge.

Moreover, the type of abortion you have will also be a factor:

1. Medical abortions involve a combination of two medications that cause you to shed your uterine lining, which prevents the pregnancy from progressing.
2. Surgical abortions, aka in-clinic abortions, usually involve local anesthesia before a medical professional inserts a device up through your vagina to empty your womb from any fetal or uterine tissue.

Here's how much bleeding to expect from each procedure.

Medical abortion

Following a medical abortion, the bleeding usually starts one to four hours after you take the second medication. For some, however, bleeding will begin in between taking the first and second medication.

Heavy bleeding should only last for a few hours shortly after taking the second pill, and you may experience clots, which can range from the size of a dime to the size of an orange. In rare cases, heavy bleeding may not start for a few days after taking the medication.

As your body passes the pregnancy tissue, bleeding will decrease but may last 10-18 days.

Surgical abortion

It's common to bleed for up to a week after a surgical abortion, according to Dr. Kim Langdon, an OB-GYN with the digital health platform Medzino. She says the blood may be deep red to brownish, and can also sometimes include small clots that appear red to dark purple in color. Clots should be no larger than the size of a lemon.

After a week or so as the bleeding lightens up, you can expect to have a pink or brown-tinged discharge. However, how long you bleed depends on how long you've been pregnant.

The longer you're pregnant, the more time the uterine lining has had to thicken, meaning there is more tissue to shed, Langdon says. So, for example, a surgical abortion done at 16 weeks of gestation may cause heavier bleeding than one done at 10 weeks.

Additionally, bleeding may decrease when you rest and increase when you exercise.

Sometimes, Langdon says your doctor may prescribe methylergometrine, a vasoconstrictor medication, to control the bleeding after a surgical abortion. In most cases, though, Grover says you'll just have to wait it out.

Quick tip: You should always use pads instead of tampons for the first two weeks after getting a surgical abortion. It's also advisable to use pads after a medical abortion — until the bleeding stops — so you can better monitor how much you're bleeding.

Period after abortion

Pregnancy hormones disrupt your menstrual cycle so you may not have your period at the regular time following the procedure, Langdon says.

Grover says you can expect your next period to begin anywhere between four to seven weeks after getting an abortion.

It may take some time for your hormones to regulate and your body to readjust, but according to Grover, your periods should become regular within two to three cycles.

Note: It's not uncommon for your first post-abortion period to be lighter or heavier than you're used to. Medical abortions tend to cause a heavier than normal period, while surgical abortions tend to cause a lighter than normal period.

When to see a doctor

If you experience any of the following symptoms, OB-GYNs say you should reach out to your doctor right away:

• Heavy bleeding that lasts for 12 hours or more
• Heavy bleeding that soaks more than two pads in one hour
• Severe cramps that do not improve with over-the-counter pain medication
• Fever and/or chills
• Foul-smelling discharge

You should also contact your doctor if you don't bleed at all after a medical abortion, because that may mean the medications didn't work and you are still pregnant.

According to Langdon, the most common cause of excessive bleeding is an incomplete abortion. If that's the case, the bleeding will typically be accompanied by abdominal or pelvic pain.

An incomplete abortion means that pregnancy tissue is still left in your womb. In rare cases, an incomplete abortion may cause other complications, including:

• Sepsis: an immune response that can cause tissue damage and organ failure
• Hemorrhagic shock from severe blood loss
• Uterine rupture

Less frequently, excessive bleeding may also signal a uterine injury that happened during the abortion procedure.

Both an incomplete abortion and a uterine injury can increase your risk of infection — which, if left untreated can spread to the fallopian tubes and cause infertility.

Insider's takeaway

"It's normal and common to have some bleeding after an abortion," Grover says.

The farther into your pregnancy you get an abortion, the more bleeding you're likely to experience. Bleeding will typically be heaviest in the 24 hours after getting a medical abortion, and then you might experience light bleeding and/or spotting for up to 18 days.

Overall, bleeding tends to be lighter after a surgical abortion, but will typically last for several days to several weeks. The bleeding may also be accompanied by clotting as well as cramping.

If you're ever concerned about the amount of blood or how long the bleeding has lasted, contact your doctor.