Complications are rare, and you will soon return to normal. Please call us if you have a problem or question. Most of these will be routine and can best be handled during regular daytime office hours. Medical staff is here Monday through Friday, 8:00 am to 5:00 pm and Saturday 7:00 to 12:00 noon. Emergency calls only, may be made anytime. Call 205-933-1118 . Or if after hours, call 205-930-4443 (answering service).

WHAT CAN I EXPECT NOW?

EMOTIONS: Some women feel weak, tired, or depressed for a while. These reactions may be due to emotional factors or to abrupt changes in hormone levels. We suggest you relax for a day or so and resume your normal activities when you feel comfortable. If you have trouble shaking depression after a few days, contact New Woman All Women Health Care, a family service agency, a pastoral counseling center, or any other agency concerned with helping people deal with their feelings. We would be happy to make referrals for you if you call us.

BLEEDING: Bleeding following an abortion is normal. The amount of bleeding varies from woman to woman. Some women don't have any bleeding after their abortion. Usually women have some bleeding though, which is no heavier than normal menstrual periods. Bleeding may stop and start many times or you may only bleed for a day or two. These conditions are all normal conditions. Heavy bleeding is usually caused by too much standing, walking, and/or lifting. We consider too much bleeding to be soaking more than one pad in an hour. Depending on certain factors you may have been given a Methergine (or Ergotrate) prescription to help control bleeding. This medicine may cause cramps because it causes the uterus to contract, (and may cause leg cramps as well). You should take this medication every four hours until you have taken six pills. Hold the remaining six pills. If you call with bleeding concerns, we may direct you in taking the last six pills. It is advisable to either wear or keep with you a sanitary pad for about the next 30 days in case you restart bleeding, which can normally occur.

CRAMPING: Some women may experience pain or cramping. Cramps can usually be relieved by Tylenol. A heating pad or hotwater bottle may also bring relief. Cramps typically only last a few days. They are caused by contractions of the uterus and aresometimes associated with the passage of large clots. If cramping is strong you might try ALEVE, an over-the-counter medication for pain. (Note: you should not use this medication if you are sensitive or allergic to aspirin or aspirin-like products, such as ibuprofen, etc., have recent history of ulcers, or aspirin induced asthma). If any medication causes drowsiness, do not drive or operate complex machinery. Avoid aspirin, ibuprofen, or similar medications or any medications you can't tolerate or are allergic to.

POSSIBLE COMPLICATIONS

FEVER: Significant problems are unusual after an abortion. One problem to watch for is infection, and fever is the first sign of an infection. You should check your temperature twice a day for ten days; once in the morning and once before bed. Fever, which may indicate infection, usually shows up on the second or third day. If you have an infection, it can almost always be handled with medication. To help prevent infection, it is important for you to take all of the Doxycycline antibiotic (or other antibiotic which you have been prescribed). Take your medications correctly. Doxycycline or Ampicillin should be taken by mouth about every twelve hours. If you've been given a different antibiotic, take according to directions given to you by the doctor. If your temperature goes above 100.4 degrees, call NWAWHC for advice. Severe or persistent abdominal pain or urinary discomfort may also be signs of infection.

TENDER BREASTS: Breast soreness and tenderness are normal for the first few days and may get worse before it gets better. You may even have some milk in your breasts for a day or two. Do not try to expel any fluid because this will cause more milk to be formed. You will probably be more comfortable in a tight fitting bra. If discomfort is severe, ice packs or a warm
shower may bring some relief. Do not breast feed for at least 24 to 48 hours after receiving or taking any medications.

GETTING BACK TO NORMAL

MENSTRUATION: Most women will start their birth control pills the first Sunday following their abortion. If you started on birth control pills after your abortion, you will usually have a normal menstrual period following your first packet of pills or occasionally after the second pack of pills. If not, you can expect a period usually within four to eight weeks. If you havenot had a normal period or a follow-up visit, you need a pregnancy test 3 to 4 weeks after your abortion to make sure you are not still pregnant or pregnant again and thereafter every 4 to 6 weeks until your menstrual cycle resumes. In rare cases it may take as long as 6 months to restart.

SEXUAL RELATIONS: No intercourse for at least three weeks, or not until after your check-up. Your chances of getting an infection from intercourse are much greater during this time. Do not douche or use tampons for the same reason. You can get pregnant even though you have not yet had a normal menstrual period. Remember to use foam and condoms with your first pack of birth control pills because the pills may not be fully effective the first full month. Also, Remember, use foam and latex condoms to help prevent transmissions of sexually transmited diseases as well as to help prevent unwanted pregnancy. Statistics say that
for six (6) months after any pregnancy, you are seven (7) times more likely to get pregnant, so be very careful about birth control.

ACTIVITIES: For the next 10 days, you should not be on your feet standing or walking more than 10-15 minutes out of an hour, should not lift over 10 pounds, or do strenuous activities. Otherwise, you can return to normal activities, such as going back to work, school, or housekeeping tomorrow or sooner if you feel like it. Driving a car is fine as long as you don't feel weak, drowsy, or lightheaded. Too much physical activity can cause heavy bleeding, blood clots, fever, and menstrual cramps up to several days later. Remember not to drive a car or operate machinery for 24 hours after your abortion if you received intravenous medications or other medications that interfere with your level of consciousness or ability to concentrate. If you've been given Doxycycline, stay out of the sun and tanning beds until at least 24 hours after finishing the Doxycycline.

DIET: No special restrictions. If you have been bothered by nausea, be careful not to overindulge. If you've been given Doxycycline, avoid milk products and alcohol until after the medicine is finished so that all of the medicine is absorbed properly. If you've been given metronidazole you must absolutely avoid alcohol for 24 hours until after the metronidazole is
finished because it will make you very sick and is dangerous to your health!

BATHING: Shower and shampoo whenever you like. No tub baths or swimming for three weeks. (Showers are fine).

YOUR CHECK-UP: It is important that you be examined in three weeks to help make sure that you have healed properly and you are no longer pregnant. If you intend to return to NWAWHC for a check-up, please make your appointment while you are here. If you do not come back for a follow-up at NWAWHC, make an appointment with a doctor or other medical group. They must know that you have had an abortion and how far in the pregnancy you were. A Pap smear is recommended at your follow-up visit if you have not had one in the last six months, and would be necessary if you want NWAWHC to help you with continued birth control. The cost for a Pap smear is $25.

BIRTH CONTROL: There is no better way of taking care of yourself than learning the facts about birth control, selecting a method, and using it correctly. If you go to your private physician or a clinic for your follow-up visit, ask about birth control while you are there. We at NWAWHC will be happy to answer any questions you might have about the birth control pill, the IUD, the Depo-Provera shot, or a diaphragm, all of which we offer here.

BE SURE TO CALL NWAWHC IF:

(1) Your temperature is over 100.4 degrees.

(2) Your bleeding is heavier than one pad per hour.

(3) You have severe or persistent abdominal pain.

(4) You have any other symptom that distresses you or is out of the ordinary.

We will be glad to answer your questions and discuss any concerns you may have. We will likely refer you to the nearest Emergency Room or to your doctor if there is a possibility of an ectopic pregnancy or other problems that may need immediate evaluation and treatment.