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  • Please note our new address: 1259 Berri Suite 900 Montreal, Qc.
 
     


Our post-abortion service

Please read the following information and instructions carefully. This will give you information about the next few weeks, and will give you an idea as to what is normal, what to expect and what to do if a problem / concern arises. Our clinic staff is available to answer any questions. We would prefer that you call the clinic first if you have any questions or concerns as we specialize in abortions.

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During office hours:
514-844-4844
We will inform you of the after-hours emergency number

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Complications are very rare. We are open from Monday to Friday from 9 a.m. to 5 p.m., but a doctor is not always present at the clinic. If you have a concern, please call the clinic if it is within office hours. Call the after-hours line if you need to speak with a nurse in the evening or on the weekend. You can reach us by phone 24 hours a day for urgent questions. If the emergency requires a rapid intervention, please go to the emergency room of your local hospital.

If you call the after-hours number, please leave a clear numeric message with your phone number (including area code), and stay by the phone, keeping the line clear. If you don’t hear from the nurse in a half hour, call again.

We ask that you keep the instruction sheet we will give you in the recovery room as a reference. All information you give us remains confidential; your health and privacy are important to us.


Bleeding

Every woman and every pregnancy is different. Bleeding after an abortion also varies; some women have no bleeding at all after an abortion (common with small pregnancies), while some may bleed immediately and for 3-4 weeks, and rarely, more.

Intermittent bleeding (bleeding on and off), blood clots, pinkish tissue, and clear or brownish discharge are normal. Bleeding may also be heavier after exercise. Some bleed immediately and for two to three weeks, or have periods of bleeding off and on. Bleeding usually increases three to four days after the abortion due to normal changes. It is normal to pass clots when rising in the morning, when sitting on the toilet, or when doing strenuous activity. It is also normal to have brown, clear or bright red discharge. Drinking excessive amounts of alcohol, lifting heavy objects, using marijuana or taking medication such as Midol or Aspirin may increase bleeding, and should be avoided.


Excessive bleeding

Bleeding that is not normal after an abortion would soak through several maxi pads in one hour or soak through one maxi pad every half hour for more than two to three hours. If this should happen, please call the clinic.

If bleeding is heavy, it is helpful to lie down for a while and put up your feet; increased bleeding may happen after a short period of increased activity, exercise etc. Wearing sanitary pads may sometimes make it seem that there is more bleeding than normal. If you are concerned, call the clinic at the numbers in the instructions.


Cramping

Cramping after an abortion is normal. The uterus was enlarged and is returning to its normal size. Cramping can occur off and on for two to three weeks after the procedure, and may be worse than period cramps. Many women complain of increasing cramps on the third or fourth day after the abortion and when they pass clots. Some women do not have cramps. Some have a feeling of pressure in their lower abdomen or pain in their lower back or inner thighs. This is normal.

To ease the cramps

  • Take one or two tablets of Tylenol extra strength with one or two tablets of ibuprofen, every 4 hours
  • Triatec 8 (Tylenol with codeine) is available over the counter and may be taken as one or two tablets every 4 hours, as long as you are not allergic to codeine
  • If you usually take Anaprox, ask our doctor for a prescription

Other things that may be helpful are:

  • a heating pad on the sore area
  • drinking warm fluids
  • walking around
  • bringing knees to chest with hips up, and changing position frequently

If all this does not relieve the cramps, please call us.


Preventing infection

The cervix may remain slightly open for a few days after the abortion - anything put into the vagina may cause an infection. We recommend that for one week you follow these instructions:

  • no tampons ; use only sanitary pads
  • no sexual intercourse with penetration
  • no swimming in public pools, no hot tubs or Jacuzzis, no vaginal douching
  • no tub baths ; showers only if you had a second trimester (i.e. 14 weeks or more) pregnancy

If you were to develop a uterine infection, it would most likely occur two to three days after the abortion. Infections that are detected early can be treated easily and effectively, often with oral antibiotics. The usual signs of infection may include fever (of 38°C or more), lower abdominal tenderness, and abnormal vaginal discharge.


Medication

We may prescribe antibiotics to take after the procedure:
Doxycycline / metronidazole / amoxicillin/ azithromycin are antibiotics to prevent infection and should be taken as directed.

Misoprostol may be given to help contract the uterus and decrease bleeding. It may cause increased cramping, and it may be helpful to take Triatec or ibuprofen (Advil or Motrin) with the medication.


Hormonal changes: post-abortion syndrome

There are a few hormonal changes that occur immediately after an abortion that lead to a syndrome we see with most women, and this is a normal part of the post-abortion period.

Commonly, women have little to no bleeding for the first two or three days following the procedure; the cramping usually returns by day 3. Usually on the fourth or fifth day after the procedure the cramping gets worse and bleeding becomes heavier, often accompanied by clotting. Abdominal bloating and breast tenderness often get worse and do not go away entirely for up to two weeks. Women who had a second trimester pregnancy may have discharge from their nipples. There is no medical treatment for this and we recommend that women not squeeze their nipples to relieve the discomfort. Comfort measures include taking an anti-inflammatory and using cold compresses. The body temperature increases slightly (to 38°C) for 24 hours and it is normal to feel feverish or have chills. Women sometimes feel a bit depressed around this time and some say they feel like crying. It can be good to rest, treat the symptoms as suggested above, and wait for them to pass. The syndrome usually lasts for 48 hours.


Pregnancy symptoms

Most symptoms disappear within a week. Nausea is the first to go, usually within 24 hours. Some women find that their breasts become painfully swollen and hard, and some women have discharge. This eases after several days and is usually gone within two weeks. You should not squeeze or massage the breasts as this makes it worse. Wearing a snug support bra, putting ice packs on for 10-20 minutes a few times daily and taking Tylenol may ease discomfort. Abdominal bloating also gets worse in the first week and resolves after two weeks.


Resuming normal activities

Some women return to work or school the day of their abortion. Some take it easy for the rest of the day. Most feel better after a good meal. We recommend waiting a few days before resuming more strenuous activity such as high impact fitness activities. Respect your limits.


Resuming sexual activity

Some women are ready to resume sexual activity right away and some find it takes a few weeks to become comfortable again with penetration. Women sometimes experience cramping or bleeding with intercourse in the first month or two, and this is normal. Listen to your body and your needs. It is important to remember that fertility returns within 7 to 10 days, even if there is bleeding.


Contraception

It is possible to get pregnant as early as 7-10 days after the abortion. We will help to provide and review instructions for the contraceptive method chosen. We recommend that couples always use a condom if no other method is used; we do not recommend withdrawal or the calendar method as effective modes of contraception as ovulation can occur spontaneously at any time. The condom must be used with spermicide (or with diaphragm and spermicide) to have 98% effectiveness. We are usually able to supply a sample of the birth control pill, the contraceptive patch or the Nuva-Ring if this method is chosen. The first pill should be taken on the first Sunday following the procedure whether there is bleeding or not, and the patch is also on the first Sunday after. Depo-provera by injection is available here. The IUD or Mirena system may be inserted three weeks after the procedure. Emergency contraception (Plan B) is available at the pharmacy without a prescription.


Sexual health

Sexually transmitted infections, such as HIV, chlamydia, genital warts, gonorrhoea, etc. are spread during sexual intercourse. Most contraceptive methods, such as the contraceptive pill, do not protect you from sexually transmitted infections; only condoms provide this protection. Safe sex is a sign of respect, not distrust.


Post-abortion check-up

A routine post-abortion check-up is not required if all goes well. We ask you to do a urine pregnancy test 3 weeks after the procedure if your pregnancy was at 6 weeks or less and four weeks after if you were more than 6 weeks pregnant. A urine test may give you a positive result as it takes 3 to 4 weeks for the hormones to disappear. To avoid the possibility of complications, we ask you to call us in the event of a positive result. If you are worried about something, if you have questions, if you would like to discuss contraception or if there seems to be a problem, we ask you to call us to make an appointment or to speak to a nurse.


Next menstrual period

It is impossible to predict when the next period will be. Most women will have a period in 4 - 8 weeks, some later. Often with the first period women have heavier cramps than usual, heavy bleeding, clotting, clear or brownish discharge, and some women expel pink or white tissue. The first period often lasts longer, sometimes up to two weeks. All this is normal.


Other recommendations

We will ask you to avoid drinking alcohol for 24 hours after the procedure to prevent adverse reactions to the medication we give you.

Women of childbearing age who are not immunised against the rubella virus (German measles) should see their doctor or a community health centre to get the vaccine.


Emotional reactions after an abortion

It is normal to have some feelings, perhaps strong ones, after the abortion. There may be a sense of relief following the stress of the decision and the procedure. However, it is not uncommon for a woman to have some sense of loss and feelings of sadness. It helps to share these feelings with someone close.

Sometimes a woman can experience feelings which seem beyond her control. She may even find herself depressed or angry to the point of crying. These reactions can be normal for the first week or so, but if they last longer or are very disturbing, talking to a counsellor here or getting a referral for post-abortion counselling may be necessary.

 
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