How to Know If a Medical Abortion Was Complete

A medical abortion is a non-surgical procedure that uses prescribed medications, such as mifepristone and misoprostol, to safely end a pregnancy. Typically performed within the first seven weeks, this process involves taking abortion pills that first block the hormones needed to sustain a pregnancy, then trigger uterine contractions to expel the pregnancy tissue. Many women choose this method for its convenience and effectiveness.

However, the process does not end after taking the medication. Medical abortions are not 100% guaranteed; hence, it is crucial to confirm that the abortion was complete. If the abortion is incomplete, tissue may remain in the uterus or the pregnancy may continue, potentially leading to serious complications such as heavy bleeding, infection or severe cramping.

Signs a Medical Abortion Was Successful

Paying attention to physical symptoms in the days and weeks following a medical abortion can help indicate whether the process was successful. Below are common signs that suggest the abortion is complete:

• Heavy Bleeding With Clots

  Passing heavy bleeding and blood clots, sometimes as large as a lemon, is expected as the pregnancy tissue is expelled. This typically occurs within the first 24 hours after taking the second abortion pill (misoprostol).

• Gradual Decrease in Bleeding

  After the initial heavy bleeding, the flow should gradually decrease over the following days. Light spotting may continue for up to two weeks as the body recovers.

• Reduction or Disappearance of Pregnancy Symptoms

  Symptoms such as breast tenderness, nausea and fatigue should lessen or disappear entirely within a few days to a week, indicating hormonal changes as the pregnancy ends.

• Mild Cramping That Improves Over Time

  Cramping is normal and should ease gradually after the tissue has passed. Persistent or worsening pain could signal retained tissue or infection and should be checked by a doctor.

Warning Signs of an Incomplete Medical Abortion

While medical abortion has a high success rate, there are times when the process may not be fully complete. Recognising the warning signs early is crucial to preventing complications and protecting your health. Common warning signs include:

• Heavy Bleeding

  Bleeding that soaks through two or more pads per hour for over two hours may indicate excessive or incomplete bleeding.

• Severe or Worsening Abdominal Pain

  Persistent or intensifying pain that does not improve with rest or medication should be evaluated by a doctor.

• Fever Lasting Over 24 Hours

  A fever above 38°C that continues for more than a day could signal an infection.

• Continued Pregnancy Symptoms

  Ongoing signs of pregnancy, such as breast tenderness, nausea or fatigue, may mean the abortion was unsuccessful.

• Foul-Smelling Vaginal Discharge

  This could be a sign of infection or retained tissue and requires prompt medical attention.

If you notice any of these symptoms, seek medical care immediately. Early intervention helps prevent serious health risks and ensures you receive the follow-up treatment needed for a safe recovery.

How to Confirm Completion

Confirming that a medical abortion is complete is essential to ensure the process was successful and to prevent complications. While physical symptoms can provide initial clues, they are not always reliable on their own.

You may take a home pregnancy test about two weeks after the procedure, but the most accurate and reassuring way is through a follow-up appointment with your abortion doctor. In Singapore, these follow-up visits are mandatory and vital, as they allow the doctor to confirm that the uterus has fully cleared and that your recovery is on track.

During these follow-up visits, the doctor may use a combination of methods to confirm that the abortion is complete:

• Ultrasound Examination
  An ultrasound may be performed to visually check the uterus, ensuring that no pregnancy tissue remains.
• Blood Tests
  The doctor may order a blood test to measure the levels of the pregnancy hormone (hCG). A significant decline in hCG levels indicates that the pregnancy has successfully ended.
• Physical Examination
  A physical exam may also be carried out to assess whether the uterus has returned to its normal size and to check for any signs of complications.

For a safe and well-monitored medical abortion, consult our clinic. We provide confidential care, clear guidance throughout the process and thorough follow-up support to ensure the abortion is complete and your recovery is progressing smoothly.

Our Gynaecologist

Dr Jen Shek Wei
Consultant Obstetrician & Gynaecologist

MBBS (S’pore), MMed (OBGYN, S’pore)

FRCS (OBGYN, London),FAM(S)

MBBS (S’pore), MMed (OBGYN, S’pore)FRCS (OBGYN, London), FAM(S)

Dr Jen Shek Wei is an abortion doctor with more than 30 years of experience in the field of OBGYN. At his Ministry of Health (MOH)-accredited clinic, he provides medical abortion (abortion pills) with an attentive follow-up to monitor progress and manage any side effects. Throughout the entire process, Dr Jen is committed to offer compassionate and confidential care for his patients during what is often a difficult and emotional time for them.