Emergency Care vs. Urgent Care: Seeking Help After a Medical Abortion
I am a 34-year-old woman weighing 190 lbs, with a medical background that includes two cesarean sections and a diagnosis of long COVID alongside endometriosis. On July 25th, during a visit to a carespot, I discovered that I was expecting. I was also informed I had bacterial vaginosis (BV). Although I was prescribed vaginal medication, I hesitated to use it extensively due to concerns about my ongoing abortion process. Prior to starting the abortion, I consulted with my obstetrician, who performed my last two cesarean sections (the latest on December 26, 2024). He assured me that the risk of uterine rupture was minimal and gave me the green light to proceed. On July 1st, I followed the protocol from a reputable organization and began taking the abortion pills. Initially, I experienced a typical week of bleeding and cramping. This was followed by a quiet week of minimal bleeding with no cramps. However, just a few days ago, I abruptly began to experience intense bright red bleeding accompanied by severe, sharp pain localized in my right pelvic area and hip. I have faced discomfort in this region intermittently since my cesarean sections, but the current episode is more excruciating than previously encountered. The pain is so intense that it brings me to tears, even after taking 1000 mg of Tylenol. I only manage to find slight relief for a few hours before the pain returns with a vengeance. Additionally, I took 0.25 mg of Klonopin to alleviate the tension and anxiety I am feeling. The discomfort has started to radiate from my right abdomen to my hip, thigh, and down into my leg. While I don’t have a fever, I’m experiencing cold-like symptoms, including nasal congestion, postnasal drip, and green mucus production, although I’m uncertain if these are related to my current situation. Is this kind of bleeding and pain typical after such a procedure? Should I visit urgent care, or is a trip to the emergency room warranted? I worry about burdening the emergency department but also have doubts about whether urgent care could conduct the necessary tests adequately. Moreover, my regular OB is two hours away, as I’ve relocated and haven’t established care with a new provider yet. Thank you for any advice; I’m feeling quite anxious about my condition.
Answers (1)
8/15/2025, 5:02:20 PM
OpenHealth AI
It sounds like you’re experiencing a concerning situation following your medical abortion, particularly with the severe pain and bright red bleeding. Here’s a structured breakdown of your situation and recommendations on how to proceed:
Main Points
- Severe Pain and Bleeding: Intense pain and new symptoms after a medical abortion may require immediate medical evaluation.
- Urgency of Care: Given the nature of your symptoms, it’s crucial to seek help promptly.
- Consideration of Care Options: Understanding the difference between urgent care and emergency care will help you choose the appropriate facility.
Explanation
After a medical abortion, especially within the context of your history of cesarean sections and endometriosis, it’s important to recognize that while some bleeding and cramping can be normal, sudden changes such as intense bright red bleeding and severe localized pain are not typical and could indicate complications.
Your symptoms of sharp pain radiating from your right abdomen to your leg, combined with heavy bleeding, may suggest conditions like retained products of conception or other issues that could necessitate medical attention. The fact that over-the-counter pain relief hasn’t provided sufficient relief further heightens the need for evaluation.
Next Steps
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Seek Emergency Care: Given your severe symptoms (intense pain and significant bleeding), you should go to the emergency room rather than urgent care. They can conduct the necessary examinations, including an ultrasound if needed, to assess your condition thoroughly.
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Document Symptoms: Before you go, note down:
- The onset and progression of your bleeding and pain.
- Any other symptoms (like the cold-like symptoms and their duration).
- The medications you have taken and their effects.
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Prioritize Comfort: While waiting for care, try to stay in a comfortable position and consider using a heating pad on the painful area if it helps ease discomfort (avoid any excessive movement).
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Stay Hydrated: Ensure you are drinking some fluids, unless monitoring your intake is difficult due to the pain or bleeding.
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Manage Anxiety: Given the anxiety you’re experiencing, continue to practice calming techniques such as deep breathing until you receive care. Reach out to a friend or family member for support during this time if possible.
It’s understandable to worry about possibly burdening emergency services, but your health and safety are paramount. Don’t hesitate to seek the help you need.
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