This is the same information that you will receive when you leave the clinic. There is a 24-hour medical assistance line. The number is given to you when you come to the clinic.

Aftercare

Please read this information so that you know what is normal after the procedure and what to do in case of a problem. Keep this pamphlet to read when the need arises.

As a patient today you agreed, by signing the consent form, that you will not drive a motor vehicle for 24 hours. This restriction is for your safety so please follow it.

Please call with any questions or concerns. Call us first. If you need further medical attention, we can often facilitate it.

During work hours (Mon-Fri): 780-484-1124 (our clinic number)

Holidays, evenings, weekends: our medical assistance line

If you call the medical assistance line and are asked to leave your name and number, please do so. This is a private line and your call will be confidential. Speak slowly and clearly so we can call you back. If your phone does not accept blocked numbers, we can't return your call. If this is the case, please call the number again. If you are staying in a hotel, please include the phone number and the room number.

Once you call us, please keep the line open and stay by the phone; your call will be returned quickly. It is possible the number you gave us was not recorded clearly enough to return your call. If your call is not urgent and not returned within 1 hour, please try again.

Emergency Care

If you are unable to get through to our medical assistance line and you are bleeding heavily or are in severe pain, please proceed to the Emergency Unit at your nearest hospital. However, please try our medical assistance line first as we can often help you manage your bleeding and cramping from home. If you need to see a doctor in an emergency, the nurse on our medical assistance line will refer you and may be able to facilitate your visit to the hospital to decrease your waiting time.

Please contact the clinic in the event of any unexpected admission to a hospital post-procedure.

Bleeding

You may be bleeding after the procedure. The bleeding varies from woman to woman. It may start right away or 3 days later or not at all. It may last from a few days to 3 weeks. Some women pass clots and the bleeding may seem heavier if you get up suddenly, go to the toilet or increase exercise. Blood clots the size of your thumb are common. Often the bleeding stops and then starts up again. Between 4 and 6 days after the procedure, you may have cramps and pass clots. As your hormones are dipping back to normal levels, you may also feel sad or cranky.

Clots may be dark colored (black) and toonie-sized or larger. Cramping that is uncomfortable can be eased with Tylenol Extra Strength or Advil (follow package directions). It usually eases within a couple of hours. If you do not notice any improvement in 2 hours, phone us.

Drinking alcohol, lifting heavy objects, using Aspirin or marijuana can cause slightly heavier bleeding.

Excessive Bleeding

You have excessive bleeding if you soak through 2 to 3 sanitary napkins/pads in 1 hour or soak 1 sanitary napkin/pad an hour for 3 hours. If this happens, you need to call us. With heavier bleeding, it can be helpful to lie down and put your feet up. If you usually use tampons, then you may think that there is more bleeding than usual because it looks like a lot on your sanitary napkin/pad. Please phone us if you are worried about the amount of bleeding you experience.

Cramping

Most women will have cramping. It is usually from blood clots that need to pass. The uterus is a muscle that tries to push the blood and clots out to remove them. Once the clots have passed the cramps will usually disappear. Light activity will help to minimize or clear out clots. For the rest of the day of the procedure make sure you are moving around at least once every hour. If you sit or rest too long (e.g. a long car ride), you can increase the cramping and bleeding.

Try light activity such as walking or using stairs, then lift your knees up to your chest to try and pass the clots. You can also use a hot water bottle or heating pad or hot shower. Cramping that is uncomfortable can be helped with Tylenol Extra Strength or Advil (just follow package directions). You should not need anything stronger than this. If you do, please call us.

Antibiotics

You will be given antibiotics. Start these on the day of the abortion and follow the directions on the package. You may have to take food with the medications. You cannot drink alcohol during this time because it may cause the antibiotics to not work properly or cause you to feel very ill. If you have any questions about this, please call us.

Preventing Infection

After an abortion, the cervix (the opening of the uterus) can remain slightly open for some time. Anything you put into the vagina may cause an infection in the uterus. To decrease the risk of infection, please follow these instructions for 2 weeks, until you see a doctor:

No Tampons (only sanitary napkins/pads)

No Tub baths (only showers)

No vaginal intercourse (sex)

No swimming or hot tubs

If an infection develops, it is most likely to happen 2-3 days after the abortion. Usual signs of infection can include fever of 38.5 C (100.4 F), tenderness in the abdomen and vaginal discharge.

If you phone us, we will ask for your temperature. If you have a temperature and you think it is a cold, flu or sore throat, still call us. Any fever after an abortion should be checked out by us. Infections that are treated early by antibiotics will decrease the chance of later problems. With proper care, hospitalization is rare.

Swabs for Infection and Pap Exams

If you requested to have a pap exam and/or swabs, to check for bacterial vaginosis, gonorrhea and chlamydia, the nurse or counselor would have asked you where we could contact you privately by phone or email. If you have a negative result, you will not be contacted. If you have a positive result, you will be contacted within 1-2 weeks after the procedure. If you have an infectionhe nurse will have to call in a prescription for you. If the nurse cannot reach you and call in the prescription, another nurse (Sexually Transmitted Infection nurse) will have to contact you, likely through a letter in the mail. If the pap exam indicates and abnormal result a nurse from the clinc will call to inform you.

Post-Abortion Check-up

You must visit a doctor 2 weeks after the abortion to make sure your body is back to normal. The doctor will ask you how you have been since the abortion and check your cervix and uterus. For the first couple of weeks, a pregnancy test will still have positive results, as your body is returning to its pre-pregnancy state. Please take the follow-up letter we gave you and ask the doctor (or you can) to mail or fax it back to us at 489-3379. Follow the instructions we have given you (see Preventing Infection above) until you visit your doctor.

Next Menstrual Period

When your next period comes will vary from woman to woman. However, you may be fertile as soon as 10 days after an abortion so use a condom if you have sex.

If you are using a type of hormonal birth control (such as the pill, the patch, or the ring) your next period will come within 3-4 weeks after starting it. If you are not using hormonal birth control, your next period will come between 4 and 8 weeks. Often the first period can be heavier and longer than your usual period. If you have not had a period by 8 weeks, please call us during work hours.

If you are using Depo Provera (the needle), you may not have bleeding right away or you may have frequent bouts of bleeding and spotting.

Birth Control

There are various methods of birth control. Each type works in a different way. If you were prescribed a type of birth control, you will have a prescription in your brown envelope. You can take this to a pharmacy to be filled and you will have to pay for it. You should also have a 2-3-page handout from our clinic with information about the specific birth control you will begin. You can also find more information on our web site at www.womanshealthoptions.com

In order for your hormonal birth control (the pill, patch, or ring) to be effective in a month, it should be started within 4 days of the abortion procedure. Use a condom for the first month if you have sex.

If you get Depo Provera (the needle) within 4 days of the procedure, it will be effective immediately. You will need to get the next injection between 10 and 12 weeks later. For more information about Depo or to get an automatic reminder call for your next injection, call 1-888-671-DEPO (3376).

Barrier methods, such as male condoms, with or without female barrier methods (Vaginal Contraceptive Film, other spermicides, sponge or diaphragm) should be used to prevent pregnancy until hormonal birth control has become effective.

If you have been given a prescription for an intrauterine device (IUD) also called, Nova-T or Mirena, you may return to the clinic for your two-week check-up and have it inserted.

If you and the counselor discussed using Fertility Awareness Methods (FAM) or having a tubal ligation or your partner having a vasectomy, you will have specific information about these methods in your brown envelope.

Whatever your choice of birth control, remember to have your post-abortion doctor check-up before having intercourse. At this visit you can review your birth control decision and ask the doctor for a prescription if needed. If you have any questions about birth control, and you live in Edmonton, you can call the Birth Control Centre at 780-735-0010. If you live outside of Edmonton, talk to your health care provider.

Final Reminder

The most important thing you can do for aftercare is pay attention to your body. If you have chills, fever (38.5 C or 100.4 F), heavy bleeding or severe cramping (not helped by suggestions here), call us at the clinic or on the 24-hour cell phone.

Before you call the clinic you should know:

1. Your temperature in the last hour

2. The number of sanitary napkins/pads you have used in the last hour

3. The phone number of your local pharmacy