I took the first abortion pill but did not get the bleed. Why?

Hello,

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It is really a very short description of your concern. It would be better if you would send me your detailed gynecological, menstrual, obstetric, medical and other histories. Which pill have you taken and how much dose? Had you confirmed your pregnancy status before having the pill? If not, have serum beta hCG (blood pregnancy test) to have a clear idea about your pregnancy. On which date have you taken the pill and what was your last period date? If pregnancy is confirmed and it is early pregnancy, emergency contraceptive pills give withdrawal bleed but if already few weeks pregnancy it needs proper dosage to have induced miscarriage. Kindly send me your details so that I can guide you.

In case of a positive pregnancy test, check again the level of beta hCG after 48 hours from the previous test. It will give us a clear idea about pregnancy progression or the effect of the pill on it as well. If the second level comes less than the previous it is a miscarriage. If the second level shows increase more than 60 % then it is a normal growing pregnancy. If the second level shows less than 60 % increase it is alarming and you need a transvaginal scan to exclude pregnancy outside the uterus (ectopic pregnancy). In case of pain, bleeding, dizziness with a positive pregnancy test, better to report to a tertiary care unit.