Brief Answer:
Seems to be a normal period, expected to be heavy right after D and C.

Detailed Answer:
Hello,

Thanks for writing to us with your health concern.

I would be glad to assist you with this query.

Yes, it is possible for your cycles to resume a month after the D and C.
It generally takes 4 - 6 weeks for your periods to resume.
It is also normal to expect a heavier than normal period after the D and C.
When a D and C is done following a miscarriage, the interior of the uterus (womb) is scraped thoroughly to remove all the products of conception.
Whatever gets left behind is shed off with the subsequent period.

That said, you should be aware of what else this bleeding could be.
It could be actually some retained products of conception, significant amounts, which are left behind inspite of the D and C.

When present in substantial amount, they can lead to heavy bleeding with cramping and infection later on.

This does not seem to be the case with you, because there are no other ominous symptoms - pain, cramping, a foul smelling discharge, bits and pieces of flesh and dark clots in the blood.

It is fine to have a longer than average period, and then again to also spot for a few more days.
It can take upto 3 months for your menstrual cycle to stabilize and normalize.

You should be taking good iron supplements to avoid getting anaemic, and also should be making sure you are using some kind of contraception to avoid falling pregnant inadvertently during this period.

Sexual activity and gradual exercise can be resumed 6 weeks after your D and C.

Now for your last question - when should you be seeing your doctor ?
You should be seeing your doctor -
1. As a routine visit 15 days after your D and C to have an ultrasound scan of the uterus to check that the procedure was complete and nothing got left behind.
2. If this bleeding does not subside even after a week, or keeps getting heavier, or you develop any of the sinister symptoms that I listed above.
3. If you need detailed contraceptive guidance ( since post menstrual phase is the best time to start a new method of contraception ).
4. If the heavy bleeding recurs again next month too, and is much heavier than usual.

I hope this answered all your queries.
Please feel free to discuss further.
Just as a matter of caution, I wish to add my two bits here about the miscarriage.
It is quite unfortunate that you had it.
Was cervical incompetence properly diagnosed and established as the sole reason for the miscarriage ?
Was this your first pregnancy ?

Take care.

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Brief Answer:
Investigations suggested.

Detailed Answer:
Hello again XXXXXXX
Thank you for the update.
Well, it does sound like cervical incompetence was the reason for the miscarriage.
It is unfortunately, am glad you overcame this sad event.
I think that you need to go through some investigations, both for irregular cycles and for the miscarriage, before you embark upon a pregnancy again.
Right now, there is no need to get concerned about the heavy bleeding.
As I said, it is a natural phenomenon to bleed heavily the first time after a miscarriage.
If you have any accompanying features of retained products ( the ones I listed ) , then you need to have a repeat pelvic ultrasound scan to check .
Otherwise, you need to take iron supplements for 3 months, and then go for the following investigations -
1. HSG ( XXXXXXX test of uterus and tubes ) to confirm cervical incompetence.
2. Karyotyping ( chromosomal testing ) of the aborted fetus was an essential investigation to rule out any genetic abnormality in the baby. I hope that was done. Karyotyping for both you and your husband also should be done.
3. I also assume your blood pressure, weight, height are within normal limits.
4. Hormonal tests ( for irregular cycles ) - FSH, LH, TSH, Prolactin, OGTT ( oral glucose tolerance test to rule out diabetes ), Lipid Profile.
5. Testing for antiphospholipid antibodies ( important cause of miscarriage ) - APA, ACA, LAC, aPTT, ANA, Serum homocysteine.
This set will suffice.
You should start folic acid 5 mg per day 3 months before planning the next pregnancy.
A stitch to tighten the cervix should be placed at 12 - 14 weeks itself next time if the diagnosis of cervical incompetence is confirmed.
Take care.

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