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Understanding Pregnancy After Medical Abortion: Risks & Considerations


Question
QUESTION: Hi,

 I had a medical abortion on January 18th, and my boyfriend and I are planning on having sex again February 6th. Is the chance of getting pregnant then high? If I do get pregnant, is my lining going to be thick enough to sustain a pregnancy?

Thank you!
Aubrey

ANSWER: Hello, Aubrey,

You're welcome.

Do you WANT to get pregnant? If not, you should plan to stop having sex. Otherwise, you will eventually face the same situation again. If you do want to, I can't tell you for sure that your lining will be thick enough. This depends on how YOUR body is reacting to the abortion, what your hormones are like. The only person who can answer such a question would be a doctor who can examine you and test your hormones.

Are you still bleeding? You should not have sex as long as you are bleeding, either, because of the danger of infection. But it doesn't really sound like you're really ready to have a child, since you just have a boyfriend. Let me know what you are trying to accomplish. If you learn to tell when you are fertile, that will also be a partial answer as to whether or not you might be able to conceive on the 6th.

Please take care of yourself. Abortion is dangerous. Those pills can kill you. You really deserve better. Let me know how things go.

---------- FOLLOW-UP ----------

QUESTION: Yes, I want to get pregnant. The reason for abortion was because it was unplanned, and certain medications I was taking had a high risk for birth defects.

No, I'm not bleeding. Maybe a drop of "spotting" which is brown.

I read online that people are most fertile after an abortion/miscarriage. Is this true?
Is there a chance I could get pregnant on the 6th?
If I was to try, when should I take a test that would be accurate?

Thanks so much!

ANSWER: Hello, Aubrey,

You're welcome.

Unfortunately, having an abortion can also cause birth defects, so we will hope for the best. Pharmaceutical companies tend to exaggerate the possibility of birth defects as much as possible to avoid legal liability if a woman has a baby with a defect as a result of taking medication. I think that's why a good many women who don't have an abortion go on to have a normal child. It's not that there isn't a danger. It's that nobody seems to know how to calculate the probabilities.

I don't think anybody knows if a woman is "most fertile" right after an abortion or miscarriage. I would tend to think it is the opposite. Here's how I see it. A miscarriage is caused by either a defect in the baby, or because the woman's hormones are too low. It may be that a woman will be more fertile after a miscarriage, but given the mechanism involved, I think it would be about the same. I think the myth happens because women who have an abortion and get pregnant right away again talk about it. As for after an abortion, I think it is LESS likely a woman will get pregnant within the next three to four weeks. This is because it takes awhile for pregnancy hormones to decrease, and high pregnancy hormones could keep a woman from having the right hormonal balance to produce fertile mucus and stimulate ovulation.

A woman generally starts her period 14 days before her next menstrual period will start. A pregnancy test tends to work reliably about a week after the period is due, although some are more sensitive. If you are able to tell when you are fertile, that will give you an idea of when to try, and if you keep track of when you had sex, you can first test three weeks after that date. Obviously, if you have sex more than once, any sex you had later in that 3 week period won't show up with that first test. What you might want to do is test weekly from now on for awhile, and see if the test shows a fainter positive at first, and then shows a better positive later. The fainter positive would be the result of the hormones from your pregnancy declining. But it might be a good way to keep track.

I hope for the best for you. Please take care. Let me know what happens.

---------- FOLLOW-UP ----------

QUESTION: Hi, I went for a check up U/S today, and everything passed and it all looks good.
I was prescribed birth control pills, and told I am very fertile right now.
I took a pregnancy test, and it was a faint positive. So I guess all the hormones aren't yet.
Do your hCG levels have to be 0 in order to get pregnant or ovulate?

Answer
Hello, Aubrey,

A woman's hCG levels are never zero. They are very low when she is not pregnant. If you WANT to get pregnant, you should not take birth control pills. I don't know why they gave you the prescription since that is what you want to do. Just ignore it.

Take care.