QuestionQUESTION: Hi Jean. I had a surgical abortion on June 1. I was 14 weeks along. I started on birth control pills on the following Sunday after the surgery. I had unprotected sex on June 15 and did a home pregnancy test the day after that and it came back positive. I still haven't got my period yet ever since the abortion. Is this normal? Is it possible that this is a new pregnancy? After the abortion, I bled for only about a week. No cramping. I need to know if it'd be unsafe/risky for me to have a second abortion. Would that also affect my fertility in the future? Thank you Jean.
ANSWER: Hi Chris,
If you have been taking birth control pills since the 3rd of June (the Sunday after the surgery), then it's extremely unlikely that you are pregnant again. The obvious explanation for the positive home pregnancy test is that the hormones from your terminated pregnancy are still in your body.
Immediately following conception, your body begins to manufacture human chorionic gonadotropin (hCG), the "pregnancy hormone". This hormone hangs around in your body for a long time after the pregnancy has been terminated by an abortion or a miscarriage - up to six months. Because of this hormone still being present in your body, you may experience one or more of the following symptoms of pregnancy for 2-4 months after the abortion:
1. Missed periods
2. Morning sickness
3. Tender, swollen breasts
4. Frequent urination
5. Fatigue and/or headaches
6. Moodswings
7. Slight bleeding or cramping
8. Food cravings and/or aversions
9. Raised basal body temperature
10. False positive result on a home pregnancy test
So I really don't think you have anything to worry about.
In case I misread your message and you only started taking the birth control pills on the 10th of June and not the third, I still don't think the chances are very high that you are pregnanct again. Five days is usually enough for the pill to have its effect (though doctors recommend 7 days to be on the safe side), and though in theory it is possible that you ovulated exactly two weeks after your abortion, most women (80% or so) ovulate between 3-6 weeks after an abortion. Of course, in this case, the chances of you being pregnant again are higher than if you started your pill on the 3rd, but it's really very unlikely.
Another possibility is that your previous pregnancy was not properly terminated, and is still continuing. However, if you had a follow-up appointment two weeks after your procedure, this would have been obvious to your doctor and you'd know about it. If you didn't go for your post-op checkup two weeks later, then please do so immediately. It's really important to check that there were no complications from your abortion, like an infection or uterine damage, and that your cervix is fully closed. (If your cervix is not fully closed, you shouldn't be having vaginal sex, or putting anything in your vagina, or even swimming or taking baths, as that may allow water to seep into your vagina. There is a high risk of serious infection if this happens.)
The last and least likely possibility is that you really are pregnant again. The only way you can know for sure is to go for a blood test. I'd advise you to wait 2-3 weeks and take the HPT again. Keep taking your birth control on schedule, and try not to worry too much.
In case you are pregnant again and you want to have another abortion, it will not be risky, especially if you go for the procedure early. If your abortion is carried out by an experienced physician in a proper clinic, it is an extremely safe procedure - three times safer than having your tonsils taken out. The chances, for example, that your uterus is perforated is less than one in a million. In fact, a previous childbirth is much more likely to endanger future pregnancies than a safe, uncomplication abortion especially if it was early-term.
Multiple abortions are probably more common than you think. 45% of women seeking abortions have had at least one abortion in the past. There are many studies that show that safe, uncomplicated abortions do not affect your ability to have a child in the future.
In future pregnancies, abortions do not
* cause birth defects
* cause premature birth or low infant birth weight
* make ectopic (not in the uterus) pregnancy more likely
* make miscarriage more likely
* make the risk of infant death more likely
This does not mean that abortions are GOOD for your reproductive health - it is very important to try and prevent abortions by consistently using contraceptives.
Hope this helps. Get in touch again if you have any more questions.
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QUESTION: Thank you very much for your quick informative reply. I did start the pills on the 3rd of June. I called the abortion clinic today and they told me that it is not normal if the pregnancy test still came back positive after 3 weeks. Is this just a misinformation you think? Today I noticed that I had a spotting. Could this be from the pills? When should I expect to get my period again? Thanks again Jean.
ANSWER: It's impossible to predict when you'll get your next period so soon after an abortion. Mine was 10 days late the first time, 4 days early the next, 6 days late after that, and only then it got back to normal.
That spotting could be your period! It's common to experience extremely light, spotty periods after an abortion. At least you can take heart that it isn't implantation bleeding, because that only happens 2 weeks after fertilization, and you had sex just 1 week and 2 days ago.
Your doctor's clinic is quite wrong if they tell you it's not normal to get a positive pregnancy test result at this point. I'm not a medical professional, but I know because I personally experienced this 5 weeks after my abortion when I was scared out of my mind that I was pregnant again because I was feeling nauseous and fatigued and had all my pregnancy symptoms back. I took two tests and both were positive, and I nearly died from shock. :) But it turned out to be nothing after all, just hormones that hadn't cleared out from my body. False positives are extremely uncommon in HPTs - false negatives are much more common. It was therefore safe to assume, since I took TWO tests, that it wasn't the test malfunctioning, but the hormones in my body that caused the positive results.
Did you have a follow-up appointment two weeks after your abortion? Did your doctor say that your pregnancy was fully terminated? If so, please don't worry any more - I don't know why your doctor's office would tell you the positive test was not normal. It's so so SO very unlikely that you could be pregnant again, given the timing of when you had sex, and especially when you have been taking the BC pill all the while.
If you want, you can go and get a blood test just for peace of mind. But honestly, Chris, I wouldn't worry if I were you.
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QUESTION: I actually talked to the nurse and I have to agree with you that she was quite wrong. I have been browsing all over the internet about this subject and they all say the same thing you told me...that it is not uncommon for the pregnancy test to still say positive even after a few weeks. I have an appointment with a family practice doctor this coming Thursday and am hoping that they can examine me. I'm planning on telling them about my concerns but I'm not sure whether or not they're going to be judgmental. Thank you so much for your help. You make me feel better already!
ANSWER: Hello, Chris, I looked it up, and you can report your doctor to your state's medical board (just do a Google search for "(State name) Medical Board") for any improper conduct (trying to tell you it was wrong to get an abortion, making judgemental comments, making you feel uncomfortable about having had an abortion, refusing to treat you because you have had an abortion, etc).
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Actually doctors and nurses are required by law to be non judgemental and not comment on your choice to have an abortion, no matter what state you are in. Even if they have moral, religious or ethical objections, all they can do (in some states) is refuse to treat you, and in most states even that isn't possible. If your doctor makes a comment judging you, you can report them to the authorities. I need to look up which authorities exactly, I'll let you know tomorrow.
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QUESTION: I took another pregnancy test yesterday and it still came back positive. I notice that my breasts are getting a little bigger again. I remember that the next morning after I had the unprotected sex, I took my pill 2 hours later than the usual time I normally take it. Could this make me pregnant? I am now worried again. Thank you.
AnswerChris,
I still don't think it is likely that you are pregnant. It's common to continue experiencing pregnancy symptoms after an abortion.
Let's calculate the possibility of you being pregnant, OK?
The Pill has a 99.7% effectivity rate over the course of one year when you take it without skipping days (a 2 hour delay is no problem at all). (http://www.ncbi.nlm.nih.gov/sites/entrez?cmd=Retrieve&db=pubmed&dopt=Abstract&li)
Let's forget about spreading the risk over one whole year and say that the entire risk of failure is in the first month itself. So the chance that the Pill failed and you ovulated as per normal is 0.3%.
Now the percentage of women who ovulate exactly two weeks after a second trimester abortion (yours was past 12 weeks, which makes it second trimester) is only 8% (more than 60% ovulate four weeks after the abortion, more than 75% ovulate within 6 weeks after the procedure).
The probability of becoming pregnant if you have sex on the day you ovulate (or one or two days before the day of ovulation, which are the days with the highest chance of pregnancy) is 36%. (http://findarticles.com/p/articles/mi_qa3634/is_199605/ai_n8751656)
So if you are pregnant, the Pill must have failed AND you must have been ovulating around two weeks after a second trimester abortion AND you must have become pregnant when you had sex while ovulating. You put a multiplication sign wherever you see "AND" when calculating the final probability. Which gives us:
(0.3%)*(8%)*(36%)
= 0.00864% chance that you are pregnant, which is approximately an 11,600 to 1 chance.
I don't have to tell you that's a VERY small probability.
If you are really worried, go ahead and make an appointment with your doctor to take a blood test to confirm whether or not you are really pregnant. That should set your mind at ease.
