Understanding Postpartum Bleeding & Fertility After Birth Control

Question
I AM 24 YEARS OLD, I HAVE A FOUR YEAR OLD SON. ME AND MY HUSBAND HAVE BEEN TRYING TO HAVE ANOTHER BABY, I WAS ON BIRTH CONTROL FOR ABOUT THREE YEARS I CAME OFF BIRTH CONTROL ABOUT SEVEN MONTHS AGO. SINCE THEN EVERY MONTH AT THE BEGINNING OF MY CYCLE I WOULD FIRST SPOT A DARK BROWN COLOR FOR ABOUT FOUR DAYS THEN MY REGULAR CYCLE WOULD BEGIN. THE FIRST DAY OF MY LAST NORMAL MENSTRUAL CYCLE WAS OCTOBER 9,2006. ON NOVEMBER 9, 2006 I SPOTTED BROWN ONE TIME, THE NEXT DAY I SPOTTED BROWN ONCE OR TWICE, THE THIRD DAY NO SPOTTING OR BLEEDING. SO I TOOK A PREGNANCY TEST ON NOVEMBER 12, 2006 IT WAS POSITIVE. I HAVE TAKEN TWO OTHER TEST SINCE THEN THEY WERE BOTH POSITIVE AS WELL. I HAVE HAD A LITTLE NAUSEA IN THE MORNING, BUT NO VOMITTING. MY BREAST HAVE BEEN TENDER ALSO. HOWEVER, I SPOTTED BROWN SLIGHTLY TWO DAYS AGO, TODAY IS THE THIRD DAY, IT HAS ONLY BEEN SLIGHTLY ALL THREE DAYS NOW. TODAY I WAS CURIOUS SO I WENT TO VISIT WITH MY GYN. SHE PERFORMED A PAP SMEAR AND CHECKED MY CERVIX. SHE SAID EVERYTHING APPEARED TO BE FINE, THERE WAS A LITTLE BROWN BUT NO RED BLOOD. SHE ALSO DID AN TRANSVAGINAL ULTRASOUND AND SAW ONLY A SAC. SHE SAID EITHER I HAVE AN EARLY PREGNANCY OR I HAVE MISCARRIED. I HAVE NOT HAD ANY CRAMPING, BACK PAIN, OR ANYTHING OUT OF THE ORDINARY, JUST THE BROWN SPOTTING. MAY I PLEASE HAVE YOUR OPINION ON THIS SITUATION? AND HOW FAR ALONG DO YOU THINK I AM, WITH MY DESCRIPTION?

Answer
Dear Christy,

Just coming off of vacation today - hope you have not waited much more than 24 hours.

From the dates you have given me, you more than likely conceived toward the end of October. If I use 10/9 as your LMP, that would put your estimated date of conception at approximately 10/26 (based on a 30 day cycle - I used 10/9-11/9 as model). So, you'd be about 6 weeks 6 days today.

If you actually are that far along, the gestational sac should have been about 16-17mm in diameter and a yolk sac should have been able to be seen within the gestational sac at this point. However, with the spotting you've had, a true conception date is somewhat in question. I assume that your doctor is planning a follow-up ultrasound in a few weeks?

My suggestion is, for right now if you are continuing to have pregnancy symptoms and there is no bright red bleeding with tissue/clots and no severe cramping, then I'd just take it as it goes.

I hope this has helped you and answered your question. Please don't hesitate to write again if you have further question. I hope you and yours have a Merry Christmas!

Brenda