Post-Abortion Pregnancy Risks and Emergency Contraception

Emergency contraception pregnancy test?

Doctor, I would like to ask a question.
I found out I was pregnant on May 2nd, took an oral abortion on May 4th, and was supposed to see the doctor on May 19th but didn’t go until May 23rd.
The obstetrician said the bleeding might not be sufficient, so we considered it as my period for May, which lasted from May 22nd to May 26th, and then I stopped bleeding.
After that, I had intercourse with my boyfriend on June 6th.
We used a condom, but it accidentally slipped off.
We were worried about the possibility of ejaculation inside, so we immediately bought and took a single dose of emergency contraception.
However, my period, which was due on June 19th, has not arrived.
I bought a pregnancy test two days ago, and it showed negative.
Before taking the oral abortion, my menstrual cycle was very regular, approximately 28 days, and my period lasted about 5-6 days.
I would like to ask the doctor if I could still be pregnant.

Jīnyú, 20~29 year old female. Ask Date: 2017/06/19

Dr. Huang Jianzhong reply Obstetrics and Gynecology

I discovered I was pregnant on May 2nd and took an oral abortion on May 4th.
I was supposed to see the doctor on May 19th but didn't go until May 23rd.
The obstetrician said that the bleeding might not be controlled, so we treated it as my period for May, which lasted from May 22nd to May 26th, after which I stopped bleeding.
I had sexual intercourse with my boyfriend on June 6th; we used a condom, but it accidentally slipped off.
We were worried about the possibility of ejaculation inside, so we immediately bought and took an emergency contraceptive pill (one pill).
However, my period was due on June 19th, but it did not arrive.
Two days ago, I bought a pregnancy test, which showed a negative result.
Before taking the oral abortion, my menstrual cycle was very regular, approximately 28 days, and my periods typically lasted about 5-6 days.
I would like to ask the doctor if I could still be pregnant.
Answer: Check again with a pregnancy test on June 26th.

Reply Date: 2017/06/19

More Info

Understanding the complexities of post-abortion pregnancy risks and the use of emergency contraception is crucial for anyone navigating these situations. Based on the information provided, it appears that you experienced a medical abortion on May 4, followed by a period of monitoring and sexual activity. You then took emergency contraception after a condom failure on June 6, and you are now concerned about the possibility of pregnancy given that your expected menstrual period on June 19 did not occur.

First, let's clarify the timeline. After your abortion, it is common for menstrual cycles to be irregular for a short period. The hormonal changes and physical recovery from the procedure can affect the timing of your next period. It is important to note that even if your cycles were regular before, they may take some time to normalize after an abortion.

Regarding the use of emergency contraception (EC), such as the one you took after the condom failure, it is designed to prevent pregnancy primarily by delaying ovulation. If taken within 72 hours of unprotected intercourse, it can significantly reduce the risk of pregnancy. However, its effectiveness diminishes the longer you wait to take it after the incident. Since you took the EC shortly after the condom slipped, you maximized your chances of preventing pregnancy.

Now, concerning your missed period on June 19, there are a few possibilities to consider:
1. Hormonal Fluctuations: After an abortion, it is not unusual for your menstrual cycle to be delayed or altered. The hormonal changes from the abortion and the emergency contraception can both contribute to this irregularity.

2. Pregnancy: While the emergency contraception is effective, it is not 100% guaranteed. If ovulation occurred shortly before the condom failure, there is still a possibility of pregnancy. However, since you tested negative for pregnancy with a home pregnancy test, it is likely that you are not pregnant. Home pregnancy tests are generally reliable when taken after a missed period, but they can sometimes yield false negatives, especially if taken too early.

3. Stress and Lifestyle Factors: Stress, changes in routine, or other lifestyle factors can also impact your menstrual cycle. If you are feeling anxious about the situation, this could potentially delay your period.

Given these factors, if your period does not arrive within a week or two, it would be advisable to consult with a healthcare provider for further evaluation. They may recommend a blood test to confirm pregnancy or assess other potential causes for the missed period.

In terms of future pregnancies, if you are planning to conceive after this experience, it is generally recommended to wait until you have had at least one normal menstrual cycle before trying to conceive again. This allows your body to recover and can help in accurately dating a new pregnancy.

Lastly, regarding the risks associated with emergency contraception and its effects on future pregnancies, research indicates that emergency contraceptive pills do not have long-term effects on fertility or the health of future pregnancies. They are safe to use and do not pose a risk to a developing fetus if pregnancy occurs after taking them.

In summary, while the situation can be concerning, it is essential to monitor your body and consult with a healthcare provider if you have any ongoing concerns. They can provide personalized advice and support based on your specific circumstances.

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