Concerns After Abortion: Risks of Condom Failure and Emergency Contraception

The condom broke after having intercourse following an abortion?

Hello, doctor.
I apologize for the lengthy message.
On December 18, 2015, I took RU486.
During my follow-up appointment, the doctor said that the embryo had been expelled but there were still some small blood clots remaining.
Consequently, I underwent a surgical cleanup on January 1, 2016.
On that day, I had unprotected intercourse with withdrawal.
Then, on January 7, I had another encounter where the condom broke.
I noticed it felt unusual and realized the condom had broken, but there was no ejaculation inside; I only knew that the male pre-ejaculate fluid contained sperm.
On January 11, while using a condom, it unfortunately broke again! At the critical moment, it broke, and although he withdrew immediately, he had already ejaculated inside.
I quickly went out to buy emergency contraception.
Is there a chance I could be pregnant? I asked the obstetrician-gynecologist I consulted, and he only mentioned that my period might arrive in early February and advised me to start counting from the 25th.
I found online articles stating that the counting should start from the day I took the medication.
I also asked about my concerns, but the doctor just said that January 1 was not a problem and then hung up the phone.
His attitude made my boyfriend and me even more anxious! Additionally, I’m concerned that taking the emergency contraceptive may have an effect.
Will taking the emergency contraceptive cause my period to be delayed or come earlier? Thank you for your patience in reading this!

Ginnie, 20~29 year old female. Ask Date: 2016/01/13

Dr. Tian Yiwen reply Obstetrics and Gynecology

Without proper contraception, there is a possibility of pregnancy.
Emergency contraception taken within 24 hours has an effectiveness of about 80-90%.
However, since you did not take it on January 7th, it is recommended to take a pregnancy test about 2-3 weeks after the last sexual intercourse if your period does not arrive.
Taking emergency contraception can cause a delay or an advance in your menstrual cycle.

Additionally, if you frequently engage in sexual activity, it is advisable for women to use long-term hormonal contraceptives (which are the most effective) along with male condoms (to prevent sexually transmitted infections) to protect both themselves and their partners.
Relying on methods such as tracking safe periods, withdrawal, or using condoms alone are not appropriate contraceptive measures.

Frequent use of emergency contraception can lead to menstrual irregularities and should only be used as a last resort.
It is not recommended for regular use.
By practicing effective pre-coital contraception, you can avoid the anxiety that comes after each sexual encounter.
Multiple abortions can harm your body and may even lead to infertility in the future.
Please take good care of yourself.

Reply Date: 2016/01/13

More Info

After an abortion, many women experience a range of concerns, particularly regarding the risks of unintended pregnancy due to contraceptive failures and the use of emergency contraception. Your situation involves a series of contraceptive mishaps, including condom failures and the use of emergency contraception (EC), which understandably raises anxiety about the possibility of becoming pregnant again shortly after an abortion.

Firstly, it is important to understand how emergency contraception works. EC, such as the pill you took, is most effective when taken as soon as possible after unprotected intercourse. It primarily works by delaying ovulation, preventing fertilization, or preventing a fertilized egg from implanting in the uterus. However, if ovulation has already occurred, EC may not be effective. The timing of your sexual encounters in relation to your ovulation cycle is crucial in determining the likelihood of pregnancy.

Regarding your specific timeline, since you had an abortion on January 1 and had unprotected intercourse shortly thereafter, the risk of pregnancy would depend on whether you ovulated during that time. If you were still within the window of time where ovulation could occur, there is a possibility of pregnancy. The fact that you took EC after the last incident of unprotected intercourse is a positive step, as it can significantly reduce the risk of pregnancy if taken promptly.

As for the effects of taking emergency contraception on your menstrual cycle, it is common for EC to cause changes in your menstrual pattern. Some women may experience an earlier or delayed onset of their next period, and the flow may be lighter or heavier than usual. It is not uncommon for the next period to be irregular after taking EC, which can add to your anxiety. If your period does not arrive within a week of when you expect it, it is advisable to take a pregnancy test to confirm whether or not you are pregnant.

In terms of your concerns about the abortion and subsequent sexual activity, it is essential to consult with a healthcare provider who can offer guidance tailored to your situation. They can provide reassurance and help you understand your options for contraception moving forward. It is also important to discuss any physical symptoms you may be experiencing post-abortion, such as unusual bleeding or pain, as these could indicate complications that need to be addressed.

In conclusion, while the risk of pregnancy exists given the circumstances you've described, taking emergency contraception was a proactive measure. Monitor your menstrual cycle closely, and if you have any concerns or if your period is significantly delayed, seek medical advice. Establishing a reliable contraceptive method moving forward can help alleviate anxiety about unintended pregnancies in the future. Remember, open communication with your healthcare provider is key to navigating these concerns effectively.

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