Expert: Pat G - 8/29/2009

Question
QUESTION: I had a surgical abortion on July 24th.

The pregnancy was due to contraception fail, not due to unprotected sex. I always try to be extremely careful and responsible. I'm 28 years old, and have a 12-year-old daughter whom I love, but since her birth have always been more cautious in regards to birth control.

After I realized I was pregnant I discontinued use of the birth control pill, until we came to a decision together and had the procedure.

During the time before the abortion, we only had sex a couple times, but one of these times was the night before the abortion, since I was already pregnant we believed there was no need for protection.

Immediately after completion of the abortion the clinic said they performed an ultrasound (I was still under anesthesia, so I don't remember this personally) to check if the uterus was clear.

I only bled the day of the procedure, and it was not a large amount of blood, and I've had no spotting or bleeding of any kind since then.

About a week afterward, I had some unusual cramping patterns, and the doctor was concerned and asked me to come back in, which I did. They performed an internal ultrasound, and said everything looked fine, and that the cramping would eventually pass (which it did).

We have not had sex again after the procedure, other than oral, knowing that there was a higher risk of another impregnation. I've tried to be responsible in this regard, and I've also tried to be well informed, as this is the hardest decision I've ever had to make or go through.

It's now five weeks since my last period, and I've *never* had a cycle (on or off the pill) that was not 28 days apart on the dot. I'm extremely regular.

Now I know I've read that your period can be irregular after an abortion, and that missed/late periods alone are not cause for concern. I was told since we've not had unprotected sex after the procedure (being that we haven't had sex at all) that I should be fine.

However, (I searched this forum for an answer but could not find any questions that was similar enough to my situation to specifically answer this question) so, I wanted to ask, is there a *chance* -however small- that due to the unprotected sex we had when I was still pregnant (and off the pill) immediately before the abortion, that the sperm inside could have fertilized another egg which could have implanted itself again afterward. I'm extremely paranoid and worried right now... the pregnancy test came out positive and I was under the impression that my hormones from the last pregnancy would have returned to normal levels by now so it would not result in a "False Positive" due to the previous, aborted pregnancy.

Please help.

I'm especially concerned because aside from the home pregnancy test I just took being positive, I'm also having pregnancy symptoms again. I did not think there was any way I could be pregnant since we haven't had sex after the procedure, unless there's the slight chance that the sex we had the night before would have been able to cause this.

(Sorry this is so long, but I wanted to give as much information as possible.)

ANSWER: Hi, Stella,

I am glad you wrote a long message, because it gives me more to go on.

There are some things you didn't tell me, such as how far along you were. These things are important.

In answer to your basic question, yes, there is a *chance* that you come become pregnant while you already were. I know this because it happened to me! It also happened to the mother of a friend of mine. She had a twin sister who was conceived two months before she was. However, in most cases, if this happens, a woman never learns about it because there will be abnormalities and the doctor will operate, and any evidence of such a strange situation is eliminated. In general, however, I wouldn't consider it the most likely possibility.

There are a couple of other things I need to tell you. Oral sex is a very bad idea. It can lead to cancer of the mouth, throat, etc., and it can pass on nasty sexually transmitted diseases. Any kind of penetration of the body can do this, by the way. The other thing I need to tell you is that as long as you have vaginal sex at all, or allow his organ to get near your cervix, pregnancy is possible, no matter how many precautions you take. The only way to be truly safe is not to have that type of sex at all. The next most reliable method is fertility detection. In order to practice this method, you have to chart faithfully, and you can't be using any hormones at all. For more information, go here:

http://www.fertilityuk.org/

Since a woman's period will normally come 14 days after ovulation day, the week before the expected period would be relatively safe.

Did you observe any fertile mucus at the time you had sex the day before the abortion. I did while I was pregnant, but didn't think anything of it because I was already pregnant. However, that's when I got pregnant the second time. The first baby didn't live, but the second baby is now in his 30's, and very healthy. He has two children of his own.

What is more likely is that your hormones are simply whacked out. Abortion itself disrupts the hormones. Taking birth control also messes them up. A positive pregnancy test for awhile afterwards is common. So are menstrual irregularities. You can no longer say you are regular, given the facts you have presented. And yet another possibility is that you are still pregnant with the same child. It is possible that the abortionist missed the baby. Ultrasound won't always show anything. If you weren't very far along, that's even likely.

One thing they COULD have done is tested the viability of your pregnancy. If your hormone levels weren't high enough, then you would have had a miscarriage eventually. Then you wouldn't have had to undergo an abortion to produce the results you sought. That's part of what happened with me. My pregnancy wasn't viable. That's why I produced fertile mucus and conceived again.

I hope this helps. Keep trying to find out what is happening. You might want to have a doctor test your hormones a couple of times. Don't go back to the person who did the abortion. Go to someone else. Please let me know what you find out.

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

QUESTION: Thank you for all the information.

As far as the bit I left out, I'm sorry, I forgot.

The pregnancy was ended very early, I was only about six weeks into the pregnancy. The nurse who did the pre-procedure ultrasound verified this, and added that it was about 4 weeks from conception.

As to any fertile mucus when we had sex before the abortion, I honestly don't recall.

Thank you again for your advice and helpful/informative answer, I will see about visiting another doctor at this point as you suggested, to find out for sure one way or another.

Answer
Hi, Stella,

You're welcome.

At that point in pregnancy, an ultrasound might well miss seeing the baby. Although the baby is already well formed, he or she is still quite tiny, no longer than a person's thumb. At five weeks, which is only a week later, you still might miss seeing the baby. So there is a chance you are still pregnant with the original baby. The fact you bled so little does suggest that as a possibility.

I'm not surprised that you didn't notice the mucus, but I thought I'd ask anyway.

If you are having emotional difficulties, feel free to discuss them with me. I have handled this as well.

Let me know how you do. Take care.