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Pregnancy Bliss | Reproductive Health Hub

Conception despite using morning-after pill

Question:  Hi. Thanx for the help. I got pregnant last time after taking the morning after pill(p2). What could have caused it or what made it not work? AT THE 7TH month the baby died in the womb,the doctor told me its due to placental abruption so am still wondering what happened? Would be glad if you help me understand. M. (UK)

Answer: There are two issues here and it is really important that we separate them because they are definitely not related. Even though it is very effective, the morning after pill does not always work. I gather from your information you used the so-called ‘Plan B’ preparation.  Plan B is composed of two progesterone hormone (Levonorgestrel) tablets which should be taken within 72 hours of the unprotected sex act. The sooner you take it after, the more effective it is. This is the same as the morning-after pill marketed in the UK under the brand name Levonelle®. It appears you were one of those where it did not work. The hormone found in these pills is completely safe for the baby should a pregnancy ensue. There is therefore no connection between your using this and the  tragic outcome of your pregnancy. Emergency contraception has been discussed in more detail here:

The placental abruption that occurred leading to the loss of your baby was probably a random event. Most such cases are. There are factors which increase the risk of placental abruption in any pregnancy but presence of these is an exception rather than the rule. You will find those discussed in the relevant section here: I do hope you will be able to come to terms with all that has happened and be able to move forward. It is indeed the case that many such pregnancy complications have no obvious explanations. That may very well be the case with you.

Trying to conceive after a missed miscarriage

Question: Please, what are the steps, or what does one need to take for quick conception after flushing a missed abortion foetus? O.U.P  (Nigeria)

Answer: You do not need to do anything special or take any medication. Following any miscarriage, including a missed miscarriage, as long as all products of conception have been evacuated from the womb, ovulation will resume within 2 - 4 weeks. A woman should therefore expect her periods to resume within four to six weeks of having a complete miscarriage. Once the normal cycles resume, such a woman’s chances of conception are back to where they were before she conceive first time. There is absolutely no need to take hormones or any other form of medication. It is probably worthwhile to await the first period (post-miscarriage) before trying so as to be sure where you are in the menstrual cycles. A longer wait is not necessary.

Sterilisation at caesarean section

Question:  Can I be sterilised when I have my caesarean next month or should I wait and do it later? Can it be done at the same time or is that dangerous.  K. (UK)

Answer: Sterilisation at the time of a planned caesarean section is done all the time and is a routine procedure. It is technically easy, it is quick and it is effective as a form of permanent contraception. Remember that last bit: it is permanent. You should therefore be sure that you have definitely completed your family before embarking upon this. Just let your doctor know well in advance so the standard counselling can be done. If you spring this on your doctors on the day of your planned caesarean section they will regard it as an impulsive decision and are most likely going to refuse to do it.

Have PCOS; difficulty conceiving

Question:  I have polycystic ovaries (PCOS) but my periods are regular. I have been trying to conceive for over 15 months now and I have been  checking BBT and results indicate that I am ovulating. What could be the reason why I am not conceiving? T.A. (New Zealand)

Answer: The problem of sub-fertility that appear to go hand in hand with polycystic ovarian syndrome (PCOS) is not clearly understood. It is certainly the case that many women with signifinant PCOS have a readily identifiable problem of erratic ovulation. For such women, administration of ovulation induction medication such as Clomiphene (Clomid) is the obvious thing to do. However, there is strong evidence that lack of regular ovulation is not the only problem causing sub-fertility for women with PCOS. Other factors which remain largely obscure appear to be at play also. Another issue in your particular case is your apparent reliance on measuring basal body temperature (BBT) to determine ovulation.

Though useful, BBT is far from reliable. You should therefore look at getting a blood test for levels of progesterone in the luteal phase of your menstrual cycle. That is a much mre reliable way of checking whether you are indeed ovulating. Your regular cycles would suggest that you probably are. If the blood tests results also support this, it may be time to see a fertility specialist for appropriate targeted investigations on the cause of your apparent subfertility. The PCOS may turn out to be a red herring!

Methane exposure for breast-feeding mothers.

Question:  Breast feeding mothers working underground on the coal mine and exposed to methane gas what are side effects or dangers to their babies? F.M. (South Africa)

Answer: That is a tricky question to answer. It is true that when a breast-feeding woman has prolonged exposure to methane, that finds its way into her circulation and is excreted in breast milk. Prolonged exposure to methane is known to have a deleterious effect on the nervous system. It is logical to assume that babies, when subjected to that exposure have a potential to be adversely affected as they are much more susceptible to noxious compounds. However, there is a lot of conjecture here. It all depends on the level and length of that exposure. Having those parameters assessed is a reasonable and I would say essential workplace safety measure.

Light vaginal bleeding at 12 weeks pregnant

Addendum:  i am 12 weeks pregnant and having a light bleeding... i cannot go to doctor or any there any home remedy for this??please answer me as soon as possible.. I'll b grateful.. A. (UK)

Answer: OK, this sound like threatened miscarriage. As a rule, there is nothing that needs to be done in threatened miscarriage as you cannot influence what happens eventually. The bleeding does eventually stop but unfortunately for 1 in 10, this sort of development is a prelude to pregnancy loss. If this was going to happen, nothing can be done to change the course of events. I am, however, a little concerned about your comment that you cannot go to a doctor or any hospital. I would not want to pry as for the reasons for this but this suggests to me that you probably have not even had a booking scan and therefore do not have the basic information about your pregnancy. Information such as confirmation of the gestation, number of babies, viability etc. If that is the case< I would strongly urge you to find a way of getting medical attention. My best wishes.