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Pregnancy Bliss | Reproductive Health Hub

Contact Answers In the News Hot Topics

Effect of abortion on future fertility

Question:  I was wondering if it is possible for you to answer a question for me. 7 weeks ago i had an abortion because i felt a child would not be right for me and my partner at this time in my life. I am 22 and i have just graduated. However, as soon as i had it done i regretted it, so me and my partner (who is 28) are trying again, and have begun having unprotected sex.

I was wondering if my chances of getting pregnant are reduced? According to the dates, last time, i got pregnant within three weeks of us first sleeping together. However, after the abortion i got a pelvic infection for which i took antibiotics. since finishing those antibiotics, i have had no symptoms of anything, everything seems back to normal and I’ve had a perfectly normal period which ended five weeks ago.

I would just be interested to learn the likelihood of me getting pregnant again, considering the fact i have had an abortion , a pelvic infection, and been on antibiotics. Thank you for your help. C. (UK)

Answer: From your detailed explanation I cannot see how your conception potential would be reduced. Pregnancy termination, like a spontaneous miscarriage, does not influence your future fertility at all. You would normally start ovulating within 4 - 6 weeks  (sometimes earlier) of either and that means, from that point on, you could conceive. The fact that you conceived within three weeks of having unprotected sex last time  is less important than you may be tempted to believe. Second time around could be quite different. Many factors come into play for a successful conception and your previous experience should never be a yardstick for what might happen in the future.

Infection complicating pregnancy termination or miscarriage tends to be confined to the womb. It is what is called endometritis. In contrast to sexually transmitted infections (STIs), this type of infection does not usually extend to the pelvis or other pelvic organs such as the fallopian tubes. Endometritis, unlike tubal infection, does not leave any residual damage and the healing is almost always complete.

All in all, my view is that your ability to conceive is as it has always been.

Prolonged use of contraception and future miscarriage

Question: Can a miscarriage be caused by taking any type birth control for a long period of time. Such as five years or longer?  L. (USA)

Answer: No, there is absolutely no risk with any contraceptive having a residual effect that might lead to a miscarriage. Once you start ovulating, the effect of the contraceptive is finished and cannot influence what happens after that. This remains the case whatever duration the contraceptive method was used for.

Duration of second stage of labour

Question:  What is the recommendation duration for second stage of labour in a primigravida? L.M. (Zambia)

Answer: There is no such thing as a recommended second stage duration. We talk about a reasonable duration. This also needs to be individualised. Any second stage lasting more than three hours is regarded as prolonged. In most cases, this stage will last no more than 2 hours, quite frequently much shorter than that.

Fibroids in pregnancy

Question: I am 16 weeks pregnant and the doctor has told me that i have a fibroid right on my placenta. What effects can be there to my my baby and during delivery and what am i supposed to do? L.S. (UK)

Answer: The placenta being attached in the location of a fibroid is in itself of little clinical significance. What might be significant is the size of the fibroid, where the fibroid is located within the uterus and whether it is within the uterine cavity, the so-called submucosal fibroid. Since I do not have this information, I am unable to give specific advice directed at your particular case.

What I can say is that, when a fibroid or fibroids are within the uterine cavity, they tend to cause distortion of this space. That may have the effect of making the baby lie in an abnormal position. This, in turn, will make it difficult or impossible to achieve a vaginal delivery. Caesarean section becomes inevitable. In addition, even when this is not the case, fibroids can prevent the uterus from contracting effectively during labour, again increasing the risk of caesarean section.

You cannot do anything to influence the effects of a fibroid in pregnancy mentioned above, nor can your doctors for that matter.

Pregnancy not seen on ultrasound

Question: I had light bleeding and abdominal cramps.  Went to emergency room because had not had my appointment with ob/gyn yet.  Had blood test and was proven to be pregnant but when ultrasound was preformed baby was not in fallopian tubes but could not be found in the womb either.  was told to go to my appointment which I have 4 days from now and they would do another blood test to determine if I am still pregnant.  What are chances that I have not miscarried. I am having problems waiting to find out. D.M. (USA)

Answer: It is indeed the case that with such results the suggested waiting is inevitable. I take it the blood test was to check the levels of the pregnancy hormone (beta-hCG). The follow-up test will be to ensure it is rising as expected in a normal viable pregnancy. If you are having a miscarriage, the hormone level will be found to be falling, sometimes quite steeply. In an ectopic pregnancy that is still viable, there may be a rise but it tends to be much more modest than you will see in a normal pregnancy. There is really no short-cut for this. Remember, an ectopic pregnancy cannot be entirely ruled out by an ultrasound scan and with your earlier findings that is still a possibility.

STD and stillbirth

Question:  Can stillbirths be caused by std, and at what stage of the pregnancy can it happen? T. (Australia)

Answer: The commonest sexually transmitted infections including gonorrhoea, chlamydia, HPV and herpes do NOT cause stillbirth. The exception is syphilis which, though increasingly rare, is associated with significant levels of stillbirth. This can occur at any stage of pregnancy.

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