Should I be worried about getting pregnant if I have sexual contact?

YES. You should be worried about getting pregnant if you are having sex so that sperm is in contact with your vagina and you are not using birth control.

Can I get pregnant while I’m having my period?

YES. You can get pregnant even when you are on your period or any time you have vaginal bleeding. For example, a woman can have vaginal bleeding when she is ovulating. It’s possible to get pregnant any time you have vaginal intercourse, so it’s important to use contraception EVERY time you have sex.

Females have eggs, males have sperm: Females have two small, grape-shaped ovaries inside their belly on either side of the uterus. You are born with ovaries and they are filled with hundreds of thousands of eggs. When you reach puberty, your ovaries make estrogen. Once a month your ovaries will release one of the ripened eggs. This is called ovulation.

Most guys have two testicles in their scrotum. Sperm is made inside of the testicles. Unlike females, who usually release only one egg per month, males can release thousands of sperm with each ejaculation.

What happens when an egg and sperm meet?

A male releases sperm when he ejaculates and a female releases an egg each month, during ovulation. It only takes one sperm to fertilize an egg. So, if an egg and sperm meet the fertilized egg travels down the fallopian tube and implants in the lining of the uterus. If this happens, a female becomes pregnant.

During the early stages of pregnancy, the fertilized egg is called an “embryo.” As the embryo gets older it is called a “fetus.” It takes about 9 months for a fertilized egg to develop into a full-term baby.

How do people get pregnant?

• You can get pregnant if you have intercourse and a male releases his sperm inside of your vagina.
• You can also get pregnant if the male removes his penis from your vagina before releasing his sperm. This is because the fluid that comes out of the penis before ejaculation may have leftover sperm (from a previous ejaculation).
• You can even become pregnant if you don’t have vaginal intercourse! This can happen if a male releases his sperm outside of your body near your vagina because sperm can find their way to an egg.

How is a pregnancy test done?

You can have either a urine or blood test done to check for pregnancy. These can be done at your health care provider’s office. You may also buy a home pregnancy test that you can do yourself. They cost about $4-$15 per test and are sold at many types of stores. They check for a certain hormone in your urine (HCG) and can pick up a positive reading even before a missed period, but you’ll need to know when your period was supposed to come.

How soon can I take a pregnancy test?

Although many home pregnancy tests claim to give positive results as early as the first day of a missed period, research shows it’s best to wait one week after your missed period. Talk to your health care provider about having a lab test (urine or blood), if you want to know sooner.

What should I do if I’m pregnant?

The most important thing to do if you think you are pregnant is to make an appointment with your health care provider. It’s very important for you to get medical care as soon as possible so you can have another pregnancy test and discuss your options with your provider. Start taking a multivitamin (if you weren’t already taking one) and make sure you don’t drink alcohol, take drugs, or smoke. If you become pregnant, you will have important decisions to make.

What will happen to my body if I get pregnant?

There are many changes that will happen inside your body if you become pregnant. You may feel very tired, extra hungry, and/or nauseous (feeling like you want to throw up). Your breasts may get bigger and feel tender, and you may have stomach pains like menstrual cramps.

Are teens more at risk for health problems?

• Pregnant teens have a greater chance of having health problems than adult women. This is true because they are still growing and have more nutritional needs, and they often wait longer than they should to get the prenatal care they need. Sometimes teens may smoke, drink alcohol, or use drugs (illegal, prescription, or over-the-the counter) and not know they are pregnant.
• Teens who become pregnant are at a higher risk than adult women for having complications including; health problems such as anemia, high blood pressure, diabetes, premature labor, social and emotional problems such as loss of support from parent(s)/guardian(s) or partner, depression and feelings of being alone, housing and money issues – unable to afford rent, buy things such as diapers, clothing, and food.

Will I have my period if I’m pregnant?

When you are pregnant the lining of your uterus does not break down, so you will not have your menstrual flow (your period). However, some pregnant women have “spotting” (bleeding which is lighter than a period). Sometimes this spotting is mistaken for a period, and you might not realize that you’re pregnant. Spotting sometimes happens for the first few months of a pregnancy. If you’re spotting and there’s a chance that you could be pregnant, it is very important to let your health care provider know!

Will I have morning sickness if I’m pregnant?

Morning sickness is the queasy feeling some women get when they are pregnant. Some women may throw up. However, not all pregnant women have morning sickness—some never get it. Pregnant women who do have morning sickness usually feel much better after the first trimester (first 3 months of pregnancy). Although people call this queasy feeling “morning sickness”, it can happen at any time of the day or night.

How do I tell my partner that I’m pregnant?

There’s no one answer to this question. How you tell the person who got you pregnant depends upon your relationship with him. Are you in a long-term relationship with him, or is it more casual?

Has the relationship been mutually respectful, or has it been abusive? Is he someone from whom you can get support, or are you not sure? Are you certain that he IS the person who got you pregnant?

If you feel you have good communication with him, you might find a quiet space and time to share your news and begin talking about whatever might be the next step. If, however, you and he do not communicate well or you feel at all unsafe, you may choose to tell him only when you have the support of an adult, or not at all.

How do I tell my parent(s) or guardian(s) about being pregnant?

If you are pregnant, it’s important for you to get health care as soon as possible so you can learn about your options. It’s best to get support from your parent(s), guardian(s), or another trusted adult. If you’re concerned about your safety, or afraid to tell your parents, you can first talk to an adult who you feel close to, or your health care provider. You can then decide whether you want the trusted adult or your health care provider to be with you when you tell them. You may decide to talk with your parent(s)/guardian(s) about making a decision about your pregnancy, or you may prefer to think about all your options first, and then talk with them.

What if I don’t want to tell my parents(s) or legal guardian(s) that I’m pregnant?

You have the right not to tell your parent(s) or legal guardian(s) that you are pregnant. Remember though, if you decide to continue the pregnancy, your parents will eventually find out. If you decide to have an abortion, talk with your health care provider about what the laws are in your state. Most parents are helpful and will help you think through your options and get you the medical care that you need.

What are my options if I have an unplanned pregnancy?

If you are confirmed to have a intrauterine pregnancy, you have 3 options:

1. Continue with the pregnancy and become a parent
2. Continue with the pregnancy and arrange a plan for adoption
3. Terminate (end) the pregnancy (abortion)

It might be helpful to begin by asking yourself the following questions:

• Are you ready to become a parent? Do you think that you are emotionally ready? Are you in good health?
• How will becoming a parent affect whether or not you will be able to finish high school or college?
• Can you reach your school and career goals while raising a child?
• Can you support a child? Do you have a job, health benefits, and a safe and stable place to live?
• What are your (and your family’s) beliefs about having a child?
• What are your (and your family’s) beliefs about having an abortion?
• Will you have the help and support of your parent(s) or guardian(s), siblings, and friends?
• Do you have housing? Can you live at home, or do you need shelter?
• Will your partner be involved? How much? Will he be able to help support you and your baby?
• Would you be able to handle all the responsibilities as a single parent?

How do I make a decision that I can live with?

It’s important to talk with a trusted adult and make a decision as early as possible. You may know right away what you want to do, or you may need time to figure it out. Often the decision comes from within. Although difficult, and often stressful, the final decision is up to you.

If you’ve decided to continue your pregnancy, it’s very important to make healthy choices.

• Make an appointment with your health care provider (HCP) and begin prenatal care early.
• Make sure you don’t drink alcohol or take drugs. If you smoke, quit right away.
• Talk with your HCP about what medicines are safe to take during your pregnancy. Be honest and tell your HCP if you have used drugs in the past or present. Be sure to tell your HCP about ANY medication you take, – including herbs or other over-the-counter dietary supplements, medicine for acne and recreational drugs. Certain drugs can cause birth defects.
• Take the prenatal vitamins that your HCP has prescribed. Ask about taking a vitamin D
• Talk to your guidance counselor at school about your pregnancy, and find out about ways you can attend classes and finish your education. Many schools have special programs for teen parents.
• Eat nutritious food. Teens need extra calories. While you are pregnant, you’ll need more calories from nutritious food to keep you and your baby strong and healthy. Your baby depends on you for food and water. Ask your HCP if you can meet with a dietitian (a person who is trained to give advice on how to eat a healthy diet).
• Stay active and keep moving. Unless your HCP has told you otherwise, you can participate in activities such as walking, running, swimming, dancing, etc. Exercise will keep your body strong and flexible, but avoid risky physical activities such as contact sports, downhill skiing, and amusement park rides.
• Drink plenty of fluids. Getting enough fluids is important for hydration. For your calcium needs, drink 3-4 cups of milk or calcium fortified soy beverage. Also, drink plenty of water, herbal tea or other nonalcoholic drinks until your urine is clear to pale yellow.
• Brush your teeth and floss after meals and take care of your gums every day.
• Rest whenever you can. Pregnancy takes a lot of energy! There will be times when you feel tired. Resting will help.
• Keep a journal or blog of your pregnancy; reflect on your thoughts and feelings.
• Stay away from chemicals that could be harmful to you or your baby, such as certain strong cleaning products, paint, hair dyes, and chemicals that straighten or perm hair. It’s a good idea to think about a low-maintenance hair style during your pregnancy that doesn’t involve the use of hair chemicals.
• Learn the early signs of labor so you know what to expect.
• Take a parenting class. Ask your HCP about teen parenting classes. You may want to check your school or local YWCA or YMCA for classes. Being proactive and learning about how to care for your baby before it is born will help you feel more in control and confident about being a good parent.
• Find out about resources such as WIC (Women, Infants and Children Programs, Healthy Start) options for completing your high school or college degree, childcare, and other resources.
• Stay positive. You’ll need to surround yourself with people who love and care about you. You’re going to need help during your pregnancy and when your baby is born. Try to limit your stress so you can be healthy mentally as well as physically.

Adoption

Adoption is one option for teens who are pregnant and not ready and/or unable to care for a child once it is born. There are several reasons why a teen may decide to give custody of their child to someone else, such as a relative or a loving family they may not know.

Some of these reasons might be that they:

• Are still in high school or college
• Have few financial resources
• Aren’t emotionally ready to be a parent right now
• Aren’t comfortable terminating the pregnancy (having an abortion)

How does adoption work?

There are different ways in which an adoption plan can be made, and this varies from state-to-state. Your health care provider can help with providing information about adoption agencies (private and public) or the name of a lawyer who specializes in adoption. Sometimes private adoptions (for example: having a relative take care of the child) are made possible by clergy or people in the community, or it can be done formally with a lawyer. Potential parents are carefully screened to make sure that a baby is placed in a loving and safe home. In some instances, the birth mother (the woman giving birth) meets with the soon-to-be (adoptive) parents beforehand; in some situations, the birth mother has on-going contact with the child and family (open adoption). In other situations, the birth mother knows some information about the family who is adopting their child but may choose not to meet them.

How does adoption work?

There are different ways in which an adoption plan can be made, and this varies from state-to-state. Your health care provider can help with providing information about adoption agencies (private and public) or the name of a lawyer who specializes in adoption. Sometimes private adoptions (for example: having a relative take care of the child) are made possible by clergy or people in the community, or it can be done formally with a lawyer. Potential parents are carefully screened to make sure that a baby is placed in a loving and safe home. In some instances, the birth mother (the woman giving birth) meets with the soon-to-be (adoptive) parents beforehand; in some situations, the birth mother has on-going contact with the child and family (open adoption). In other situations, the birth mother knows some information about the family who is adopting their child but may choose not to meet them.

How do I know adoption is the right choice for me and the baby?

It is important to know and feel that you are making the best decision you can. Take your time and explore your resources and options. You should feel comfortable with the process and with the information about the adoptive parents, both before the baby is born and afterwards.

Here are some questions to think about:

• What kind of parents do I want to raise my baby?
• Is religion, ethnicity, or race important?
• Do I want to meet the adoptive parents?
• Are the adoptive parents able to provide an emotionally and financially stable environment?
• How much contact do I want with the baby and adoptive parents afterwards?
• Does the agency I have chosen help with my health care, transportation and other expenses while I am pregnant?
• Will I have any time with my baby after the birth? For how long?

I’ve decided to make an adoption plan. How do I explain to people who are curious or disagree with my decision?

You do not owe anyone an explanation for your decision. Being a parent is a life-long commitment and if you are not able to make it at this time, placing your child for adoption is a responsible and loving decision.

What if I change my mind and decide that I want to raise the baby?

Just as committing to an adoption plan was a serious decision, so is changing your mind. If after very careful thought, a consultation with trusted adults in your life you feel you have made a mistake, you may be able to stop the adoption process. The laws from state-to-state are all different, but all states require a waiting period between the time a child is transferred to another family and when the adoption becomes legal. Check with the agency or lawyer that originally helped with the adoption process.

What is an open adoption?

An open adoption is one in which the birth mother (and father if involved) have regular contact with the child and his/her adoptive parents. Your adoption agency can tell you more about the pros and cons of having an open adoption. This is a personal decision and there is no right or wrong way to do this.

What if I want to hear about the child as he/she grows up?

In many instances birth mothers and adoptive parents (who are not in an open adoption situation) have contact over the years on a schedule suggested by the adoption agency. For instance, pictures of the child may be sent to you every year around the child’s birthday or on a holiday. You can also ask for the birth parent to write a note each year about the child’s milestones, successes, likes, and dislikes. As part of the adoption process you can decide upon the type and amount of contact you would like to maintain with the child and the adoptive family.

What if I want to write a letter to the child after he/she is adopted?

Birth mothers (and fathers if they are involved) are encouraged to write a letter to the child who is adopted.

These letters can include:

• Your reasons for choosing adoption
• Some details about yourself (likes/dislikes, hobbies, talents)
• Some details about your family
• Your wishes and hopes for the child as he/she grows up

Typically, this letter is sealed, given to the adoptive parents or agency but not given to the child until he or she is a teenager or young adult. Other than this, communication with the child as they are growing up is part of the adoption process. You will talk about this and work this out with the adoption agency before the baby is born.

 Abortion

Many youth have questions about pregnancy and abortion.  If you have just found out that you are pregnant, you may feel overwhelmed, sad, happy, or unsure about options and next steps. You may be worried about who to talk to. In some places around the world, abortion is legal and safe, and in other locations, abortion is illegal and/or not easily available. This guide will give you accurate information on your options, depending upon how many weeks pregnant you are, whether you have any special health conditions, and where you live.  It can be helpful to talk with a trusted adult (parent, guardian, guidance counselor, etc.) about your situation and receive support in making your best decision.

If you are confirmed to have a normal intrauterine pregnancy, you may have three options:

• Continue the pregnancy and become a parent
• Continue the pregnancy and develop an adoption plan
• End the pregnancy and have an abortion

What kind of abortion is right for me?

There are two types of abortion:

• Medical abortion ( “abortion pill”)
• In-clinic or “surgical abortion.”
• The type of abortion you choose may depend on how far along the pregnancy is, how much support you have at home, your medical history, and your preference. The “right one” for you is the safest one! It’s important to talk with your provider about which type of abortion is the right one for you.

What is a medical abortion?

Medication abortion is using prescribed medicines to have an abortion up to 70 days (10 weeks) in pregnancy, which is similar to a miscarriage, at home.  It is both safe and effective, and it works 91-98% of the time. It is usually a multi-step process which requires close follow-up.

The first medicine, mifepristone, works by blocking progesterone, a hormone in your body needed to support pregnancy.  This is the medicine that starts the abortion.  Usually people don’t have side effects to this medicine, but it is normal if you experience some nausea.  If you vomit within 30 minutes of taking the mifepristone, call your provider right away, you may need to take the pill again.

The second medicine, misoprostol, is used at home between 12 and 48 hours later.  Misoprostol causes the uterus to cramp and the cervix to open.  This step causes cramping and bleeding, which ranges from being like a “regular period” to heavy with large clots.  The heaviest bleeding can last several hours, and you may have irregular bleeding for a few weeks after that.  During the abortion, you may experience nausea, vomiting, diarrhea, and a mild fever (up to 100.4 F).

The medication abortion can take several hours, so make sure you have a safe place to pass the pregnancy, access to a bathroom, and the support of someone who can help you (such as a parent or guardian).

You will need to follow up with your provider to make sure that the abortion worked.  This can be done either with blood work or an ultrasound.

Is the medical abortion safe?

While the medication abortion is considered very safe, there are risks with any procedure.  Some of them could be infection, hemorrhage (heavy bleeding that is unsafe), or allergic reaction.

It is also possible that the abortion will not be effective; sometimes the abortion is not complete (when there is pregnancy tissue still in the uterus), or will not work at all.  While this is uncommon, it is not impossible, so it’s really important to go to your follow-up appointment with your abortion provider as recommended.  If the medication abortion does not work or is incomplete, sometimes the in-clinic abortion procedure is needed to complete the abortion.

You should not take the abortion pill if:

• You are not sure that you want to terminate the pregnancy
• You are more than 10 weeks pregnant
• You don’t plan on taking the 2nd dose, or if you’re not sure you can take the second dose of medicine
• You can’t keep your follow-up appointment with your abortion provider
• You do not have a phone
• You do not have a safe place to pass the pregnancy
• You don’t have someone who can be with you when you take the misoprostol pills at home
• You have certain blood disorders (such as a bleeding disorder, or have a clotting problem and are on blood thinners)
• You have an IUD (intrauterine birth control device) in place. You will need to have this removed before having a medical abortion.

What is an In-clinic or surgical abortion?

An in-clinic/surgical abortion is a procedure that terminates a pregnancy.  Although most abortions are performed in the first trimester (up to 12 weeks), each state has different laws about how far along a pregnancy can be to have an abortion.  The in-clinic abortion is about 99% effective. A health care provider usually performs the procedure in an out-patient office, clinic, or hospital.

What happens with an In-clinic or surgical abortion?

In most cases, the procedure itself usually takes less than 10 minutes (not counting the prep time and recovery time which is a total of a couple of hours). Basically, gentle suction is used to remove the pregnancy from the uterus. Here’s how it is done:

1. First, relaxation and pain medicines are given.
2. Next, the cervix is numbed. Once numb, a thin tube is inserted into the vagina, through the cervix and into the uterus.
3. The tube is then attached to a special vacuum. When the suction is turned on, the pregnancy tissue is removed. Sometimes tissue is also removed with another medical instrument called a “curette”.
4. Afterwards, the health care provider will usually prescribe an antibiotic.
5. You will rest in the recovery room for about 20-60 minutes.

Is it safe to have a surgical abortion?

Yes. An abortion is typically a safe and routine procedure. Before abortion became legal in the US, there were no regulations to ensure a safe standard-of-care. Illegal abortions were expensive, painful, and there was a high risk of infection because of unclean conditions and lack of follow-up care. Now, abortions in the U.S. are performed in safe, clean offices with a staff of medical professionals who also provide counseling and after-care.

Although complications with a routine abortion are rare, risks include infection, hemorrhage, damage to organs (cervix, uterus), or an incomplete abortion.  If you are experiencing any of these symptoms after your abortion, call your provider right away:

• Heavy bleeding (soaking a pad in < 1 hour, for more than 1 hour)
• Fever (temperature of 100.4 or above)
• Severe pelvic/belly pain that does not go away with medicines
• Vaginal discharge that smells foul and looks abnormal
• Pregnancy symptoms that are not going away

Some people worry about seeing protesters at the clinic.  Many clinics have excellent security and escorts to walk you into the building and keep you safe.

Where can I get an abortion?

• Ask your healthcare provider for a list of names
• Go to your state’s NARAL website for a list of clinics
• Call your local Planned Parenthood

There are some facilities that may seem like they provide abortions, but actually do not; their mission is to keep you from getting an abortion.  So make sure you do your research and check whether the clinic you have chosen is giving you the counseling and access to abortion and contraception services that you want.  

How much does an abortion cost?

Many health insurances cover abortion. If you’re not sure, ask when you book your appointment and double check with your insurance company by calling the number on the back of the card.

If your insurance does not cover abortion, check the National Network of Abortion Funds to see how they can help.

The price of the abortion may vary depending on many factors (where you live, how far along the pregnancy is, sedation, transportation, etc).  Ask when you call to book your appointment.

How can I make this decision?

Sometimes the decision to have an abortion can be difficult, and sometimes it isn’t. It really depends on the person.  Many people find it helpful to talk to a trusted adult (a parent, guardian, counselor, a nurse or a primary care provider) about your options.  No matter what you decide, you have the right to accurate information and judgment-free support.

Some factors that people think about when they become pregnant are their living situation, support from their partner, family or friends, education or career plans, religious beliefs, and their financial situation…the list could go on and on!  

Does my partner in the pregnancy have any say in this decision?

Some people choose to tell the person with whom they became pregnant that they are considering an abortion and some do not; it really depends on the person and the situation. Although some people think it is helpful to tell their partner, it should always be YOUR decision about how to move forward with the pregnancy. The same is true of friends or relatives. 

Do my parents have any say in my decision to have an abortion?

Parents can be very helpful in your decision about what’s best for you. Some teens feel comfortable and safe talking with a parent or guardian, others do not.

If you are under 18 years old, some states require your parents/guardian to be involved with giving permission, or you can seek judicial bypass (permission from the court) instead of notifying a parent/guardian. No one can force you to have an abortion.

Check the to see what your state requires.

Will I be able to get pregnant and have children in the future if I have an abortion?

Yes. The best ways to protect your future fertility is to avoid getting sexually transmitted infections (STIs) such as chlamydia and gonorrhea by not having sex and/or using condoms every time you have sex.  It is also very important to talk with the clinic before the abortion  about what kind of contraception you’d like to start after your abortion.  For a list of options, click here.

How can I deal with people who tell me they do not believe in abortions and are angry with me for thinking about having one?

Abortion can be an emotional topic for some people. Both those who support abortion rights and those who don’t believe in abortion often feel strongly about their beliefs, and some conversations may feel very uncomfortable. You can say that they have the right to their opinion; however, you also have the right to your opinion and your decision.

If you’ve decided to continue your pregnancy, it’s very important to make healthy choices.

• Make an appointment with your health care provider and begin prenatal care early.
• Make sure you don’t drink alcohol or take drugs. If you smoke, quit right away.
• Talk with your health care provider (HCP) about what medicines are safe to take during your pregnancy. Be honest and tell your HCP if you have used or abused drugs in the past or present. Be sure to tell your HCP about ANY medication you take – including herbs, over-the-counter medicine, medicine for acne, and recreational drugs. Certain drugs can cause birth defects.
• Take the prenatal vitamins that your HCP has prescribed. Ask about also taking a vitamin D supplement.
• Talk to your guidance counselor at school about your pregnancy, and find out about ways you can attend classes and finish your education. Many schools have special programs for teen parents.
• Eat nutritious food. Teens need extra calories. While you are pregnant, you’ll need more calories from nutritious food to keep you and your baby strong and healthy. Your baby depends on you for food and water. Ask your HCP if you can meet with a dietitian (a person who is trained to give advice on how to eat a healthy diet).
• Stay active and keep moving. Unless your HCP has told you otherwise, you can participate in activities such as walking, running, swimming, dancing, etc. Exercise will keep your body strong and flexible, but avoid risky physical activities such as contact sports, downhill skiing, and amusement park rides.
• Drink plenty of fluids– Getting enough fluids is important for hydration. For your calcium needs, drink 3-4 cups of milk or calcium fortified soy beverage. Also, drink plenty of water, herbal tea or other nonalcoholic drinks until your urine is clear to pale yellow.
• Brush your teeth and floss after meals and take care of your gums every day.
• Rest whenever you can. Pregnancy takes a lot of energy! There will be times when you feel tired. Resting will help.
• Continue to use condoms while having sex during the pregnancy. Using condoms will help protect you from STIs that can be harmful to both you and your baby.
• Keep a journal or blog of your pregnancy; reflect on your thoughts and feelings.
• Stay away from chemicals that could be harmful to you or your baby, such as certain strong cleaning products, paint, hair dyes, and chemicals that straighten or perm hair. It’s a good idea to think about a low-maintenance hair style during your pregnancy that doesn’t involve the use of hair chemicals.
• Learn the early signs of labor so you know what to expect.
• Take a parenting class. Ask your HCP about teen parenting classes. You may want to check your school or local YWCA or YMCA for classes. Being proactive and learning about how to take care of your baby before it’s born will help you feel more in control and confident about being a good parent.
• Find out about resources such as WIC (Women, Infants and Children Programs), Healthy Start, options for completing your high school or college degree, and childcare options.
• Stay positive. You’ll need to surround yourself with people who love and care about you. You’re going to need help during your pregnancy and when your baby is born. Try to limit your stress so you can be healthy mentally as well as physically

Normal pregnancy: A normal pregnancy occurs when a fertilized egg implants inside of the uterus. The fertilized egg continues to grow developing into a fetus.

Ectopic pregnancy: An ectopic pregnancy happens when a fertilized egg implants outside of the uterus. An ectopic pregnancy can occur in the ovary, abdomen, cervix or fallopian tube, but more than 95% of the time it occurs in the tube. That’s why an ectopic pregnancy is often considered the same thing as a “tubal pregnancy”.

Tubal pregnancy: A tubal pregnancy occurs after the fertilized egg implants in the fallopian tube and begins to develop. The egg, however, cannot survive outside of the uterus because it will not get the nutrients it needs, nor have enough room (in the tube) to grow.

What are the symptoms of an ectopic pregnancy?

The early symptoms of an ectopic pregnancy are the same as a normal pregnancy, such as a missed period, breast tenderness, and sometimes, nausea. Some women may not experience early symptoms or “warning signs.”

Symptoms of an ectopic pregnancy may include:

• Vaginal bleeding (usually light at first, then bleeding often becomes heavier)
• Cramping and pain in the lower abdomen or belly

Later symptoms of an ectopic pregnancy may include:

• Severe belly pain
• Heavy vaginal bleeding
• Lightheadedness
• Dizziness

Who is at risk for an ectopic pregnancy?

Any female can have an ectopic pregnancy, but certain conditions can put you at a higher risk.

These conditions include:

• Previous ectopic pregnancy
• Pelvic infections in the past (such as chlamydia and gonorrhea) that may have caused scarring of the fallopian tubes
• Scarring of the fallopian tube(s) from past surgery

Can a fertilized egg survive outside of the uterus?

Very rarely but in general a fertilized egg cannot live outside of the uterus. It needs space to grow and a source of nourishment.

What are the types of treatment for ectopic pregnancy?

The type of treatment depends on the location of the pregnancy and your preference. A medicine called Methotrexate may be given as several injections.  This medicine works by stopping the egg from growing and dissolving the cells. Methotrexate is more successfully when an ectopic pregnancy is diagnosed earlier, but it does require follow-up blood draws afterwards to ensure the pregnancy has been successfully treated. Alternatively, surgery is another option and may be done through small incisions (laparoscopy). Surgery may be recommended especially if the fallopian tube has burst and resulted in bleeding.

Females are born with two fallopian tubes. If one is damaged or removed, the other tube should function normally.

Miscarriage

A normal pregnancy takes about 38 weeks for the fertilized egg to develop into a fetus, then a full-term baby. However, there are times when the fertilized egg doesn’t continue to grow and the pregnancy is lost. An early pregnancy loss (before 20 weeks) is called a miscarriage. Sometimes a miscarriage happens before a teen or woman even knows she’s pregnant, and there is usually nothing that she did to cause it. Having a miscarriage is upsetting. It will take time to heal both physically and emotionally.

What is the medical term for miscarriage?

The medical term for miscarriage is “spontaneous abortion”, but it’s not the same thing as a therapeutic or planned abortion. A spontaneous abortion is when a pregnancy ends “spontaneously”, unexpectedly, or suddenly. There are different reasons why this happens, but most often the reason is unknown.

What causes miscarriage?

There can be different reasons that a pregnancy will end suddenly. Most of the time miscarriage happens because the fertilized egg or fetus is not growing or developing normally. If the fetus doesn’t form and the pregnancy tissue does not grow, this is called a “blighted ovum”.

What is a blighted ovum?

A blighted ovum is a fertilized egg that has a placenta but no embryo. The fertilized egg attaches itself to the inside of the uterus. The sac develops, but since there is no embryo, the pregnancy cannot continue.

What happens when the fetus stops growing?

If the fetus stops growing (early fetal demise) then there will be a miscarriage. The fetus is usually very small and if the tissue is passed it doesn’t look like a fetus.

What are other reasons for an early miscarriage or blighted ovum?

• Most often the cause of a blighted ovum is unknown and will not occur again
• Genetic factors such as a problem with the chromosomes (genes) of the fetus
• Molar pregnancy also called GTD (gestational trophoblastic disease)

What does NOT cause miscarriage?

We know that normal activity, regular exercise, and most jobs do not cause miscarriage. There is also no proof that having sex will cause miscarriage.

Who is at risk for having a miscarriage?

Anyone can have a miscarriage, but a teen or woman is at a higher risk if she has one or more of the following conditions or behaviors:

• Infection of the uterus (womb) or fetus
• Health problems such as uncontrolled diabetes
• Problems with the uterus (abnormal shape)
• Problems with the cervix (second or third trimester)
• Smoking
• Abuse of drugs or alcohol

What are the symptoms of miscarriage?

Bleeding is the most common symptom of miscarriage; however, some teens/women can have light bleeding during the first few months of pregnancy without problems. This may seem confusing. It may be helpful to think of the following symptoms as “warning signs” and a reason to call your health care provider.

Warning signs of miscarriage:

• Vaginal spotting or bleeding
• Cramps
• Fluid that suddenly gushes from the vagina
• Thick bleeding (blood clots/tissue) from the vagina – call your health care provider right away!

What will happen if I have to go to the hospital?

You will likely need to have a pelvic exam to see if your cervix has dilated (opened) and/or a pelvic ultrasound.

If your cervix has dilated, it’s likely that you’ve had a complete or partial miscarriage. If your health care provider feels that you have had a “complete” miscarriage, after you have been examined, you may not need to have a procedure. Sometimes the tissue doesn’t completely come out of the uterus (partial miscarriage). If this happens, you may need to have a routine procedure called a D & E.

If you are RH (D) negative, ask your provider if you need to be given a special medicine called “immune globulin.”

What is a D & E?

A “D & E” is short for dilation and evacuation. This procedure can be done in a health care provider’s office or an emergency room under local anesthesia (numbing medicine), or in an operating room at a hospital (under general anesthesia – while you are asleep). The cervix may need to be dilated (widened) and then any tissue left behind is removed.

What happens after a miscarriage?

After a miscarriage you will have some vaginal bleeding, but it shouldn’t be heavy. You may also have mild cramping in your abdomen (belly). This happens because your uterus (womb) is tightening and getting smaller (back to the shape and size it was before you got pregnant). You will need to see your health care provider for a follow-up appointment in a couple of weeks for a routine check-up or sooner if you have any of the following problems.

Call your health care provider right away if you have:

• Heavy vaginal bleeding
• Fever and/or chills
• Severe pain in your belly

Your health care provider will give you specific instructions about how long you should stay home and rest, and when it is safe to be physically and sexually active.

Can I get pregnant after a miscarriage?

If you got pregnant once, you know that you are “fertile” (you ovulate and can get pregnant). It’s important to know that you can ovulate (make eggs) as early as 2 weeks after having a miscarriage. This means you can get pregnant right away if you are sexually active and you don’t use birth control. If you don’t want to become pregnant, talk to your health care provider about birth control.

Why do I feel so sad?

Whether or not your pregnancy was planned, it’s normal to feel sad when you find out that you have miscarried. Some of the feelings are due to the changes in hormones that come with pregnancy and miscarriage. You may experience a range of emotions from feeling relieved to being sad and upset.