Pregnancy Scares
by Sara Twogood, MD
Sex and the City Season 1, episode 10
The crew ends up in Connecticut for the baby shower of one of their old friends – an ex-party girl who they never imagined as a suburban mom.
In the midst of all this baby and mom talk, Carrie misses her period. She starts wondering if she’s next, if the party was a preview into a life she wasn’t sure wanted.
Samantha, in all her wisdom: “Oh honey, gray area. Sure, you are in front of the firing squad. But you haven’t been shot.”
Pregnancy scares are nothing new and can cause mental havoc.
But the worry that any sexual encounter could lead to a pregnancy scare is just not accurate or helpful. One of top negative medical messages is that anytime you have sex you will get pregnant. That you have sex just once and you can get pregnant. Better to avoid sex altogether because otherwise you will get pregnant. This is not a healthy message for a life of sex positivity!
(We talk about the medical and other types of messaging that can lead to low libido in our Sexual Wellness Course.)
The concern for an unplanned, undesired pregnancy can lead to a type of fear mongering for younger women – I get this, because responsibility that comes with sex is huge, needs to be taken seriously, and the trauma / life altering impact of an undesired pregnancy (regardless of the outcome) can be avoided.
But the medical inaccuracy of this message leads to a distortion of trying to conceive later in life. I can’t tell you how many times patients have come to me worried they are infertile because they never accidentally got pregnant.
Let’s clear this up with some evidence.
Can you get pregnant any time you have sex?
There are actually only 6-7 days each cycle that a female is fertile. To get pregnant, the ovulated egg needs to attach to a sperm inside the female reproductive system. That egg and sperm join together, forming a blastocyst that travels from the uterine (fallopian) tube to the uterus, where it implants and starts growing into an embryo / fetus / baby.
Only 1 egg is ovulated each month (rarely 2; this is when twins come into play).
Once ovulation occurs, that egg stays viable for up to 24 hours. If a sperm is waiting or comes into the female reproductive tract (through sex) while that egg is viable, a pregnancy can occur. And sperm can live inside the female reproductive tract for up to 5 days.
All this means: having unprotected sex up to 5 days before ovulation may result in a pregnancy. And because the egg can stay viable up to 24 hours, having sex up to 24 hours after ovulation may result in a pregnancy. That’s how we get the 6-7 days fertile window.
The problem is human error.
Our bodies are not robotic and ovulation can be erratic and hard to predict. Ovulation is most erratic in teens and early 20s. Even for people trying to monitor ovulation - our ovulation prediction techniques are pretty good … but not perfect. Many times, unexpected pregnancy is because ovulation occurred differently than expected and someone had unprotected sex too close to the date of ovulation. And, unfortunately, the way someone realizes their error is either their period is off later that month (and give thanks they didn’t accidentally get pregnant) or they get pregnant and realize too late their timing was off.
P.S Here is an article with ovulation prediction techniques!
Now what about this statement:
Have sex just once and you will get pregnant.
This is true … but unlikely. But the chances of getting pregnant after 1 episode of sex are related to age, with younger age being the most fertile.
I’ve always loved this study - showing the chances of pregnancy on the MOST FERTILE CYCLE DAY based on age.
Ages 19-26 years old: 50%
27-34 years old: 40%
35-39 years old: 30%
All this to say …
In general, the younger someone is, the more irregular their ovulation, the more fertile they are around ovulation, the less consistent they are with contraception, the less likely they are actively trying to conceive … the MORE likely they are to have an unplanned, undesired pregnancy. This leads to a need for education and support for this younger group of females. They need good, comprehensive medical care, including abortion support.
They do NOT need negative medical messaging, fear mongering, or limits to health care which can segue into a lifetime of the opposite of sex positivity and confidence.