Ask Dr. Joan: Am I still pregnant after an aspiration abortion?

Sunday, October 9th, 2011 by Dr Joan F.

Question: I had to have an aspiration abortion 4 weeks ago and was still getting strong symptoms 2 weeks later which I thought was normal. I took a pregnancy test at week 3 and it still registered as being pregnant. Week 4 I took one and it is showing not pregnant.  The same week I had a gush of fluid like my water breaking and 2 days later passed what looked like mucous plug. I am not sure if this is normal or not. I honestly still feel pregnant. I have horrible heart burn which I have only ever had during pregnancy.  I have had full term pregnancy before and so I know what it feels like.  I don’t want to be worried over nothing but I also have not started my period yet.  Michelle

Answer:  Dear Michelle,

A pregnancy test should be negative 3-4 weeks after an aspiration abortion.  It depends on how early you were when you had the procedure.  I’m concerned that the pregnancy test was positive at week three.  Just make sure to repeat the pregnancy test.  If it is negative again, you can feel secure that the pregnancy is over.  Sometimes it takes a while for the pregnancy symptoms to disappear.  Wait another week.  If your pregnancy symptoms are getting worse, you should see a doctor. 

As far as the “mucous plug” it’s hard to tell without seeing it.  It is common to pass clots after any kind of abortion, and sometimes these clots contain some “decidua” – the tissue that forms inside the uterus to prepare for the early pregnancy.  It’s also possible that you passed the actual pregnancy “sac” (membrane that forms in early pregnancy).  In this case the doctor may have missed removing all of the tissue.  The sac does appear like mucous.  This would also explain why the pregnancy test was delayed in turning negative.  Either way, it doesn’t sound abnormal, and there is nothing to be concerned about.

There is no concern about that fact that you haven’t gotten your period yet.  It’s common to have a delayed period, especially since your pregnancy test was positive.  I have seen it take 2-3 months to return to normal. 

I hope this is helpful,

Doctor Joan