Brief Answer: Do not worry there are ways to know this Detailed Answer: Hi, Thanks for choosing health care magic. I understand your query. Please do not get stressed. There is always a solution. For now, I must say that chances of pregnancy are highest for you between day 12-20 of your cycle for a 28-30 days cycle. So the sexual episode during this time is more likely to cause pregnancy. Pulling out and is not the safest way. Next choice acts by making the cervical mucus thick and not allowing sperms to enter, preventing or delaying ovulation, preventing the implantation of the baby if fertilization occurs. If ovulation and sperm entry have already occurred, plan B may fail. Meaning that if pregnancy has already occurred, it will fail. Having said this, it also prevents ovulation. If ovulation occurs later after stopping plan B, then there is a chance that you conceived form the second act. The best way to sort things out would be to do an transvaginal ultrasonography at 5 weeks of pregnancy counting from your last menstrual period. If a pregnancy of 5 weeks is seen, it most likely resulted form the sex at regular ovulation time, if it is smaller or it is not seen as it it too small, it may have resulted from the second sexual episode. These results are subjective and will give an idea about the possible father. The confirmation for this can be done after genetic paternity testing. This an be done between 8-12 weeks using methods like amniocentesis or chorionic villus biopsy where cells from the amniotic fluid are collected and analysed for genetic similarity with genes from the potential fathers. This can also be done after the birth of the baby using cord blood cells and is easier with no risks at that time. This will provide accurate results regarding paternity. So please do not get stressed and get investigated. I am always here to help you. Hope this satisfies your query. Thanks for using HCM. Feel free to ask any more questions that you may have. Dr Madhuri Bagde Consultant Obstetrician and Gynecologist

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Brief Answer: Ultrasound may help but genetic test is accurate Detailed Answer: Hi and thanks for the query, Thanks for the information. Counting form the last date of your menstrual period January 15 until today February 19, there are 36 days. So the duration of your gestation calculating from January 15 and ovulation after say 13-14 days is 5 weeks 1 day. If the pregnancy occurred on 7th or 8th, your calculated gestation would be around 3 weeks 5 days. This is very narrow window to be detected by ultrasound. The ultrasound itself will produce an error of about 1 week on either side of the actual gestation. Neverthless, as of now, you may get a transvaginal ultrasound done to estimate the exact gestation. If it is 5 weeks or more it will show on UGS. If it is less than 4 weeks , USG mostly will fail to show the sac. This will give an indication about which act resulted in pregnancy but not a 100% guarantee. The most accurate way to know this is by genetic testing. If you choose to get an abortion pill, it must be used within 49 days preferable 42 days. The chances of it causing incomplete abortion or failure to act are higher later. Whether you will be given an ultrasound or not is the decision of the health care provider so I suggest you may discuss this with your treating doctor. I understand your situation well and also the need for accurate knowledge. I am always willing to help you whenever you need. if you want to keep the baby, please forget the stress. Stress is not good for pregnancy. Relax, think everything out and I am sure you will reach the correct decision. Take care and have a good day. Dr Madhuri

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Brief Answer: Do not worry. Detailed Answer: Hi, Thanks for the query. I am glad I was able to help. I do understand your situation very well. I am happy that you were able to make a decision. Regarding the pills. They can be used safely till 42-49 days within the last menstrual period. That is about 6-7 weeks [ the earlier the better]. They must be used under medical supervision. They produce a heavy period and there may be some cramping with clots. Very rarely they may cause an incomplete abortion, that may need a surgical evacuation, especially is they are taken later than the prescribed date. This is the reason it is advised to use them after discussing with your doctor and facilities for a surgical procedure if needed [rare if used properly]. So do not worry but have someone with you who may be able to help you if at all the need arises. A safe abortion under medical supervision does not affect fertility. Regarding birth controls. There are many method available now. The pills contain female hormones and act by replacing the normal menstrual cycle by an artificial cycle caused by pills so that ovum does not form and pregnancy does not occur. Pills need to be taken every day preferably at the same time, so that is an issue as repeatedly missing pills means no contraceptive benefit. Another method is using injections that are given every two or three months. They are very effective but cause irregular bleeding and spotting. similar problem is there with hormone containing implants that are inserted just beneath the skin. They release hormones slowly and prevent pregnancy but again they cause irregular bleeding in some and complete absence of periods in some. Condoms are good if used regularly before every act and also protect against STD's. I would not suggest an IUD for women that have not had at least one baby as it does carry a small risk of infection. I suggest that you discuss this with your partner as well as health care provider as every method has its pros and cons. Also while choosing pills, those that contain estrogen regulate the cycle better and cause predictable menstrual bleeding but are associated with more side effects as estrogen is the one that is the one causing all the complications. If you decide to use combined pills, try ultra low dose ones to avoid side effects. Pills increase the risk of breast cancer and blood clots. They must be avoided in women with diabetes, liver disease, high blood pressure, history of stroke. This usually occurs in older women. They also protect from ovarian cancer. It is generally advised that women with positive family history of breast cancer must avoid hormonal contraceptives. Regarding the brands, it is by trial and error . I have suggested the names of few that are commonly used and are low dose at the end of my answer. I hope that this was able to help you. Wishing you the best of health. I am always here to help you whenever you need me. Take care. Dr Madhuri Bagde Consultant Obstetrician and Gynecologist Names of pills brands. Progesterone only pills or XXXXXXX pills : Microlut 28, Microval 28, Locilan 28 and Noriday. LoOvral contains 0.03 mg ethinyl estradiol and and 0.3 mg norgestrel Nordette contains 0.03 mg ethinyl estradiol and 0.15 mg levognorgestrel Ortho-Cept (Reclipsen, Solia) contains 0.03 mg ethinyl estradiol and 0.15 mg desogestrel Desogen contains 0.03 mg ethinyl estradiol and 0.15 mg desogestrel Levlen21 contains 0.03 mg of ethinyl estradiol and 0.15 mg of levonorgestrel Seasonale/Seasonique contain 0.03mg of ethinyl estradiol and 0.15 mg of levonorgestrel XXXXXXX

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Brief Answer: It was probably caused by sexual act Detailed Answer: Hi, Thanks for the query. Please do not worry so much. The only reason we advice avoiding sexual contact during pregnancy is to avoid any potential infection and also violent sex may sometimes induce uterine contractions and cause abortions. If the pain was momentary and has subsided now and there was no bleeding, there is no need to worry. It was probably caused by uterine contractions stimulated by the act that have now stopped. I suggest that you please contact your health care provider, irrespective of whether you want to continue your pregnancy or not. You will have to get an examination even if you do not want to continue. If at any point you decide to continue, you will need to start certain drugs. So please think about it. If it is possible, confide in some one close to you. You may have sex if you want but it is advisable to avoid it in the first trimester. Also try to avoid violent sexual acts as they may provoke abortions. I understand what you are going through and wish that you will get out of all this. Dr. Madhuri Bagde

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