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Reasons for a Positive Pregnancy Test After an Abortion

An abortion is a simple, common health intervention that may be provided for various health or personal reasons. Either a medical (also called medication) or surgical abortion can be used to terminate a pregnancy, with both methods proven to be overwhelmingly safe and successful. However, it is still possible to have a positive pregnancy test shortly after the procedure, which can be unexpected and confusing to experience. This article will share a few reasons why women and other people with uteruses may experience a positive pregnancy test after an abortion procedure and what it may indicate regarding their health and recovery.

How pregnancy tests detect a pregnancy

To understand what a positive test means after an abortion, it’s first important to learn how these tests can detect a pregnancy. During pregnancy, the placenta produces a hormone called human chorionic gonadotropin (hCG). The hCG hormone triggers the body to make progesterone, which helps maintain the pregnancy. Pregnancy tests are designed to detect beta hCG in blood or urine, with a positive result indicating that the pregnancy hormone is currently present in your body.

How long will you test positive after an abortion?

In general, beta hCG detection of pregnancy in serum (blood) and blood occurs as early as 10 days after conception. While it rises quickly early in pregnancy, it takes some time for hCG levels to drop after a pregnancy has been terminated. According to Dr. Jillian LoPiano, an OBGYN and Chief Health Officer of a leading sexual and reproductive telehealth provider, “A urine pregnancy test will be negative around two weeks — rarely up to three weeks — after an abortion.”

How soon after an abortion can you take a pregnancy test?

You may be provided with a pregnancy test to take to help confirm whether the abortion procedure was successful. This timeframe can vary depending on the abortion method administered, but you can generally expect to take a special pregnancy test 2–4 weeks after your abortion process (for the reasons previously discussed). American College of Obstetricians and Gynecologists (ACOG) recommends at-home pregnancy testing four weeks after medication abortion. Your healthcare providers will provide guidance on when it's best for you to test.

Possible reasons for a positive pregnancy test after an abortion

Seeing a positive pregnancy test after an abortion can be jarring. While there could be a cause for concern, it is typically completely normal if the abortion has been done in the last few weeks. The various reasons for a positive pregnancy after an abortion are listed below.

  1. Residual hormones. While the hCG hormone is expected to decrease by 80% within 6–7 days after a medical abortion, residual levels can cause a 'false positive' on pregnancy tests. When a pregnancy ends — either with a spontaneous or induced abortion — it takes time for that hormone to be cleared from blood and urine. So, if a pregnancy test is taken within a few days or a week after an abortion, a positive test may not be a cause for concern.
  2. New pregnancy. Another cause of a positive test result could be a new pregnancy. Ovulation can occur as early as 2–4 weeks after an abortion, which means it's possible to get pregnant again almost immediately. For those who are actively trying to prevent another pregnancy, it's essential to consider this possibility. In either case, be sure to discuss your reproductive care plans and needs with your healthcare provider, and remember that most contraceptive methods, except for IUDs and permanent contraception, can be started on the first day of medical abortion. The IUD and implant can be started on the same day of procedural abortion.
  3. Failed or incomplete abortions. Unlike the previous two reasons, these are, unfortunately, possibly alarming causes of a positive pregnancy test. In these cases, the abortion method did not work, and the pregnancy is still ongoing, or your body may have retained some products of conception. However, a failed abortion is an extremely infrequent complication that may occur with either surgical or medical abortions. Incomplete abortions, in which some tissue from the pregnancy remains in the body, have also been rarely reported. However, continuing pregnancy occurs in only 0.9% of medication abortions and 0.05–0.2% of surgical abortion cases.
  4. Other interfering factors. Another possibility of a positive pregnancy test includes medication use (such as aspirin and methadone), rare genetic conditions (such as the benign familial hCG syndrome) that can elevate hormone levels, or the presence of blood and protein in the urine. However, seeing a healthcare professional would be a good idea if something doesn't feel right or if bleeding is longer than expected.
  5. Human error. Simple human error can also lead to obtaining a 'false positive' result. To avoid this, be sure to follow the manufacturer's instructions on using the pregnancy test and interpret the results carefully.

What causes or contributes to unsuccessful abortions?

The risks of experiencing a failed or incomplete abortion increase for various reasons. Surgical abortion carries a much higher risk for complications when the procedure is done unsafely by a person lacking skills or in an improper environment. Similarly, with medical abortion, incorrect usage and lack of medical supervision can increase the risk of an unsuccessful abortion.

However, abortion procedures have high success rates when administered by qualified medical professionals, as early medical and surgical abortions are 99.6% and 99.8% effective. Proper supervision and appropriate follow-up are important for safely ending a pregnancy and evaluating for and addressing any complications that may arise.

When it comes to supporting the success of your abortion, you will still play an important role in the process. “With medical abortions, patients should always follow the provider's instructions as they are given and ask questions when something is not clear,” says Dr. LoPiano. While there is not much you can do during a surgical abortion, you should still ensure clarity on the process prior to the procedure and closely follow provider guidelines for the period following the process.

It is also essential to know who to reach out to or where to go if you experience complications related to the procedure. For example, healthcare providers may offer an after-hours emergency line you may reach out to with concerns after your procedure.

Post-abortion care

Being familiar with the common side effects will help you understand what to expect after an abortion. As with any procedure, you will be provided with a detailed list of precautions and expected side effects. Overall, cramping and bleeding are normal symptoms to experience during and after an abortion, and the pain can be managed with over-the-counter medication and heating pads. The cramping should go away within a day or two. Your healthcare provider will also share what signals to look out for that indicate you need to go to the emergency room. These signals typically include excessive pain or bleeding (soaking through more than two pads for two or more consecutive hours, as well as bleeding for a prolonged time) or signs and symptoms of an infection (such as a fever).

Regarding emotional responses to abortion, Dr. LoPiano noted that those are “complex and individual to each patient's circumstance — the best population data we have shows that the prominent emotion is relief and certainty about the decision.” It is not uncommon to feel a wide range of emotions after an abortion, both positive and negative. However, if you experience extended periods of negative emotions, such as anger, sadness, guilt, or reduced self-esteem, it's essential for you to reach out to your healthcare provider. Mental wellness can often be easily overlooked but is equally as important as caring for your physical well-being, including after an abortion.

It is also critical to highlight the legal landscape of abortions in the United States. Per the World Health Organization (WHO), comprehensive abortion care is an essential health care service. However, the current legal climate may mean that navigating abortion healthcare, including preventive, procedural, and post-abortion care, may be challenging. As abortion laws are currently regulated at the state level, what may be considered legal or not regarding abortion can be widely different from one state to the next. For example, 14 states currently have a total ban on abortion, while 27 other states ban abortions based on gestational age (such as either at, before, or at some point after 18 weeks of pregnancy). “In addition, restrictive laws are often vague, new, and often in flux due to litigation or legal challenges,” says Dr. LoPiano. As a patient, it's more important than ever to ensure you understand the current laws in your area and how they may affect your access to abortion healthcare. The Guttmacher Institute provides a constantly updated U.S. abortion policy map by state.

Overall, both medical and surgical abortions are safe when administered using methods recommended by the WHO and by a healthcare provider with the required skills to provide them. If you have concerns about a positive test result after an abortion or your right to an abortion, contact your healthcare or abortion provider. They will help assess the situation and (if needed) determine the best course of action for you. Proper follow-up care and monitoring will also help ensure a safe and successful abortion.

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Comments

Karunga Annitah
prefix 2 months ago
Thanks so much for the information
It's simple and straight forward more so I had some questions but following the blog down I got my all my answers. Thanks again
Ashley Smith
prefix 11 months ago
Thanks for this blog. It is said in simple terms and you have explained everything easily that anyone can make sense out of reading it.