Women's Health - Early miscarriage


Q: Hi! So one of my best friends thinks she had a miscarriage yesterday morning. I advised her to go to the doctor just to check that everything is fine but she says she doesn't want to go. I am trying to advise her and be supportive but I will like to know a little more about what should be done, and check if she is ok. She is in birth control right now, and has been for the last 5 months approx. Around 3 weeks ago she had to take the "day after pill" and yesterday she said she had weird cramps and bleeding and finally a big "clog" that is nothing like period, so she concluded that it was a miscarriage. Personally, I am not sexually active so I can't give her the best advises but she's one of my closest friends and I really want to make sure that she is ok, or if she needs a follow up. She is 18, just if that helps. Thank youu!

Symptoms:  Cramps, vaginal bleeding

A:   Hello,
Thanks for the query to askthedoctor.com for an opinion,
Firstly if she has been on a regular birth control without missing any pills then she is not likely to ovulate during the cycle and hence the chances of pregnancy are minimal in that case. But as you said she had taken a morning after pill 3 weeks back and the continued on her birth control pills as well without allowing a withdrawal bleed, then it is likely to have a heavy bleed this time with clots.
Considering that antibiotics have been taken by her off and on for different causes which are known to decrease the efficacy of the pills, if the clog which she passed was more fleshy and not a clot, then she should get a serum beta hcg test at least which is a lab based blood test. This can detect the hcg levels in the blood, hcg being secreted by pregnancy, any higher levels of the same shall confirm a pregnancy and this episode being an abortion. But if the levels are less than 1, then pregnancy is ruled out ad the heavy clog is possibly a clot due to likely side effect of the morning after pill.
I hope i have answered your query in detail,
Wishing her good health,

Comments / Follow Ups

Patient: Hello! Thank you for answering this quickly.

Well that's the thing, she did forget to take her birth control pill a couple of times.. Do you think the antibiotics may counteract the effects of the birth control? But just to rule out I will let her know about the blood test!

Thank you so much again!!
Doctor: Yes , as she has missed her pills then she must get the blood serum beta hcg test done to rule out pregnancy.

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