Worried about a possible pregnancy? You're not alone: most people who've had sex that presents a risk of pregnancy (or who have been sexually assaulted) have experienced a scare at some point. Heck, many people who simply have a uterus, and even people who don't have one but have been within 20 miles of one, have experienced fear about potential pregnancy. Anyone who's been in that terrifying place knows how overwhelming a pregnancy scare can feel. While we can't give you the hug you probably need right now, we do understand and can help you to assess your risk, figure out what to do next, and hopefully provide you with some support and comfort that'll help you get through this and have less scares in the future.
First Things First
Take a breath. A nice, long, big one. Now let it out. Take another. Rinse, then repeat.
They don't call these scares for nothing: this is scary. But none of us handles things well when we're flipping out. Scary things feel a lot scarier while hyperventilating, and adding more stress to an already stressful situation only assures you'll feel worse. So, breathe. As you keep reading, be sure to also keep breathing. Let's start by first figuring out if you've had a pregnancy risk or not.
- Did you have sex only with yourself? Masturbation does NOT pose risks of pregnancy.
- Have you not had any kind of sex at all (and were not sexually assaulted), but are worried because of something like touching a partner's hand then touching yourself, or using a towel that may have had dried semen on it? These kinds of scenarios do NOT pose risks of pregnancy. Sperm and ovum need specific conditions in which to co-create a pregnancy, and these ain't them.
- Did you have the same kinds of genitals as the other person you had sex with or who sexually assaulted you, as in, you have a vulva, they had a vulva, or you have a penis, and so did they? Same-sex contact can NOT create a pregnancy.
- Were you only kissing, having oral sex, manual sex and/or dry sex, where someone (or everyone) had clothes on and/or no one ejaculated on or very near anyone else's vulva? These kinds of sex do NOT present pregnancy risks, though some present risks of STIs.
- Were you or a partner using a reliable method of birth control perfectly for either that incident or, for methods like the pill or charting, for the whole of a cycle? If so, pregnancy is unlikely. If more than one method was used perfectly, it is WAY unlikely.
If any of the above scenarios describe the situation you're worrying about, it's anywhere from very unlikely to downright impossible that you have or will become pregnant. With those scenarios, you or your partner are most likely NOT pregnant and will NOT become pregnant unless you do or have done very different things than those.
When pregnancy occurs, it is almost always when people have genital intercourse or other very direct genital-to-genital contact and/or when someone ejaculates directly inside a vagina or onto the vulva.
- You DID have direct genital-to-genital sex with someone, or were sexually assaulted with direct genital-to-genital contact, and the other person's genitals WERE very different than yours. Vaginal intercourse, where a penis is inside a vagina, is the kind of sex that MOST commonly results in a pregnancy. If a person with a penis ejaculated (came) into a vagina or directly onto a vulva, this is a high pregnancy risk; if they did not, it is much less likely.
- There was not direct genital-to-genital sex or contact, but someone with a penis DID ejaculate inside a vagina or directly on or very near a vulva (like on or around the anus).
- Reliable methods of birth control were NOT used at all, or were not used properly in either or both of the above situations.
If any or all of those things describe the situation you're worried about, there probably WAS a real risk of pregnancy.
For readers in their teens and twenties who do NOT use at least one method of birth control consistently, and who have the kinds of sex that present a risk of pregnancy, around 90% will become pregnant or co-create a pregnancy within one year. We can't ever say what a risk was in numbers for one single incident, because fertility varies both from person-to-person and from day-to-day.
Correct and consistent use of reliable methods of contraception reduce that risk massively. When people use reliable methods of birth control all the time and use them correctly, the risk of pregnancy is much lower. Most forms of birth control, used perfectly, cut that risk to less than 10%; the most effective forms used perfectly make the risk less than 1%. If you used or use more than one method perfectly, like combining condoms or withdrawal and a hormonal method, you can rest assured that your risk of pregnancy is as close to zero as it gets, unless you're pregnant with the second coming of Christ. It's when people don't use birth control methods at all, or don't use them consistently or correctly, that the majority of pregnancies occur.
Below are effectiveness rates for current methods of birth control (listed from highest to lowest protection in typical use) and the ways they most often fail. "Typical use" means the way most people use it in their daily lives, and allows for minor mistakes, like taking pills late now and then or not putting a condom on quite right. If you want to assess what your risk may have been when you used birth control methods, take a peek:
- The implant or IUD: Over 99% effective with perfect use and with typical use. How do these usually fail? They don't (seriously, it's very uncommon), but if they do, usually because of improper insertion by a healthcare provider, or because an IUD expelled itself.
- The shot: Over 99% effective with perfect use, 97% effective with typical use. How does this usually fail? If a user does not get their injections on time.
- The pill, the patch or the ring: Over 99% effective with perfect use, 92% effective with typical use. How do these usually fail? Skipped, missed or late pills, patches or rings, taking longer than one week off during the placebo period or leaving the ring out for more than 3 hours during the active period, or using any of these methods without a backup method too soon after first starting them.
- Cervical barriers (diaphragm, cervical cap): 94% effective with perfect use, 86% effective with typical use. How do these usually fail? Not using spermicides or enough spermicide with them, improper placement, removing them too soon, or not putting them in at all or only after some genital contact has already occurred.
- Male condoms: 98% effective with perfect use, 85% effective with typical use. How do these usually fail? By not being used at all, used only after some genital contact has occurred, putting them on wrong, improper storage, not using an extra lubricant with them, not holding the base with withdrawal after ejaculation, or not leaving room in the tip.
- The contraceptive sponge: 91% effective with perfect use, 84% effective with typical use. How does this usually fail? Improper placement, not being used at all, using them for repeated intercourse past the time period they are effective for, or taking them out too soon.
- Fertility awareness methods (FAM): 98% effective with perfect use, 80% effective with typical use. How do these usually fail? Lack of abstaining during most fertile times; incorrect calculations or analysis of the data; or not charting properly, completely, or daily.
- Female condoms: 95% effective with perfect use, 79% effective with typical use. How do these usually fail? Not being used at all, only being used after genital contact has already occurred, or improper placement.
- Withdrawal ("pulling out"): 96% effective with perfect use, 73% effective with typical use. How does this usually fail? Not being used at all, not withdrawing well in advance of ejaculation, still ejaculating on someone's genitals, or using after a very recent ejaculation.
- Spermicides: 82% effective with perfect use, 71% effective with typical use. How do these usually fail? Not being used at all, not being put in/applied in advance, or for repeated acts of sex without additional spermicide being used.
If it does look like you had a real risk -- or does not, but you still feel scared about a possible pregnancy -- keep reading.
Has it been less than 120 hours (five days) since a risk? If so, emergency contraception can be used to reduce the risk of pregnancy by 75-95%. The sooner it's used, the more effective it is: it's best to use it within 24 hours of a risk. You can get emergency contraception from a healthcare provider, pharmacy, emergency room or health clinic. Depending on your age and location, you may need a prescription, but those over 17 in most countries can purchase it over-the-counter from a pharmacist. To find EC near you, click here.
Time for That Test
If it's been more than 120 hours since your risk, you or your sexual partner don't want or can't access EC, or EC has already been used, the next step is a pregnancy test. We're often asked about pregnancy symptoms, particularly by people afraid to take a test, for whom access to a test isn't easy, or when it's too early to test. Most often, the very first symptom of early pregnancy is a missed period. Sometimes women experience other symptoms, but they are very similar to PMS symptoms, so aren't a reliable way to determine pregnancy.
To accurately find out if there's a pregnancy, we've just got to take a test. I know it's scary, and if you have to wait a bit before taking one that waiting really sucks. I also know it can be tempting to put off taking that test. Years ago, one of my closest friends (who may well kill me when I tell the whole internet this, so it's been great knowing all of you) asked me to read her tarot cards to find out if she was pregnant when she was having a scare. I told her we did have more accurate ways of finding that out in this modern age, and offered to run down the street and buy her a pregnancy test. She's not a moron: she knew she could and should take a test. She just didn't want a definitive answer yet because she was scared to death to find out if she was pregnant. So, we just hung out instead, she got to talk out her fears and get support she needed, and she got herself a test the next day.
The longer we wait to test, the more limited our choices with pregnancy become. If you will want to terminate, there's a limited window of time when that's possible; the longer you wait, the tougher it can also get to access an abortion provider and the more an abortion costs. If you will want to remain pregnant, it's important to start on prenatal care early for your health and the health of a fetus, especially if you're in your teens. If you're not pregnant at all, the longer you wait to test, the longer you have to stress when you didn't even have anything to worry about. While I understand a desire for tarot cards, coin-flipping, deciding that if your dog barks you're pregnant and if he doesn't you're not, or total avoidance, you will need a pregnancy test soon if you want to handle this as best you can and have as many options as possible.
A pregnancy test can be used as early as around two weeks after a risk or when a menstrual period is late, whichever comes first. Home pregnancy tests are most likely to be accurate when taken a little later, around one week after a missed period, three weeks after a risk, or any time after. Urine tests are very accurate, whether done at home or by a doctor, nurse or other clinician. Clinics most often do urine tests, not blood tests: you really can do a test for yourself with just as much accuracy as in a clinic if you follow the directions. You can purchase home pregnancy tests at pharmacies and often also in supermarkets/grocery stores. You can also go to a doctor or healthcare clinic for a pregnancy test, and some clinics offer pregnancy tests for free.
If a pregnancy test is taken properly at least 1 week after a missed period, or 3 weeks after a risk, and there's a negative result, you can be around 99% certain you or a partner are NOT pregnant. If that 1% unnerves you, tests have shown negative results but a menstrual period is still MIA, or you or a partner have symptoms you think may be due to pregnancy, check in with a doctor or clinic. If a test taken properly shows a positive result, you can be very sure there is a pregnancy.
Are you pregnant?
If you or a partner did not want to be pregnant and got a positive result on a test, to say this is probably not your best day ever may be the understatement of the century. Because everyone's situation and feelings with unwanted pregnancy are so different and so complex, there's no simple, pat advice or comfort I can give anyone.
What I can tell you is that no matter what, it is going to be okay, even if it is very difficult or you feel terrified right now. I can tell you that no matter how you're feeling, it's okay to feel that way. There are no wrong feelings here. I can tell you that whatever choices you or a partner make with pregnancy, so long as they're the choices made thoughtfully, based on what you know and feel is best for you, your life (or a pregnant partner knows and feels is best for them and their life) and what you feel would be best and that you can handle when it comes to you being or not being the parent of someone else very soon, I support and trust you and your judgment, honor your choices and think you are a person of worth and great value.
Even if pregnancy is something you wanted, it can still feel pretty scary when a wish becomes a reality. So, if you wanted a pregnancy, but still feel scared now that you are pregnant, it's okay. It's also okay to have thought you would have made one choice before you became pregnant, then find yourself feeling you might or do want something different once you are pregnant: many people have that experience.
If you've just found out you're pregnant, seek out and ask for some support. Talk to someone first who you trust and know will treat you with kindness and respect. That may or may not be your sexual partner. No matter how you feel about it, pregnancy is big and something no one should have to be alone in. We're glad to talk with you at our message boards, or you can connect with a friend, partner, mentor or family member. In the United States and Canada, you can get sound support by phone at Backline, 1-888-493-0092, the NAF hotline, 1-800-772-9100 or Planned Parenthood's hotline at: 1-800-230-PLAN.
If you have just found out a partner is pregnant, then most or all of the choices from this point forward will be theirs to make and own. That doesn't mean you don't get to have or sensitively voice your own wants, needs and feelings. But something happening in someone else's body is mostly about them and for them to make choices about, since it's going to impact them much more than you. Hopefully, what you can do is be as supportive as possible with what that person wants, feels is best and feels capable of, and also take good care of yourself. You may need to reach out to people to talk about your feelings. If your immediate network isn't cutting it, you can use the same kinds of resources listed above and below to get some support and/or referrals to other services you can use.
After you've been able to get started with what you need emotionally, the next best step is to verify a pregnancy. You can have pregnancy verified by a general physician; a gynecologist; at an abortion clinic (even if you don't want to choose to have an abortion); or a school, general, or sexual health clinic. They may do another urine test, a blood test and/or an ultrasound.
If you are determined to be pregnant, the next step is to decide what you want to do and feel is best for you to do: if you want to stay pregnant, and either parent or arrange an adoption, or if you want to terminate the pregnancy. Those are big choices to be making, and many people want or need help making them, and also will not be able to make them well without taking some time to consider all options. You can get help in these choices by talking with people who care about you and can unconditionally support you, using this pregnancy options workbook online (one options counselors often use), and/or seeing an options counselor. Clinic systems like Planned Parenthood or Marie Stopes usually offer options counseling that supports ALL possible choices, and many abortion clinics do, too. We can also provide you options counseling at our message boards.
Sometimes unintended pregnancy is so unwanted and so scary that people will be tempted to harm themselves in some way. If you feel you may do yourself harm, please get immediate care -- like calling a suicide hotline or going to your local emergency room -- or tell someone you know will help keep you safe. Sometimes unintended pregnancy can make us feel very desperate. If you are feeling like this and do not know where to find care, please email us and we will do our best to refer you to someone nearby who can help.
Not Pregnant, Still Scared.
People sometimes express having a hard time letting go of fears from a pregnancy scare, or even being convinced they are pregnant despite using three methods of birth control, having several negative pregnancy tests, and after a few regular menstrual periods.
Before anything else, if you're feeling like this, make sure you see some kind of healthcare provider. Sometimes that strong sense we're pregnant is because we are, and we futzed up tests or wound up being the one in 100 who get false results, though more than one false result is very rare. If even with negative pregnancy tests, you have missed a period or two, and/or are not feeling good, it's smart to check in with a doctor or clinician to be sure you aren't pregnant or that something else isn't wrong. Already did that? Not pregnant but still fearful?
Maybe you're scared because you need to emotionally process how a scare made you feel now that the crisis itself has passed. Just because we avert crisis doesn't mean we have the resolution with it we need. We might need to talk to someone about how we felt, what we were most worried about, and what we might still be worried about now. We might just need someone else to acknowledge that the experience we had was big for us and to tell us that we're okay. It's also not uncommon for us to intellectually know something presents a risk of pregnancy, but to not fully feel or get how real that is until we have tangible experiences that make it feel really, unmistakeably real.
If that's not it, or you're already all talked out, you may still be scared because a scare has illuminated or illustrated changes you need to make or think about making in your life, sex life, or relationships.
Maybe you're still scared because you aren't using birth control when and how you should be, or feel unable to deal with any risk of pregnancy at all, even a tiny one. Have you been or are you using a reliable method of birth control? If not, then you've got good reason to feel scared if you don't want or feel ready for a pregnancy: again, within just one year of going without reliable birth control, the vast majority of people who have sex that can cause a pregnancy will experience a pregnancy. So, this might be a wakeup call for you to take care of that now, before you have sex again. You can walk yourself through our tool to find birth control methods here. Are any sexual partners of yours supportive of using birth control properly? Do they seem to get how big a deal a pregnancy would be to you? If the answer to either of those questions is no, you probably still feel scared because you either need to make some changes in that relationship so you are and feel more safe, or because you need to get out of any relationship where a partner isn't doing their part with pregnancy prevention.
If you're already using a reliable method of birth control, do you feel like you understand how it works, how well it can work, and how to use it properly? If not, you can read up on your method at Birth Control Bingo, at Managing Contraception, the FWHC, Marie Stopes or via this great tool from Planned Parenthood. Are you comfortable using the method you have been, or do you feel like you might feel safer using something different? If so, have a chat with your healthcare provider, or cruise the aisles of your over-the-counter options and see if there's something you would feel better using. If you don't keep a pack of Plan B handy already, getting one to keep in your cabinet or purse may make you feel safer (guys, you can get a pack, too, in case a partner ever needs it). If you are only using one method, perhaps you'd feel better adding a backup method? If you want to shop for a good pairing, you can take a look at The Buddy System.
Maybe you still feel scared because sex just isn't the right thing for you right now. Have you taken some time for yourself to re-evaluate yourreadiness? Sometimes we think we're ready for something, then find out once we've done it that we're not, after all. Anything you may have heard about how people who aren't having sex aren't as mature as people who are is bollocks. When it comes to maturity and sex, that tends to be more about people having the self-awareness and self-assurance to make whatever sexual choices they feel are the best ones for them and their lives at a given time. That can certainly be a choice to have sex, but it can also be the choice to take a break or hold off.
Sometimes in life, we'll also do something called displacement, where if we feel upset or stressed about something that feels dangerous or unacceptable, we'll put those feelings on something else felt to be safe or acceptable. While it might seem like an unwanted pregnancy is hardly something that feels safe, sometimes it can be by comparison. For instance, it might feel less scary to tell a partner or yourself you're scared about pregnancy than to acknowledge or say that you don't feel safe or right having sex with them, period. It might be easier to tell a partner you don't want to have sex because you got scared about pregnancy than to say you just don't find sex with them is worth the risks it poses. It might feel safer to be pregnant if a pregnancy would make you seem or feel more important to a partner or your family and get you attention or care you need but can't get without being in crisis. It might feel more acceptable to worry about pregnancy than to worry about HIV, or easier to focus on a pregnancy than to accept that you were sexually assaulted or abused. It might feel more manageable to focus on a pregnancy as a crisis than to focus on the crisis that an unhealthy or abusive relationship your pregnancy scare happened because of it. It might feel easier to freak about something that just happened to you than to face up to any choices you have been willingly making on your own that are really making a mess of your life. If you've gotten this far in the piece, aren't pregnant, are using sound birth control, it's probably worth thinking about things like that, because it may be your fear is trying to tell you something really important you need to know and deal with.
If you've gotten to the end of the piece and all the steps here, you may have found out or suspected that you or a partner either likely are or are not pregnant. You may have found out you've been worrying for no real reason or for very good reason. Wherever you're at now, pregnancy is big stuff, even when it's not something that's actually happened, but which might have happened. Just like with other big stuff, we will all often need some help and support. No matter where it is you landed with this scare, if you still feel scared, whether you're pregnant or not, still feel overwhelmed, or need something to help you out with all of this, please remember that it's always okay to ask for help, and with the super-big-deals in life, we're usually a lot better off when we do.