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Morning-after pill failure: will this harm baby?

by Dr. Fred Coleman

question
I have taken a home pregnancy test and found out that I am pregnant. This was a surprise because it has happened despite taking the morning-after pill. Will this harm my baby?

answer
The morning-after pill prevents implantation by messing up the lining of the uterus to keep the egg from finding a good place to grow. While it is fairly effective, it does have a small failure rate (as you know). The actual failure rate is hard to know for sure. About eight out of 100 women will get pregnant in any one month, if they were having sex around ovulation. The morning-after pill seems to reduce that chance to about one to two out of 100.

The good news is there is no effect (that we know of) on your baby from the drug. The likelihood of an effect on pregnancy is very small (almost non-existent) if the exposure occurs in the first two weeks of pregnancy. This is because of the ‘toti-potential’ ability of the cells. In other words, each cell has the capability of becoming a whole baby. After two weeks, the cells start to differentiate (become certain types of cells). So if you damage or kill some cells in the first two weeks of pregnancy, the other cells fill in for the damaged ones. If you do that after the first two weeks, the cells can't fill in and parts of the baby may not develop correctly. If those are critical parts, the baby would not survive and you would miscarry. But if they are not critical parts, the baby could survive and would be born with defects of some kind.

Since these pills are taken close to conception, they are unlikely to have any effect on the baby. The limited studies that have been done so far seem to bear that out.

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