Ask Emma! Answers

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Since we cannot diagnose anything over the internet, we would encourage you to be seen by a medical professional so you can be properly diagnosed and treated for these symptoms. The symptoms you are experiencing may or may not be sexually transmitted, but it is always important to use protection (ie condoms, dental dams) when you have sexual contact, oral, vaginal, or anal. Being open with your practitioner about your sexual history will help him/her make an accurate diagnosis. To find a clinic near you, you could try searching in the phonebook or online for "gynecology" or "family planning." Clinics in your area should be able to answer any questions you have regarding your symptoms as well confidentiality concerns.
-Emma

It is best to have a pap smear at a point in your cycle when you are not bleeding. In a pap smear, sample blood cells can obscure cervical cells and make the test difficult for the lab technician to read.
-Emma

From what you’ve told me, I’m not sure if I’m clear on whether or not you are on birth control pills or not. Birth control pills are highly effective at protecting against pregnancy, whether or not a guy cums in you, so you would be having relatively protected sex if you are on pills. We always recommend condoms to protects against sexually transmitted infections (plus, they add another method of protection against pregnancy).

There are things that can decrease the effectiveness of birth control pills, and antibiotics are included in that list. Amoxicillin is an antibiotic and antibiotics can indeed decrease the effectiveness of your pills – we tell clients here that if they are taking antibiotics, to use a backup method like condoms for the duration of the antibiotics and a full 7 days afterwards. Just to be safe. The reason for this is because the antibiotics can cause the pills to be less effective, which means that you could ovulate, and thus you can become pregnant if you have unprotected sex. It is OK to have sex while on antibiotics as long as you use condoms and use them correctly.

If you had sex when you weren’t on the pill, emergency contraception (EC) is your second chance at birth control when used asap and within 5 days of unprotected sex. We can’t tell you the chances of being pregnant – only that it’s lower the sooner you take EC after unprotected sex. A pregnancy test should be accurate within about 10 days of a sexual encounter.
-Emma

Without other information, it would not be prudent to guess a diagnosis. I would suggest you ask this question of the Emma Goldman Papers, an archive of her life and writings housed at the University of California at Berkley. They can be reached at: http://sunsite.berkeley.edu/Goldman/ or emma(AT)berkeley.edu (510) 642-4708
These folks are the premiere authority on Emma Goldman.
-Emma

It's great that you're thinking about this important test. Pap smears involve collecting a small sample of cells from your cervix. This preparation is then sent to a laboratory and examined for cancerous or pre-cancerous cells.

Student health clinics at universities and colleges sometimes offer pap smears. Most high school/junior high/elementary school nurses in the US do not provide reproductive health care. You can certainly ask the nurse at your school whether that service is provided. If not, s/he should be able to give you a list of health clinics in your area where you can get a Pap smear.
-Emma

First things first. It is important not to place anything inside your vagina for at least two weeks after an abortion. Doing so may put you at risk for a uterine infection, as your body has not yet had a chance to completely heal from the procedure. If you have any questions about your aftercare and how to prevent complications like infection, do contact the provider who performed your abortion.

Secondly, while it is not likely that your body has regained its ability to conceive, there is a small chance that you may have ovulated. If you ovulated, then yes, you can get pregnant if you had unprotected sex.

Lastly- emergency contraception pills are a second chance at birth control if you had unprotected sex and you can read more about it here. Since you are not in the U.S., I don’t know what emergency contraception methods are available to you and I would recommend you speak to the provider that performed your abortion for advice. In general, emergency contraception pills can help prevent a pregnancy if a woman is not already pregnant and takes the pills within 5 days of unprotected sex. EC is not as effective as choosing a birth control method that you can use accurately and consistently.
-Emma

Some women have lighter periods or no periods while using Depo Provera, and it is normal. It is VERY common for women to have irregular bleeding when first starting on Depo. You can read more about Depo Provera here, and we encourage you to contact the clinic/provider who gave you the shot if you have any specific questions about your body’s reaction to Depo.
-Emma

An ectopic pregnancy occurs when the fertilized egg implants itself somewhere other than inside the uterus. Usually it happens inside one of the Fallopian tubes, which connect the uterus and ovaries. Implantation can also take place in the cervix, ovary or abdomen.

While the signs may vary between women, there is usually pain in the lower abdomen. If you have had a positive pregnancy test and are having abdominal pain, cramping, or vaginal bleeding, it would be a good idea to check for an ectopic pregnancy. An ultrasound must be performed to know whether implantation has occurred outside the uterus.
-Emma

More than half of women who stop taking the pill ovulate during their next cycle. A few women regain their fertility a few months after stopping the pill. However, there is no evidence that long term use of oral contraceptives will keep you from getting pregnant in the future if you want to.
-Emma

”I took my last pill in the pack on the last day of my period. I’m a Sunday starter and I forgot to reorder my pills. I will receive them Thursday but I had sex the Sunday after my last pill and won't be taking any for three days until I gat my refill. My boyfriend came a little inside me, is there a possibility of being pregnant, and if so should I start the new packet when I get it Thursday?”
-M., Youngstown

Birth control pills, when taken correctly, offer effective protection against pregnancy through to the last pill and only continue being effective when you keep that hormone level constant by taking pills correctly and starting packs on time.
If I am understanding correctly, you took your last pill as scheduled, had a week with no pills, and had sex the Sunday after your last pill and end of your period. If this is the case -- since you had sex after finishing your last pack and before starting a new one, there is a chance you are pregnant. Plan B, or emergency contraception, can be taken up to five days after unprotected sex to help prevent pregnancy. You can wait ten days after unprotected sex to take a high-sensitivity pregnancy test (the ones at the drugstore).
In terms of when to begin your new pack of pills, you have several options. Since you've missed a few days of pills you could start the new pack as soon as it arrives and use a back up method like condoms for the first two weeks. The other option is to skip your pills this month (while using a backup method), wait for your period, and begin your new pack of pills the Sunday after your bleeding starts. If you go with the second option you would only need to use a back up method of birth control for the first week when you are starting the new pack of pills.
-Emma

"How were abortions done a long time ago?"
-Jatia, Detroit, MI

Abortions have occurred in various forms and in many cultures throughout history dating earlier than 2000 B.C. They have included such forms as concoctions of poisonous herbs, prescribed methods of certain physical activity, and ancient tools that resembled modern surgical instruments. Between the 1880's and 1973 (when abortion was legalized by Roe v. Wade) unsafe "back alley" abortions involved the use of such items as knitting needles, wire coat hangers, and poisons. Unsafe, botched, and dangerous procedures led to a significant number of deaths or severe health consequences for women. The coat hanger became a symbol of "never again" in early activism for the right to abortion, as it represented a dark time when women were driven to desperate measures and risked their lives to end a pregnancy.
Today, modern medical facilities, tools, methods, and laws help ensure that women have access to safe and legal abortions. However, unsafe abortions are still being performed both internationally and in the U.S. and women continue to die or suffer permanent injury from unsafe and unsanitary procedures. Challenges that continue to restrict a woman's access to abortion include stigma surrounding the choice of abortion and pressures from anti-choice activists to limit/deny access.

You can read more about the history of abortion here <http://www.feminist.com/resources/ourbodies/abortion.html> and here <http://www.prochoice.org/about_abortion/history_abortion.html>.
Get involved in public action here <http://emmagoldman.com/services/abortion/action.htm>.

"Please help me Emma, I am 20 and I need to have an abortion. I can't let my family know, I'm 5 weeks pregnant please help me, how many days does it take to have an abortion? Where do I go to get it done? I can’t go to my gp cause he is a family doc, please help."
-Shaz, London, UK

Since we are in the U.S., we could not really tell you about clinics and how they run in London.
The National Abortion Federation (NAF) recommends Marie Stopes International as an abortion provider in the UK.
To locate other clinics, you can try a websearch for "London abortion." Look for clinics that offer abortion as an option. Do avoid websites and places that mention "crisis pregnancy center" as these are centers that often have anti-abortion propaganda. You can also look in your local phonebook - in the states, abortion providers are generally listed under categories of "Abortion-Clinics" or "Abortion-Providers." If you call a clinic, ask if they offer abortions. Some women like to call more than one clinic to compare things like prices, procedures, scheduling times, options for support people, confidentiality, level of care and advocacy. Sometimes, women will go further than the closest clinic to find a provider that meets their needs the best.
For women living in the U.S., you can look up providers on the National Abortion Federation website here, or call 1-800-772-9100 for information about abortion and referrals to providers. Women living outside the U.S. can still call this number, but it may or may not be a toll-free call (you can always use a calling card).
-Emma

It is true the manufacturer of Depo reports that it is effective immediately if received within the first five days of your period. If you receive your injection outside of that window we would recommend using a backup method of birth control for the first two weeks.
-Emma

To my knowledge Chlamydia can only be transmitted through bodily fluids and sexual contact. (Oral, anal and vaginal) Be sure to complete your treatment and abstain from sexual contact for the duration of that treatment. (Usually 7 days)

-Emma

When starting a hormonal method of birth control out side of your normal menstrual cycle I would recommend using backup for two weeks. Also, you should always use a backup method of birth control when having breakthrough bleeding and for seven days following.

If you are sexually active there is always a chance of being pregnant. I recommend doing a pregnancy test. If this continues see your physician.
-Emma

We are not a fertility clinic. I can say that sperm can live up to 3-5 days in the vagina. so the longer it is in the vagina the higher your chances of becoming pregnant. Consult with a fertility clinic/provider for advice on how to increase your chances of pregnancy.
-Emma

I would advise you to use a backup method of birth control whenever you are having breakthrough bleeding and for seven days following. Also you should contact the prescribing physician regarding this matter.
-Emma

Depo is a very effective form of birth control but it does have a failure rate of around 1%. The difference between pre ejaculation and ejaculation should not make a difference in Depo’s effectiveness.
-Emma

There are currently no recommendations to stop birth control pills every few years.
-Emma

Many things can cause differences in your menstrual cycle. We cannot diagnose over the Internet, so I recommend you call you local health care provider to discuss your symptoms.
-Emma

-Anonymous, Virginia

It's good that you went to the campus health clinic for a pregnancy test based on the symptoms you're having. The test you took was probably a high sensitivity test, which means it could read positive within approximately ten days of conception. Since the test was negative you should continue monitoring your symptoms and take a second pregnancy test in about a week, preferably with your first morning urine to make sure the test was accurate. Assuming you are not pregnant, you should consult a practitioner if you miss another period.
-Emma

It is physically possible to have sex with a tampon in, however, it really should be removed before sex since leaving a tampon in can be painful and make the tampon difficult to remove later. If you think you have had sex with a tampon in, it probably got pushed to the back of the vagina near your cervix. Since tampons should not be left in place for longer than about 8 hours, you should see a practitioner if you are unable to remove it yourself.
-Emma

If you had sex on the day that you took your last pill (assuming you took pills regularly during that cycle, same time and every day), you were still protected under that dose.
If you had sex on the day after or any other day in which you were missing pills or catching up on pills, you would not be protected and should consider taking emergency contraception (“EC”/”Plan B”/”morning-after pill”) within five days of that "unprotected" encounter to help prevent pregnancy.

When you are doubling up on birth control pills you should use a back up method (like condoms) while you’re doubling up and for seven days after you have caught up.
-Emma

If you have taken your pills correctly, i.e. every day at the same time, there is a very small chance that you could become pregnant. Birth control pills are usually between 98% and 99% effective. Since no birth control method is 100% effective, you should take a pregnancy test if you miss your period.

The time frame for testing for sexually transmitted infections varies depending on which tests you have done. For Chlamydia and Gonorrhea to be detected on a test it needs to be at least three weeks from any possible exposure to the infections. For all other tests such as HIV, syphilis, or hepatitis you need to wait at least three months from possible exposure to be tested. The practitioner you see for your testing should be able to give you a good idea whether you have been exposed to Chlamydia and what, if any, effects it has had.

-Emma