Is it possible to have an abortion two weeks after having sex?

Dear Donnie, 

Your two hypotheses about what could have happened are possible: sperm may have been in your friend's pre-ejaculate orhe may have come without realizing it. In both cases, this could have resulted in a pregnancy. From that point, multiple scenarios could have taken place that would have terminated the pregnancy, but before getting into that, it’s good to have a refresher on the ins and outs (excuse the innuendo) of sexual reproduction. 

Simply put: the road to pregnancy begins when a sperm meets an egg, though a lot more goes on behind the scenes than you might expect. Most people with a uterus develop a group of eggs from their ovaries monthly as part of the menstruation process. The eggs (called oocytes) begin to grow within follicles inside the ovaries, where one egg reaches maturity. The follicle releases the mature egg in a process called ovulation. After this, the follicle develops into the corpus luteum which releases progesterone and estrogen to help build up the lining of the uterus (called the endometrium). If the egg isn't fertilized, this lining sheds during a person's period. If the egg is fertilized, the process of pregnancy may begin. 

Fertilization generally occurs after ejaculation into a person's vagina during penetrative sex, but regardless of how it happens, if a viable sperm (which can live in both semen and pre-ejaculate) enters a vagina and reaches a viable egg, it can result in pregnancy. The fertilized egg then travels down the fallopian tube that connects the ovaries to the uterus, multiplying into a ball of cells as it goes. Once it reaches the uterus it implants itself into the lining and becomes a pregnancy. 

The whole process from fertilization to implantation generally occurs over a period of six to twelve days. A pregnancy test (over-the-counter or clinically administered) can test positive as early as seven to ten days after conception when the production of human chorionic gonadotrophin hormone (HCG) begins (though the earlier it’s taken, the higher the likelihood of a false negative). Pregnancy is officially calculated based on the first day of the last menstrual period. 

There are a number of options to terminate a pregnancy, which can include a medication abortion or in-clinic procedures. Someone could theoretically get an abortion as soon as they get a positive pregnancy test—there’s no medical reason to wait. In fact, it's best to get an abortion earlier in a pregnancy, as medication abortions are only recommended until 11 weeks after the first missed period of the pregnancy. In-clinic abortions are also becoming harder to access in some states across the United States following the overturn of Roe v. Wade. Because state laws are changing rapidly, people who want an abortion are recommended to check their state laws and those in surrounding states if needed. 

Another possibility is that your friend's girlfriend may have used emergency contraception, also known as the morning after pill, which stops the fertilized egg from implanting in the uterus. This, however, isn't an abortion. There are two types of emergency contraception medications: pills with ulipristal acetate and pills with levonorgestrel. Pills containing ulipristal acetate can be taken up to five days after unprotected sex but require a health care provider's prescription. Pills with levonorgestrel don't require a prescription and while they can be taken up to five days after unprotected sex, they work best if taken up to three days after. The copper intrauterine device (IUD) can be inserted into the uterus as a form of emergency contraception, and it also protects against pregnancy for up to ten years after it has been inserted. 

Taking all of this into account, it’s possible that your friend's girlfriend could’ve discovered her pregnancy and gotten an abortion within two weeks, though this window is extremely small. It’s also possible that she could have gotten pregnant from a prior sexual encounter. Regardless of what exactly happened, or how or when your friend's girlfriend got pregnant, one thing to consider is the motivation for his doubts or discomfort with the situation. Mutual trust and open communication are pillars of a compatible relationship and he may want to ask himself if those are lacking in his current relationship. As his friend you could encourage him to talk through this with his girlfriend.  You may also suggest that he talk with a mental health professional about his relationship if he's feeling concerned.