During routine checkups, it’s common for healthcare providers to ask women if they have ever been pregnant before. This question of course becomes even more relevant if and when you try for a second child.
However, if a doctor wasn’t told of a past pregnancy, is it possible for them to know already?
Yes, it is possible for a doctor to detect a previous pregnancy by examining changes to your cervical opening or scarring on your uterus. Other more obvious signs of past pregnancy include c-section scarring, stretch marks, changes in skin pigmentation, and a wider hip region.
While there are many telltale signs to a doctor that you have been pregnant before, some cases may be undetectable even to a medical professional.
Let’s discuss how your doctor can tell of a previous pregnancy, when they can’t, and whether a previous miscarriage or abortion is detectable too.
Evidence of Previous Pregnancy: How Doctors Can Tell
Your doctor will be able to tell from a physical exam and often from more obvious outward clues on your body that you have been pregnant in the past. Here are a few of the telltale signs of a prior pregnancy.
In the case of vaginal birth, the mouth or opening of your cervix will appear noticeably different after childbirth. Retired intensive care physician Dr. Liang-Hai Sie shared this before and after image of a nulliparous cervix (never given birth) and a multiparous cervix (birthed one or more children).
According to Californian OB-GYNs Dr. Yvonne Bohn and Dr. Yen Hope Tan, the cervix is initially floppy and thin before closing and thickening post-birth. It may take six weeks to return to its normal shape, but it’s also normal for the cervix to never return to its original shape.
Uterine scarring commonly happens as a result of injury during surgery. A c-section may leave scar tissue on the uterus, but a uterine scar can also occur in the case of a miscarriage or an abortion.
Women requiring a procedure known as dilation and curettage (D&C) may also end up with uterine scarring as this involves removing uterine tissue in the case of a molar pregnancy.
A more obvious indication of a previous pregnancy is in the scar left on your abdomen as a result of your cesarean incision. While the incision typically takes only 3 months to heal fully, the scar, though faded, will remain permanently.
Scar From Episiotomy or Tearing
Another clear sign can be in a previous vaginal scar that occurred during delivery, either from a natural tear or an episiotomy cut to widen the vaginal opening.
Wounds from both types of tears can take up to a month to heal fully with the scab fading soon after, but some women can be left with a noticeable raised scar.
Changes in Pelvic Muscles
Most women find that their pelvic floor muscles regain strength within two months, but others can experience months or even years of pelvic floor weakness and pain, which can lead to disorders, such as pelvic organ prolapse, that your doctor can detect in an exam.
During pregnancy, a woman’s body can create Rh antibodies (proteins on the surface of red blood cells) if the mother’s immune system perceives the fetal blood cells as a threat.
Luckily the baby is usually born before the mother can produce enough of these antibodies to do harm. These Rh antibodies are quite persistent though, and as some studies reveal, they can remain in the body even decades after pregnancy.
The vast majority of pregnant women will have stretch marks if they have carried to full term. These appear on the stomach, breasts, and buttocks and start off purplish before fading to white, though they’re still visible to doctors.
Other Physical Changes
Other changes to your body that would indicate a previous pregnancy to your doctor are things like skin pigmentation and changes to your nipples due to hormones. Nipples can protrude more, seem more prominent, and/or become darker in color than before pregnancy.
These color changes can also be obvious in the dark line running along your abdomen from your umbilical area to the pubis. This is known as linea nigra. In women with darker skin, it’s also common for a kind of post-pregnancy “mask” to appear on the face due to areas of dark skin highlighting lighter areas.
Some other physical changes include:
Varicose veins – appearing as a prominent network of bluish/black veins in the legs
Wider hips – skeletally, the hip region will measure wider after birth as the pelvic bones separate to facilitate birth
Hemorrhoids – the immense pressure placed on your lower rectum can lead to this condition during birth and after pregnancy. After the hemorrhoids decrease in size, the shriveled skin usually signifies a previously swollen hemorrhoid.
Cases When a Doctor May Not Be Able To Detect Previous Pregnancy
If you had a c-section delivery and a subsequent tummy tuck procedure to completely remove your c-section scar, there would be no evidence in your vagina or cervix, so a doctor would only be able to make a guesstimation that your abdominal scar from tummy tuck surgery was actually covering up a c-section scar.
In the case of ectopic pregnancy (when an embryo implants itself inside a fallopian tube), surgery is often needed to remove the damaged fallopian tube, which could make a previous pregnancy detectable.
However, there are other reasons to do laparoscopic surgery besides ectopic pregnancies, so a doctor would have to look inside to see if the fallopian tube was damaged or removed. In some cases, however, the affected tubes can be repaired, so in this instance, an ectopic pregnancy may not be so easily detected years later.
Lastly, pregnancies that result in very early abortion may not be detectable in the cervical opening as these are usually “unlikely to dilate the 3 mm cervical canal” according to retired physician Dr. Liang-Hai Sie.
Can a Doctor Tell if You’ve Had a Miscarriage Months Later?
Yes, there are three ways a doctor may be able to detect a previous miscarriage. Certified consultant and curator of the Classified Mom blog Marjorie R. Rogers explains that a pelvic exam can reveal if a uterus is scarred or misshapen, and an ultrasound can detect if there is abnormal tissue in the uterus.
Thirdly, a doctor can also order blood tests to check for the presence of hCG (human chorionic gonadotropin). This hormone is only present during pregnancy, so if this is found in your blood, you’ll likely have a previous miscarriage.
Can a Doctor Tell if You’ve Had an Abortion?
Yes and no. In medical terms, a miscarriage is classed as a “spontaneous abortion” while an abortion as we recognize it is an induced abortion.
Doctors will not be able to distinguish between a true induced abortion and a miscarriage. Some miscarriages pass on their own while others require a surgical evacuation, called a dilatation and curettage or D&C.
While no tests can detect whether an induced abortion has taken place, doctors may be able to tell if you have taken the abortion pill Misoprostol (which is inserted vaginally in combination with the oral Mifepristone medication) as traces of it may remain, according to the non-profit Women Help Women.
Can a Doctor Tell How Many Pregnancies You’ve Had?
No. A doctor won’t be able to know the number of past pregnancies. The birth canal and vaginal tissue are designed to stretch and return to a pre-pregnancy shape, regardless of multiple births. A woman’s pelvic spread may indicate previous pregnancy but not frequency.
Why Do Doctors Ask if You’ve Ever Been Pregnant?
Doctors typically enquire about past pregnancies because your medical history can help them make safer, informed decisions in relation to a current pregnancy or treatment.
If there were complications with a previous pregnancy, for example, they need to know this to be prepared and take precautions.
To sum up, a doctor is typically able to know you’ve had a previous pregnancy based on certain outward signs (stretch marks, skin pigmentation, etc.) and through physical examination that can reveal changes to your uterus and cervix.
In some cases (such as pregnancies that were not carried to term), a doctor may be unable to detect this. Choosing to share a previous pregnancy with your healthcare provider is completely up to you — but know that a doctor has your best interests at heart and has a legal duty to protect your personal history from improper disclosure.
Mom of three (including identical twin boys), wife, and owner of Parents Wonder. This is my place to share my journey as a mother and the helpful insights I learn along the way.