Post-Abortion Contraception

Women may ovulate soon after an abortion. Many patients presenting for pregnancy termination are dissatisfied with their current contraceptive method and open to making a change.

Depending on the woman’s medical history, the following contraceptive methods are safe and effective post-abortion:

• Estrogen/progestin pill, patch, ring
• Progestin-only pill, injection, implant
• Progestin IUD
• Copper IUD (also is highly effective Emergency Contraception)
• Sterilization

Initiating contraception at the time of surgical abortion is ideal. Adherence increases when patients begin contraception right after the abortion.

Following medication abortion, the timing of initiation depends on the method. An IUD can be inserted at the follow-up appointment, as early as 4 days after the patient takes the medications. Patients may start any other contraceptive method (pills, patch, ring, shot, barrier methods) on the day they take the misoprostol. Because most hormonal contraceptives take one week to reach full efficacy, women should use a back-up method during that time.

See the Medical Eligibility Chart for greater detail about the most appropriate contraceptive methods for your patient, and read the Quick-start Algorithm to learn more about initiating contraception immediately. The contraceptives choices sheet can help you streamline your contraceptive counseling.

Clinicians should advise women to start contraception as soon as possible after an abortion — high-quality counseling improves contraceptive adherence.

We appreciate your feedback! Please write us at pearls@reproductiveaccess.org with any questions, comments or additional resources to add to our list.

Helpful Resources

Medical Eligibility for Initiating Contraception Chart

Quick-start Algorithm

Your Birth Control Choices Handout

Sources

Nobili M.P., Piergossi S., Brusati V., Moja E.A. (2007); The effect of patient-centered contraceptive counseling in women who undergo a voluntary termination of pregnancy; Patient Education and Counseling; 65; 361-368.

Grimes DA, Lopez LM, Schulz KF, Stanwood NL. Immediate postabortal insertion of intrauterine devices. Cochrane Database of Systematic Reviews 2010, Issue 6. Art. No.: CD001777. DOI: 10.1002/14651858.DC1777.pub3.

Zieman, Mimi. A Pocket Guide to Managing Contraception 2010-2012. Bridging the Gap Foundation.

Kavanaugh, ML, Carlin EF, Jones RK. Patients’ attitudes and experiences related to receiving contraception during the abortion care. Contraception December 2011, Volume 84, Issue 6; 585-593.

Pharma-free

The Reproductive Health Access Project does not accept funding from pharmaceutical companies. We do not promote specific brands of medication or contraception. The information in the Contraceptive Pearls is unbiased, based on science alone.