Contraception after an abortion

A surgical abortion (also known as surgical termination of pregnancy) deliberately ends a pregnancy using a surgical procedure performed by a trained doctor.

A medical abortion (also known as medical termination of pregnancy) deliberately ends a pregnancy using specific medications that need to be prescribed by a trained doctor.

Prior to your abortion, your healthcare professional will be able to discuss your contraception options. If your particular choice is not immediately available, suitable or effective, you may wish to start on another type of contraceptive initially to be protected until you can switch to your preferred method later.

Your medical history and prior experience of contraception are some of the information that your doctor will take into account when discussing your contraception options with you.

How soon after an abortion can I get pregnant?

Whether you have a surgical or medical abortion, you can ovulate (become fertile, by releasing eggs from your ovaries) again very soon after the abortion. This can happen even before your period returns. Therefore, it's important to start using contraception immediately if you wish to prevent any unwanted pregnancies.

How soon after an abortion can I have sex?

You can have vaginal sex after 2 weeks, or a few days after bleeding has stopped.

You may also be advised by your doctor to avoid swimming, baths and using tampons or menstrual cups for 2 weeks or a few days after bleeding has stopped.

Which contraception methods can I use after an abortion?

Discuss with your doctor which methods you can choose from and which methods are suitable for you. Most contraception methods can be safely started after an abortion and will become effective straight away or within the next few days.

Contraception methods include short-acting, long-acting or permanent types:

• Short-acting methods – include barrier methods (such as condoms) that must be used every time you have sex, or methods that require taking a contraceptive pill daily.
• Long-acting reversible contraception (LARC) – these are the most effective reversible contraceptive methods, requiring no further action for several months or years depending on the type you use. They include implants (such as Implanon), injections (such as Depo Provera), and intrauterine devices (IUDs) (such as the hormonal IUDs like Mirena or Kyleena, or the copper IUD).
• Permanent methods – include female sterilisation and male vasectomy; intended to be non-reversible.

How soon will contraception work after abortion?

How soon contraception will work after an abortion depends on the type of contraception you choose, and the type of abortion you had.

Contraception after a surgical abortion

Contraceptive implants, contraceptive injections, IUDs and hormonal contraceptive pills are all considered effective immediately after a surgical abortion and can be provided to you at that time.

If you have the contraceptive injection or commence contraceptive pills more than 5 days after an abortion, you'll need to use additional contraception for one week.

An IUD can be inserted straight away after a surgical abortion, including while you are still under anaesthetic or sedation. This is considered acceptable and convenient by many women, as no separate appointment is required, and is one of the most effective options.

Research has shown that there is a slightly increased risk of an IUD being expelled (moving out of the ideal position or falling out) when inserted right after an abortion. This is more likely when the abortion is in the second trimester (over 12 weeks) but is still a very low possibility.

Contraception after a medical abortion

You can start most hormonal contraceptive methods (pills, injections or implants) at the time of your medical abortion.

The exact timing can vary with the type of contraception. For example, you may be advised to start it when you take the first medication (mifepristone), or the last medication (misoprostol), or after it has been established that the abortion is completed. Your doctor will provide the prescription for your chosen method of contraception and advise on how to access it and when to start it.

An IUD can be inserted immediately or a few days after the completion of a medical abortion. It requires an appointment in a clinic setting and you will need to use another contraceptive method in the meantime if you do not want to risk an unwanted pregnancy.

Emergency contraception

If you have had sex without contraception following an abortion, or think the contraception might have failed, there are 3 different types of emergency contraceptives you can use to avoid a pregnancy:

• copper IUD
• ulipristal emergency contraceptive pill
• levonorgestrel emergency contraceptive pill.

Copper IUD

The copper IUD is the most effective method of emergency contraception. It can be inserted within 5 days of unprotected intercourse or, if the date of ovulation can be estimated, up to 5 days after ovulation, in women for whom they are suitable.

Another advantage of copper IUDs is that they can provide effective contraception for at least 5 years.

Copper IUDs require a prescription and need to be inserted by a trained professional.

Emergency contraceptive pill

The emergency contraceptive pill are tablets that, when taken (swallowed), prevent or delay ovulation. They are approximately 85 percent effective in preventing a pregnancy but should be taken as soon as possible after unprotected sex for maximum effectiveness.

There are 2 types of emergency contraceptive pill, both available at pharmacies without a prescription:

• ulipristal (UPA-EC) can be taken up to 5 days (120 hours) after unprotected sex
• levonorgestrel (LNG-EC) can be taken up to 3 days (72 hours) after unprotected sex.

Ulipristal has been clinically demonstrated to be more effective than levonorgestrel in reducing the risk of pregnancy when taken up to 5 days (120 hours) after unprotected sex.

Which contraception is right for me?

You can discuss your options with a nurse or doctor at the service providing you with an abortion, with your GP or local contraception and sexual health service.

Where to get help

• The abortion clinic you attended
• Your GP (doctor)
• Pharmacy
• 1800 My Options Tel. 1800 696 784
• Your local sexual health clinic
• Melbourne Sexual Health Centre Tel. (03) 9341 6200 or Tel. 1800 032 017 or TTY (for the hearing impaired) Tel. (03) 9347 8619
• Sexual Health Victoria (SHV). To book an appointment free call Tel. 1800 013 952, or call their clinics in Melbourne CBD Tel. (03) 9660 4700 or Box Hill Tel. (03) 9257 0100 – these services are youth and LGBTIQA+ friendly