After the Abortion Pill: Start Birth Control
After the Abortion Pill. Start Birth Control. Santa Teresa Guide.
After the Abortion Pill: When to Start Birth Control & Which Methods to Consider
Ending a pregnancy via medication abortion is just one step in your reproductive journey. Once the abortion process is over, many patients want to start birth control right away—to regain control, prevent an unintended pregnancy, or shift to a method that fits their life. At Women’s Reproductive Clinic, we support same‑day contraceptive counseling and initiation. Here’s a guide to timing, safety, and method options after taking the abortion pill.
Start Birth Control: Timing
Ovulation can return surprisingly fast. Studies and clinical guidance show that many people begin ovulating within 3 to 4 weeks of an abortion if no contraception is used. (ACOG) Because of that, offering contraception immediately reduces the risk of a rapid repeat pregnancy. (ACOG) Clinical guidelines from ACOG, WHO, and family planning organizations support offering any contraceptive method immediately after abortion when clinically appropriate. (ACOG)
For medical abortion (using mifepristone + misoprostol), many methods can be started on the same day the first pill is taken, with a few exceptions. (ACOG) This approach reduces barriers—no need to ask you to come back later for birth control.
After the Abortion Pill: Which Methods Can Begin Immediately (or Very Soon)
Here’s a breakdown of when various contraceptive methods can safely be initiated after the abortion pill, with caveats and best practices:
| Method | When to Start | Notes / Considerations |
|---|---|---|
| Progestin-only pills, combined pills, patch, ring | On the day of mifepristone (day 1) | These are considered Category 1 (no restrictions) after abortion. (srhr.org) If you start later, you may need backup protection for several days. (Reproductive Health Access Project) |
| No restrictions post‑abortion (in first-trimester settings). (srhr.org) | Immediately | There is some evidence that giving DMPA on the same day as mifepristone may slightly increase the risk of continuing pregnancy. Providers may offer alternate timing or discuss trade‑offs. (ACOG) |
| Implants (e.g., Nexplanon / progestin implant) | Same day or shortly after | Implant insertion doesn’t reduce the effectiveness of abortion. (Reproductive Health Access Project) |
| Injectables (e.g., DMPA / depo shot) | Same day with some caution | For medical abortion, insertion is often done once pregnancy expulsion is confirmed (often 4 days or more). Some methods allow for insertion sooner, depending on the provider’s protocol. (Reproductive Health Access Project) Levonorgestrel IUD may have additional timing rules. (srhr.org) |
| Copper IUD | After abortion completion or as early as “immediate” insertion | After confirmation, abortion is complete |
| Permanent sterilization | Sterilization (e.g., tubal ligation) is typically delayed until the abortion is confirmed complete. | Sterilization (e.g. tubal ligation) is typically delayed until the abortion is confirmed complete. |
Note: “Same day” for medical abortion is generally defined as the day mifepristone is taken. (NCBI) The abortion must be complete before you can safely confirm some longer‑acting methods in specific settings.
Start Birth Control: What to Consider in Choosing a Method
Choosing contraception after abortion is highly personal. Some factors to consider:
- Desire for fertility in the future
- Bleeding patterns (especially after abortion)
- Hormonal vs non‑hormonal preferences
- Medical conditions (e.g., hypertension, migraines, clotting risks)
- Ease of use and comfort with the method
- Access in your area (some methods require in‑clinic insertion)
At WRC, we counsel you on all options and support whichever method you choose—no pressure.
After the Abortion Pill: Practical Steps at WRC (Santa Teresa)
- During your abortion visit, the care team will ask if you want to start birth control.
- They’ll review your medical history to rule out contraindications.
- If you select a method, we’ll supply or insert it the same day, when possible.
- You’ll receive instructions, backup support, and emergency contacts.
- Follow-up (if needed) is offered via phone or in person—no mandatory return visit is required.
Start Birth Control: Myths & Misconceptions
- Myth: You must wait weeks to start birth control after an abortion.
Truth: Most methods are safe to begin immediately or very soon after abortion. (ACOG) - Myth: Starting hormonal methods interferes with the abortion pill.
Truth: Except for DMPA (injectable), evidence does not show meaningful interference with mifepristone efficacy. (ACOG) - Myth: You can’t use IUDs after a medical abortion.
Truth: IUDs can be used after expulsion of the pregnancy, sometimes even inserted soon after. (Reproductive Health Access Project)
After the Abortion Pill: Final Thoughts
Starting contraception after the abortion pill can be empowering—it’s about choosing what comes next for your body. At WRC, we aim to make that process seamless, supportive, and tailored to you. Whether you opt for a pill, implant, IUD, or injection, we’re here to help you begin when you’re ready.
If you have questions or want to learn more about contraception after your abortion, visit our medical abortion page or contact us directly.