Chapter 10 – Pregnancy Options

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Contraception post abortion

Fertility can return within a week post abortion. Patients are advised not to have sex for 7 days after MTOP to minimise the risk of infection.

An important part of the MTOP consultation and follow up is to ensure adequate and timely initiation of contraception.

Providing the patient is medically eligible according to the UK Medical Eligibility Criteria (MEC), most methods of contraception (with the exception of the hormonal or copper IUD) can be started either at the time of, or soon after, MTOP.(35)

If the combined Pill, POP, depot medroxyprogesterone acetate (DMPA), vaginal ring or implant is commenced within 5 days of the MTOP, pregnancy can be excluded and they will be effective immediately.

There is a concern with regard to commencing DMPA at the time of the MTOP and impairment of the progesterone blocking action of mifepristone and subsequent reduction in efficacy of the mifepristone. This needs to be considered on a case by case basis. The potentially higher risk of failed medical termination with concurrent DMPA use should be discussed with women, and appropriate follow-up should be arranged. Nevertheless, DMPA can also be a useful bridging method until an IUD is inserted.(36)

Insertion of an IUD should be delayed until completion of ... Buy now