For safe2choose, in collaboration with Find My Method
In collaboration with our sister platform, Find My Method, in the next few months, we will be posting pieces that speak to the intersectionality between abortion and contraceptives. We hope to contextualise access to contraceptives as they pertain to abortion rights, in a bid to highlight the need for an intersectional understanding of sexual reproductive health for womb-bearers.
As part of the recommendations set forth by the World Health Organisation under the framework of integrated care, contraceptive recommendations should be part and parcel of abortion services, unless limited by other extenuating circumstances. After an abortion has been conducted, your fertility almost immediately returns, and this is the best time to ask your practitioner for the most suitable contraceptive for you. This post serves to inform you on the various methods you could bring up in conversation following your abortion, and which are the safest for you.
In the absence of complications such as excessive bleeding, contraceptives can be started almost immediately and virtually any methodology can be used. Should you want to prevent unwanted pregnancies, many healthcare professionals suggest using a long-acting reversible contraceptive, otherwise known as LARC.
This subset of contraceptives include:
- The Implant– A hormonal treatment that is placed under the skin of your arm and is viable for 3-5 years, depending on the brand and types of implant. This particular contraceptive can be inserted directly after an abortion has been conducted, and has a 99% success rate in curbing unwanted pregnanices. If inserted immediately after an abortion, you should wait 7 days before having sex without another form of contraception, such as a condom.
- The Intrauterine Device (IUD)- This can be hormonal or non hormonal and it is placed inside the womb via the vaginal canal, lasting 5-10 years. Due to the nature of many abortions causing an ejection of the uterine lining, it is generally suggested that you wait 2 weeks before having an IUD placed as this reduces the likelihood of it being rejected. If inserted immediately after an abortion, you should wait 7 days before having sex without another form of contraception, such as a condom.
- The DMPA (Depot medroxyprogesterone acetate) is a long-acting progesterone hormone that is given as an injection every 12 weeks. This can be administered immediately following an abortion but similar to the above mentioned LARC, another form of contraception should be used during sexual intercourse for the first 7 days following insertion.
Each of these contraceptive methods is generally safe and effective in preventing unwanted pregnancies, but each body is different, and care should be taken when deciding which contraceptive to use. Use the find my contraceptive tool on the Find My Method website to have a better understanding of each of these LARCs, their characteristics, limitations and more.
Should you opt not to use a LARC for any reason, there are other options that can also be used soon after abortions have been conducted. These include:
- The Pill– A hormonal contraceptive that is taken orally daily for the duration of one’s cycle. This option can be used right after an abortion, but it is advised that you wait 2 days before relying on it as the sole contraceptive method you use if it is a progesterone only pill, and 9 days if it is a combination pill.
- The Patch– You wear the patch on certain parts of your body, and it releases hormones through your skin that prevent pregnancy. This can be administered as soon as abortions are completed but you should wait 7 days before using it as your sole contraceptive option.
- The Ring– You wear the small, flexible ring inside your vagina, and it prevents pregnancy by releasing hormones into your body. This form of contraceptive can also be used immediately after an abortion, but similar to the patch, there should be 7 days before you rely on it as the only birth control option.
In addition to the above mentioned contraceptives, the Emergency Contraceptive Pill is also an option that can be used following abortions. Although not long-term, it is still a viable option should you find yourself in a situation where you need one. After the use of emergency contraceptives, it is generally advised that you consult a practitioner on the available long term contraceptives at your disposal. For more information on contraceptives, visit the Find My Method platform.
About the author: Marie-Simone Kadurira is the consultant for Southern Africa and South-East Asia at safe2choose. Outside of this work, she is a champion for SRH rights in sub-saharan Africa through her non-profit “Vasikana Vedu” that provides sanitary products to underrepresented communities.
Instagram: @_bampassy_
Facebook: Marie Kadurira
Resources:
- Safe abortions: technical and policy guidance for health systems. World Health Organization. Retrieved July 2020.
- Contraception Counselling. Marie Stopes International. Retrieved July 2020. https://www.mariestopes.org.uk/other-services/contraception/
- LARC Overview. Family Planning Victoria. Retrieved July 2020. https://www.fpv.org.au/for-you/contraception/long-acting-reversible-contraception-larc/long-acting-reversible-contraception-larc