Contraception
Volume 80, Issue 4 , Pages 355-362, October 2009

Use of combined oral contraceptives post abortion☆☆☆

  • Mary E. Gaffield

      Affiliations

    • Department of Reproductive Health and Research, World Health Organization, Geneva, 27, Switzerland
    • Corresponding Author InformationCorresponding author. Tel.: +41 22 791 1806; fax: +41 22 791 4171.
    • ,
  • Nathalie Kapp

      Affiliations

    • Department of Reproductive Health and Research, World Health Organization, Geneva, 27, Switzerland
    • ,
  • Anita Ravi

      Affiliations

    • Centers for Disease Control and Prevention, Atlanta, GA 30341, USA

Received 9 January 2009; received in revised form 7 April 2009; accepted 7 April 2009. published online 05 June 2009.

Abstract 

Background

Providing combined oral contraceptives (COCs) following surgical or medical induced abortion offers women an opportune moment to initiate a reliable contraceptive method.

Study Design

We conducted a systematic review, searching MEDLINE and The Cochrane Library for articles in any language concerning COC use following spontaneous, induced (medical or surgical) or septic abortion, from 1966 through June 2008. Seven articles were identified and evaluated using the United States Preventive Services Task Force system.

Results

Immediate COC initiation after first-trimester medical or surgical induced abortion did not increase side effects or prolong vaginal bleeding compared with use of a placebo, copper-bearing intrauterine device (IUD), nonhormonal contraceptive method or COC initiation at a later time. Initiating COCs after first-trimester surgical abortion produced small increases in coagulation parameters compared with IUD use; although they are statistically significant, their clinical relevance is unlikely. No study examined second-trimester induced or spontaneous abortion, or septic abortion.

Conclusions

Evidence shows that COCs can be safely initiated immediately following surgical and medical abortion in the first-trimester of pregnancy.

Keywords: Combined oral contraceptive, Medical abortion, Surgical abortion, Safety

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☆ The views expressed are those of the authors and may not necessarily reflect those of the World Health Organization or the Centers for Disease Control and Prevention.

☆☆ This review was supported by resources from the Department of Reproductive Health and Research at the World Health Organization in Geneva, Switzerland, and from the Centers for Disease Control and Prevention, the Association of Schools of Public Health, the United States Agency for International Development and the National Institute of Child Health and Human Development, in the USA.

PII: S0010-7824(09)00121-8

doi:10.1016/j.contraception.2009.04.005

Contraception
Volume 80, Issue 4 , Pages 355-362, October 2009

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