From the Guidelines
Depo-Provera can be administered immediately after an abortion, ideally within the first 7 days, including immediately postabortion. The standard dose is 150 mg given as an intramuscular injection in the gluteal or deltoid muscle. This immediate post-abortion administration is recommended because fertility can return quickly after an abortion, sometimes within 7-10 days, and immediate administration provides immediate contraceptive protection 1. If Depo-Provera is given more than 5 days after the abortion, a backup contraceptive method should be used for 7 days after the injection.
Key Considerations
- The injection works by suppressing ovulation, thickening cervical mucus to prevent sperm entry, and thinning the uterine lining to prevent implantation.
- Each injection provides contraceptive protection for approximately 12-14 weeks, though it's typically recommended to get the next injection after 12 weeks.
- Patients should be informed that Depo-Provera may cause irregular bleeding initially and potential side effects including weight gain, headaches, and mood changes.
- It's also important to note that Depo-Provera does not protect against sexually transmitted infections.
Administration Guidelines
- According to the U.S. Selected Practice Recommendations for Contraceptive Use, 2013, the first DMPA injection can be given within the first 7 days, including immediately postabortion 1.
- The woman needs to abstain from sexual intercourse or use additional contraceptive protection for the next 7 days unless the injection is given at the time of a surgical abortion 1.
- The CDC also specifies that any contraceptive method may be started after completion of emergency contraceptive pills, and patients who vomit within three hours after using emergency contraceptive pills should take another dose 1.
From the FDA Drug Label
To ensure the patient is not pregnant at the time of the first injection, the first injection should be given ONLY during the first 5 days of a normal menstrual period or within the first 5-days post-partum. In post-partum mothers who exclusively breastfeed, administer medroxyprogesterone acetate injectable suspension during or after the sixth post-partum week
The answer to how soon Depo-Provera can be administered after an abortion is not directly stated in the label. However, based on the information provided for post-partum mothers, it can be inferred that Depo-Provera can be given immediately after an abortion if the patient is not pregnant at the time of the first injection. But since the label does not explicitly address the timing of administration after an abortion, caution should be exercised and a pregnancy test should be performed before administering the drug 2.
- Key consideration: The patient should not be pregnant at the time of the first injection.
- Administration timing: The label does not provide a specific time frame for administration after an abortion, but it does provide guidance for post-partum mothers.
From the Research
Administration of Depo-Provera after Abortion
- Depo-Provera (medroxyprogesterone) can be safely initiated immediately after first- or second-trimester surgical abortion, as stated in the clinical recommendations by the Society of Family Planning 3.
- The provision of postabortion contraceptives, including Depo-Provera, substantially reduces subsequent unintended pregnancy 3.
- A study comparing the choice of levonorgestrel intrauterine device, etonogestrel implant, or depot medroxyprogesterone acetate for contraception after aspiration abortion found that women who chose Depo-Provera were more likely to be experiencing intimate partner violence and had different characteristics compared to those who chose long-acting reversible contraceptives (LARC) 4.
- While there is evidence supporting the immediate initiation of various contraceptive methods after abortion, the specific studies on Depo-Provera administration after abortion are limited, but it is included in the general recommendation for immediate postabortion contraception 3, 4.
- Other studies focus on different aspects of postabortion care and contraception, such as self-administered versus provider-administered medical abortion 5 and the timing of initiating the contraceptive patch after abortion 6, which do not directly address the administration of Depo-Provera but contribute to the broader understanding of postabortion contraceptive options.