Medication After Abortion
Yes, you typically need to take medication after an abortion, but the specific medications depend on the type of abortion and your individual circumstances.
Antibiotics After Procedural (Surgical) Abortion
For surgical abortion procedures, you should receive a single dose of antibiotics BEFORE the procedure begins, not after. 1
- Doxycycline 200 mg orally OR azithromycin 500 mg orally is recommended as a single pre-procedure dose 1
- The antibiotic should be given before instrumentation with adequate time for absorption 1
- Antibiotics should be discontinued after the procedure is completed - there is no benefit to continuing them 1
- This prophylactic antibiotic reduces infection risk across all gestational ages for surgical abortion 1
Antibiotics After Medication (Medical) Abortion
For medication abortion, routine antibiotics are NOT recommended. 1
- The infection rate after medication abortion is extremely low (less than 1%) 2
- The number of patients who would need to take antibiotics to prevent one infection is very high 1
- Studies show that when doxycycline is routinely prescribed after medication abortion, only 28.3% of women take it correctly, and it causes significantly more vomiting (25.2% vs 18.5%) 3
- Universal antibiotic prophylaxis is recommended AGAINST for medication abortion 1
Testing and Treatment for Sexually Transmitted Infections
You should be tested and treated for gonorrhea and chlamydia if: 1
- You have symptoms suggesting infection
- You have a positive diagnosis
- You are under 25 years old (routine screening age per CDC guidelines)
Important: The abortion should NOT be delayed while waiting for test results or treatment 1
Rh Immune Globulin (Anti-D Injection)
If you are Rh-negative, you may need RhIg (RhoGAM) after abortion: 4
- For abortion before 12 weeks: A dose of 50 μg RhIg should be given within 72 hours 4
- If the 50 μg dose is unavailable, use the standard 300 μg dose 4
- This prevents a serious complication called Rh alloimmunization that could affect future pregnancies 4
- Even at 6 weeks gestation, fetal red blood cells can cause maternal sensitization, so RhIg should be considered 4
Pain Medication
While the evidence provided focuses primarily on infection prevention, pain medication (such as ibuprofen or acetaminophen) is routinely prescribed after both surgical and medication abortion for cramping and discomfort, though this was not specifically detailed in the guidelines reviewed.
Common Pitfalls to Avoid
- Do not take antibiotics for 7 days after medication abortion - this is not evidence-based and causes unnecessary side effects 1, 3
- Do not delay your abortion waiting for STI test results - testing and treatment can happen simultaneously 1
- Do not skip RhIg if you are Rh-negative - even early pregnancy loss can cause sensitization 4
- Do not assume you need antibiotics after a medication abortion - the infection risk is already very low 1