Can a woman after an abortion have all required post‑abortion follow‑up (ultrasound confirmation, Rh‑immune globulin, antibiotics, contraception counseling) performed by an obstetrician‑gynecologist?

Post-Abortion Follow-Up by OB-GYN

Yes, an obstetrician-gynecologist can and should provide all post-abortion follow-up care, including ultrasound confirmation, Rh-immune globulin administration, antibiotic prophylaxis verification, and contraception counseling. 1

Primary Care Physician's Role in Coordination

Your primary responsibility is to cancel the original OB-GYN referral for pregnancy management and verify that essential prophylaxis was completed at the abortion clinic. 1

• Contact the OB-GYN office to close the pregnancy management appointment, as this referral is no longer needed 1
• Directly confirm with the reproductive health clinic that administered the abortion whether they provided:
  • Antibiotic prophylaxis (mandatory to prevent post-abortal endometritis, which occurs in 5-20% without antibiotics) 2, 3
  • Rh-immune globulin for Rh-negative women (required to prevent alloimmunization) 3, 4
• This verification step is critical because gaps in clinic protocols may occur 1

OB-GYN Follow-Up Components

The obstetrician-gynecologist is fully qualified to provide comprehensive post-abortion care including:

Confirmation of Complete Abortion

• Ultrasound examination remains the criterion standard for confirming complete abortion 5
• Alternative simplified follow-up using telephone contact plus high-sensitivity urine pregnancy testing at 30 days is feasible (97% complete follow-up achieved) 6
• Low-sensitivity urine pregnancy test at 2 weeks has 100% sensitivity and negative predictive value for detecting ongoing pregnancy 7

Contraception Counseling

• The American College of Obstetricians and Gynecologists mandates comprehensive counseling addressing safety, effectiveness, accessibility, affordability, and acceptability of the full range of contraceptive options 1, 3
• Long-acting reversible contraception (LARC) should be offered using patient-centered, non-coercive counseling 1
• Counseling should help identify the method that best aligns with the patient's reproductive goals and life circumstances 1

Complication Screening

• Monitor for signs of infection, retained products of conception, and excessive bleeding 8
• The natural history of severe complications (infection, unrecognized ectopic pregnancy) has time courses inconsistent with routine follow-up visit timing, so patient education about self-recognition of warning signs is essential 9

When Primary Care Should Resume Management

After the OB-GYN completes post-abortion follow-up, you should:

• Resume comprehensive primary care for any underlying health conditions that may have influenced the pregnancy decision (metabolic, gastrointestinal, mental health issues) 1
• Provide ongoing reproductive health counseling as part of routine well-woman care 2
• Ensure access to pre-conception counseling if the patient desires future pregnancy 1

Critical Pitfall to Avoid

Do not assume the abortion clinic provided all necessary prophylaxis—actively verify completion of antibiotics and Rh-immune globulin administration. 1 Failure to confirm these interventions can result in preventable complications (endometritis rates increase from 1.3% to 5-20% without antibiotics; alloimmunization risk without Rh-immune globulin). 3, 4