From the Guidelines
Depo-Provera can be administered immediately after an abortion, and the first injection can be given within the first 7 days, including immediately postabortion, as recommended by the U.S. MEC 1 1.
Key Considerations
- The standard dose is 150mg given as an intramuscular injection, which is effective for 3 months.
- If the injection is given at the time of a surgical abortion, no backup contraception is needed, but if given more than 5 days after the abortion, a backup method should be used for 7 days.
- According to the CDC, Depo-Provera is classified as a category 1 method for postabortion contraception, indicating no restriction on method use 1.
Mechanism of Action and Side Effects
- Depo-Provera works by preventing ovulation, thickening cervical mucus to block sperm, and thinning the uterine lining, making it highly effective at preventing pregnancy while the body recovers from the abortion.
- Common side effects include irregular bleeding, weight gain, headaches, and mood changes.
Important Considerations for Patients
- Patients should be aware that return to fertility may take 9-10 months after discontinuation.
- Regular injections every 12 weeks are necessary for continued protection, with a 2-week grace period for the next injection.
- It is essential to note that any contraceptive method may be started after completion of emergency contraceptive pills, and the patient should use a barrier method or abstain from intercourse for seven days (14 days after ulipristal use) 1.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Depo-Provera After Abortion
- Depo-Provera, a long-acting injectable contraceptive, has been used by women after abortion 2.
- Studies have shown that it is safe to administer Depo-Provera immediately after medical abortion, with no significant differences in efficacy or adverse outcomes compared to delayed administration 3.
- Women who choose Depo-Provera after abortion may have different characteristics and preferences compared to those who choose other long-acting reversible contraceptives, such as intrauterine devices (IUDs) or implants 4.
Effectiveness and Safety
- Depo-Provera has been shown to be an effective contraceptive method, with a high percentage of users becoming amenorrheic over time 2.
- The safety of Depo-Provera has been established, with no major adverse reactions observed and minor side effects comparable to those of oral contraceptives 2.
- However, women who use Depo-Provera may experience weight gain and changes in menstrual bleeding patterns 2.
Comparison to Other Contraceptives
- Depo-Provera is one of several contraceptive options available to women after abortion, including IUDs, implants, and oral contraceptive pills 5, 6.
- The choice of contraceptive method depends on individual preferences, medical history, and lifestyle factors, and should be discussed with a healthcare provider 5.
- IUDs and implants have been shown to be highly effective and safe, with low failure rates and rare serious risks 5, 6.
Clinical Recommendations
- The Society of Family Planning recommends that most methods of contraception, including Depo-Provera, can be safely initiated immediately after surgical abortion 6.
- Healthcare providers should discuss the benefits and risks of each contraceptive method with patients and provide individualized recommendations based on their needs and preferences 5, 6.