When Is It Safe to Attempt Conception After Abortion?
Women can safely attempt conception immediately after a completed abortion, with no mandatory waiting period required for medical reasons. 1, 2
Immediate Return of Fertility
The critical factor to understand is that fertility returns extremely rapidly after abortion:
- Ovulation can occur as early as 8-13 days after abortion, with most women ovulating within 2-3 weeks 1, 3, 4
- In one study, 34% of women had already ovulated by 3 weeks post-abortion, and 78% by 6 weeks 4
- The likelihood of ovulation is low only within the first 7 days after abortion 1
Evidence-Based Recommendations
There is no medical reason to delay attempting pregnancy after abortion. The evidence supporting immediate conception includes:
- A 1985 study of women who conceived within 12 weeks of spontaneous abortion showed no increased abortion risk and normal pregnancy outcomes in 18 of 19 cases 5
- Women who conceived later (>26 weeks after abortion) actually had higher abortion rates (7 of 42 pregnancies) compared to those who conceived earlier 5
- Induced abortion has no impact on future fertility 3
Practical Clinical Algorithm
If the patient desires immediate pregnancy:
- Conception can be attempted as soon as the woman feels physically and emotionally ready 2
- Ensure the abortion is complete before resuming unprotected intercourse 2
- No waiting period is medically necessary 1, 2
If the patient does NOT desire immediate pregnancy:
- Contraception must be initiated immediately, as fertility returns before the first menstrual period 1, 3
- Combined hormonal contraceptives can be started within 7 days of abortion, including immediately, without backup contraception if started at time of surgical abortion 1, 2
- Progestin-only pills require only 2 days of backup contraception 2
- IUDs can be inserted within 7 days, including immediately post-abortion 1, 2
- Long-acting reversible contraceptives (implants, IUDs) are the most effective methods to prevent unintended pregnancy 3
Critical Pitfalls to Avoid
The most common mistake is assuming women need to wait for their first period before they can conceive or need contraception. This is false—ovulation precedes menstruation, and pregnancy can occur before the first post-abortion period 1, 3, 4
Do not advise women to postpone conception unless there are specific emotional or medical reasons unrelated to the abortion itself. The historical practice of recommending a waiting period is not evidence-based 5