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Contraception after medication abortion should be determined by convenience and choice
  1. Kelly Blanchard
  1. Correspondence to Kelly Blanchard, Ibis Reproductive Health, Cambridge, MA 02140, USA; kblanchard{at}ibisreproductivehealth.org

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Abortion is a common experience and people seeking abortion are increasingly choosing medication abortion (abortion with medicines, most often mifepristone and misoprostol). Many women who have had an abortion will be interested in contraception services, and providing information about and access to a wide range of contraceptive methods where abortion is offered is a critical component of high quality care. Because mifepristone is a progesterone antagonist, there has been some concern that offering progestin-only methods (like progestin-only implants or injectables) at the time medication abortion drugs are taken might interfere with the effectiveness of medication abortion. This analysis from Lang and colleagues1 provides information from a large number of women who received a progestin-only injectable (depo medroxyprogesterone acetate, DMPA) at the time they received misoprostol (the second drug in the regimen, taken 24–48 hours after mifepristone). The findings are an important addition to the literature and add to the existing data that support providing contraception based on women’s choice and convenience.

Although research has shown that implants inserted on the day of mifepristone do not impact medication abortion effectiveness, a study by Raymond et al recently reported that the risk of continuing pregnancy after medication abortion was higher when DMPA was …

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