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Abstract
The return of fertility is rapid after first trimester abortion. The first ovulation may take place as soon as 2 weeks after abortion, and half of the women have ovulated by 3 weeks. Hence, commencement of effective contraception is necessary even before the first postabortal menstrual period. Women are highly motivated as regards contraception at this time. Several studies, both in developed and developing countries, have shown that the Insertion of a modern copper intrauterine device (IUD) at the end of the abortion procedure is a safe and well-accepted way to start the method. Hormonal methods, such as NORPLANT, levonorgestrel-releasing IUD, injectables and oral combination pills do not affect the recovery of the pituitary-ovarian system, even though introduced immediately after abortion. The combination of preceding pregnancy, abortion procedure and immediate start of low dose oral contraceptives containing 30 μg of ethinyloestradlol results in a slight tendency towards hypercoagulability. This may be clinically insignificant, but it can be avoided by postponing oral contraceptives until 1 week after abortion, without losing the contraceptive efficacy of the method.