[Post-abortion contraception]

Abstract

Objective: To establish guidelines of the French National College of Gynecologists and Obstetricians about post-abortion contraception.

Materials and methods: A systematic review of the literature about post-abortion contraception was performed on Medline and Cochrane Database between 1978 and March 2016. The guidelines of the French and foreign scientific societies were also consulted.

Results and discussion: After an abortion, if the woman wishes to use a contraception, it should be started as soon as possible because of the very early ovulation resumption. The contraception choice must be done in accordance with the woman's expectations and lifestyle. The contraindications of each contraception must be respected. The long-acting reversible contraception, intra-uterine device (IUD) and implant, could be preferred (grade C) as the efficacy is not dependent on compliance. Thus, they could better prevent repeat abortion (LE3). In case of surgical abortion, IUD should be proposed and inserted immediately after the procedure (grade A), as well as the implant (grade B). In case of medical abortion, the implant can be inserted from the day of mifépristone, the IUD after an ultrasound examination confirming the success of the abortion (no continuing pregnancy or retained sac) (grade C).

Keywords: Abortion; Contraception; Contraception orale; Contraception progestative; Dispositif intra-utérin; Implant; Interruption volontaire de grossesse; Intra-uterine device; Pill; Termination of pregnancy.