Post-Abortion Sexual Activity: Safety and Contraceptive Options

Sexual activity after abortion?

I would like to ask, my wife and I accidentally conceived a child about half a month ago.
After discussing it, we decided to undergo a medical abortion, and she took RU486 on the 11th.
However, on the 25th, she experienced light bleeding, and she felt it was probably fine, so we had sexual intercourse using a condom.
Later, we noticed that the condom seemed to have broken.
Now, to prevent an unintended pregnancy, can she take emergency contraception while still experiencing light bleeding? We do not want to go through the pain of terminating another pregnancy again.

Yang, 20~29 year old female. Ask Date: 2015/10/27

Dr. Lü Lizheng reply Obstetrics and Gynecology

I would like to know if you returned to the obstetrics and gynecology department to confirm that the abortion was complete after taking RU486 on the 11th.
If you took RU486 and did not return for a follow-up examination, would you be concerned about whether the previous abortion was effective? There is a possibility that the previous pregnancy status may still be ongoing.
Typically, after a miscarriage, ovulation does not occur immediately, especially in patients who undergo a medical abortion; it usually takes at least three weeks or more for ovulation to resume.
Therefore, the likelihood of becoming pregnant from sexual intercourse on the 25th is very low, and there is no need to take emergency contraception.
Sincerely, Dr.
Li-Cheng Lu, Taoyuan Hospital.

Reply Date: 2015/10/27

More Info

It's understandable that you and your wife are concerned about the possibility of pregnancy following a recent abortion, especially given the emotional and physical toll that such an experience can take. Let's address your questions regarding post-abortion sexual activity, contraceptive options, and the use of emergency contraception.

1. Safety of Sexual Activity After Abortion: After a medical abortion, it is generally recommended to wait at least two weeks before engaging in sexual intercourse. This allows your body time to heal and reduces the risk of infection. However, if your wife has experienced only light bleeding and feels comfortable, it may be possible to engage in sexual activity. It's essential to listen to her body and feelings during this time.

2. Risk of Pregnancy: If you had sexual intercourse and the condom broke, there is a risk of pregnancy, especially if it occurred during her fertile window. After an abortion, ovulation can resume relatively quickly, sometimes as soon as two weeks post-procedure. Therefore, if you are concerned about the possibility of pregnancy, it is wise to consider emergency contraception.

3. Emergency Contraception: The use of emergency contraception (EC) is an option if you are worried about an unintended pregnancy after a contraceptive failure, such as a broken condom. There are two main types of emergency contraception:
- Levonorgestrel (Plan B): This is most effective when taken within 72 hours after unprotected intercourse but can work up to five days after.
- Ulipristal Acetate (Ella): This can be taken up to 120 hours after unprotected intercourse and is generally more effective than Levonorgestrel, especially closer to ovulation.

4. Using Emergency Contraception Post-Abortion: Given that your wife is still experiencing light bleeding, it is crucial to consult with a healthcare provider before taking emergency contraception. While it is generally safe to use EC after an abortion, a healthcare professional can provide personalized advice based on her specific situation and health history.

5. Long-term Contraceptive Options: If you and your wife are looking to prevent future pregnancies, it may be beneficial to discuss long-term contraceptive options with a healthcare provider. There are various methods available, including hormonal birth control pills, intrauterine devices (IUDs), implants, and barrier methods. Each option has its benefits and potential side effects, so a thorough discussion with a healthcare provider can help you choose the best method for your lifestyle and health needs.

6. Emotional Considerations: It's also important to address the emotional aspects of your situation. Both of you may be experiencing anxiety or fear regarding pregnancy after the abortion. Open communication about these feelings can help alleviate some of the stress. Consider seeking support from a counselor or therapist who specializes in reproductive health if either of you is struggling with the emotional aftermath of the abortion.

In conclusion, while it is possible to use emergency contraception after a recent abortion, it is essential to consult with a healthcare provider to ensure it is appropriate for your wife's current health status. Additionally, discussing long-term contraceptive options can provide peace of mind and help prevent future unintended pregnancies. Remember to prioritize open communication and emotional support during this time.

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