After Abortion Pill: When Can I Get Pregnant Again?

The abortion pill, also known as medication abortion or medical abortion, has become an increasingly common method to end an early pregnancy. If you have recently had a medication abortion, you may be wondering how soon you can become pregnant again afterwards.

This thorough guide covers everything you need to know about fertility and getting pregnant after taking the abortion pill.

Key Takeaways:

  • It is possible to get pregnant again right away after a medication abortion. Ovulation resumes as early as 11 days after using the abortion pill.
  • Most doctors recommend waiting at least 1 normal menstrual cycle before trying to conceive again. This allows the uterus to heal and restore its lining after the abortion.
  • Using birth control in the meantime prevents pregnancy until you are ready. Methods like condoms, the pill, IUDs, or Nexplanon can be started soon after taking the abortion pill.
  • Your periods should return within 4-8 weeks after a medication abortion. Your cycle may be irregular initially but should regulate over time. Track your periods to have a better sense of when you are ovulating.
  • Get evaluated if you don’t get your period back after 8 weeks or if you have signs of infection like fever, chills, or foul-smelling discharge.
  • There are no increased risks to getting pregnant again after properly completing a medical abortion as long as you allow your body to recover.
  • Most women can conceive and have healthy pregnancies in the future after taking the abortion pill. Make sure to start taking folic acid and maintain a healthy lifestyle.
  • Talk to your doctor if you have concerns about future fertility or want to get pregnant again soon after using the abortion pill.

How the Abortion Pill Works

The abortion pill regimen involves taking two different medications – mifepristone and misoprostol. This medication combo works to end an early pregnancy up until 10 weeks gestation.

Here is a brief overview of how it works:

  • Mifepristone – This medicine is taken first either at the clinic or at home depending on your state’s laws. Mifepristone blocks the hormone progesterone which causes the uterine lining to break down and detach from the pregnancy.
  • Misoprostol – The misoprostol tablets are taken 24-48 hours after mifepristone, often at home. Misoprostol causes uterine cramping and contractions to expel the pregnancy from the uterus.
  • Bleeding – Most women will start bleeding anywhere from immediately up to 48 hours after taking the misoprostol. Moderate to heavy bleeding and cramping is common as the uterus contracts and empties.
  • Pregnancy Ends – For most women the pregnancy passes and the abortion completes within a few hours after taking the misoprostol. Follow-up care confirms the abortion was successful based on ultrasound, lab tests, or physical exam.

The medication abortion process causes cramping and bleeding as the uterine lining sheds. This is very similar to an early miscarriage. After the abortion completes, the uterus needs time to heal and restore its lining before trying to conceive again.

When Does Fertility Return After the Abortion Pill?

It is possible to ovulate and become pregnant again right away after a medication abortion. However, this is not recommended by most doctors. Here’s a breakdown of how fertility returns:

  • As early as 11 days – Studies show the menstrual cycle can restart and ovulation resume in as few as 11 days after medical abortion. This is why it’s so important to start contraception immediately if you do not want to become pregnant right away.
  • Within 4 weeks – Most women who were regularly menstruating prior will ovulate again within 4 weeks after taking the abortion pill. This means you could conceive by this time.
  • After first period – The first post-abortion menstrual period marks a full return to fertility. This cycle “reset” allows the uterine lining to rebuild and be ready for a pregnancy again.
  • By 8 weeks – Almost all women who were ovulating regularly before the abortion will have ovulated at least once within 8 weeks after a medication termination. Periods should restart for most women by this time.

While you may ovulate and release an egg very soon after the abortion pill, most OB-GYNs recommend waiting longer before trying to get pregnant again.

When Can I Start Trying to Conceive After the Abortion Pill?

While it may be possible to get pregnant again right away, most doctors recommend waiting a certain amount of time after a medication abortion before trying to conceive. Here are the medical recommendations:

  • At least 4 weeks – The minimum amount of time recommended by many health providers before conceiving again is 4 weeks after taking the abortion pill. This allows the uterus to heal after the pregnancy passes.
  • One normal period – The most common advice is to wait until you get at least one normal menstrual period before trying to get pregnant again after an abortion. This cycle allows the uterine lining to shed and rebuild normally.
  • 3 menstrual cycles – Some sources suggest waiting 3 regular periods, or about 3 months, before attempting pregnancy again. This gives the body more time to fully recover and replenish important nutrients like folic acid.
  • 6 months to a year – If you had complications with your abortion or certain medical conditions, your provider may suggest waiting for 6 months or longer before conceiving again after taking the abortion pill.

The amount of time recommended often depends on each woman’s individual health circumstances. Talk to your ob-gyn about what’s right for you.

Using Birth Control Before Trying to Conceive Again

Using contraception in the weeks and months after your abortion prevents pregnancy until you are ready to carry another pregnancy. Here are some birth control options to consider after the abortion pill:

  • Condoms – External condoms create an effective barrier and can be used as soon as you stop bleeding after taking the misoprostol. Condoms prevent both pregnancy and STIs.
  • Copper IUD – A non-hormonal copper IUD provides immediate pregnancy protection and can be placed right after a medication abortion. It does not affect future fertility.
  • Progestin IUD – The Mirena, Kyleena, Liletta, or Skyla IUDs release progestin hormones and can be inserted 4-6 weeks after abortion once the cervix has closed. Progestin IUDs are also top tier pregnancy prevention.
  • The Pill – Birth control pills can be started the Sunday after using the misoprostol for the abortion. The pill prevents ovulation and thickens cervical mucus to block sperm.
  • The Shot – The Depo Provera birth control shot provides 3 months of pregnancy protection with one injection. It can be started within a week after taking the misoprostol.
  • Nexplanon – The Nexplanon implant releases progestin into the arm for up to 3 years of pregnancy prevention. It must be inserted after the abortion is complete and the arm has healed if an IV line was used.

Discuss options with your provider to find the right contraceptive method for this time frame. Using birth control will give you full control over when to conceive again.

What to Expect for Future Periods After the Abortion Pill

During a medication abortion the uterine lining sheds, similarly to a menstrual period. It takes time after this bleeding for normal menstrual cycles to resume. Here’s what to expect:

  • Irregular periods – The first 1-2 periods after taking the abortion pill may have irregular timing and heavier or lighter flow. It can take several cycles for your body to adjust and find its rhythm again.
  • Spotting – Light spotting between periods is common for the first month or two as the uterine lining continues to shed and regrow. Don’t be alarmed by intermittent spotting.
  • No period for 4-8 weeks – It can take 4-8 weeks after the abortion for your first real period to start. This gives the uterus time to heal before shedding its lining again.
  • Return to normal – Within about 3 post-abortion cycles, your periods should return to their regular timing if you were previously regular. Cycles regulate as ovulation resumes.
  • Ovulation timing – Try to track your cycles to identify when you are ovulating after the abortion pill. Ovulation may be delayed at first but regulate over time.

Period tracking apps or ovulation test strips can help identify when you are most fertile as your cycles normalize. Watch for cycle length, period heaviness, and PMS symptoms to stabilize.

Signs of Complications to Watch For

Serious complications after a medication abortion are very rare, especially if directions are properly followed. However, some women may experience:

  • Prolonged heavy bleeding – Soaking through 2 pads per hour for 2 hours in a row or excessive bleeding for 12 days could signal an incomplete abortion. Seek care immediately.
  • Severe cramping – Abdominal cramping more than a week after the abortion that gets worse instead of better can be a warning sign.
  • Fever or chills – Temperature over 100.4°F, foul-smelling discharge, abdominal tenderness, or general illness could indicate an uterine infection. Get evaluated ASAP.
  • No period after 8 weeks – If your period hasn’t returned 8 weeks after the abortion pill, take a pregnancy test. No period for this long could mean an ongoing pregnancy.
  • Ectopic pregnancy – Severe one-sided pelvic pain with abnormal bleeding after a medication abortion should be evaluated urgently for possible ectopic.

Get prompt medical care if you have any of these symptoms or other concerns following the abortion pill. Make sure the abortion fully completed.

Effects on Future Fertility and Pregnancies

When done correctly in early pregnancy, medical abortion is extremely unlikely to impact your future fertility or ability to have normal pregnancies. Here’s what the research shows:

  • No increased infertility risk – Well-conducted studies find medication abortion does not increase the risk of secondary infertility compared to those who did not have the procedure.
  • No change in ovarian reserve – The abortion pill has no detrimental effect on your ovarian follicle count or egg supply. It does not accelerate loss of eggs as you age.
  • Does not cause miscarriage – There is no evidence that the abortion pill leads to a higher chance of miscarriage or complication in future wanted pregnancies.
  • Healthy pregnancies afterwards – The vast majority of women go on to conceive and deliver perfectly healthy babies following use of the abortion pill.
  • Preterm birth controversy – Some studies suggest there may be a small increased risk for preterm birth or low birth weight in pregnancies after an induced abortion. But the evidence is conflicting. Clearly more research is needed.

Barring any complications, medication abortion when performed early in pregnancy is very unlikely to cause fertility problems or adverse outcomes in subsequent pregnancies.

Getting Pregnant After Abortion: Healthy Pregnancy Tips

Once your body has fully recovered and you have gotten the green light from your provider, you can start trying to conceive again. Give yourself the best chances of having a healthy pregnancy after your abortion by:

  • Taking a prenatal vitamin with at least 400mcg of folic acid before conception to prevent neural tube defects.
  • Seeing your healthcare provider for a preconception checkup to make sure any health conditions are controlled, and get up to date with vaccinations.
  • Having your partner get checked for any issues with sperm health. Use lubricant when trying to conceive.
  • Kick unhealthy habits like smoking and drinking alcohol which can affect fertility and fetal development.
  • Reach a healthy BMI if you are over- or underweight as extremes can interfere with getting pregnant.
  • Track your cycles, monitor for ovulation, and properly time intercourse to boost your chances each month.
  • Try for 12 months of well-timed unprotected sex before getting concerned and seek fertility testing.

Remember most couples conceive within 6 months to a year of active trying through natural cycles or treatments like Clomid, if needed. Be patient with your body and speak with your doctor if you have any concerns getting pregnant again after your abortion.

FAQs About Getting Pregnant After the Abortion Pill:

How soon after can I take a pregnancy test if I think I’m pregnant again after the abortion pill?

Take a sensitive home pregnancy test 21 days after the abortion pill if you haven’t gotten your period. The tests work by detecting hCG hormone which your body starts making upon conceiving. False negatives are possible before 21 days.

Do I need to use backup contraception if I start birth control soon after the abortion pill?

Yes, use condoms or abstain from sex for the first 7 days on birth control pills, the first week of Depo Provera shots, or the first 7 days after a Nexplanon implant. This allows time for the contraceptive to become effective.

Does the abortion pill increase my risk for ectopic pregnancy in the future?

There is no evidence that having a medication abortion increases your risk for ectopic pregnancy in the future. However, get evaluated for ectopic any time you have concerning one-sided pelvic pain and abnormal bleeding.

How much folic acid should I take when trying to conceive after using the abortion pill?

Take a daily prenatal vitamin with at least 400 micrograms of folic acid starting 1-3 months before conception and continuing through pregnancy. Get this critical nutrient to help prevent brain/spine defects.

How long should I wait to have sex after a medication abortion?

You can resume sex whenever you feel ready after the abortion pill – usually after bleeding slows down in a few days up to 2 weeks. Use protection if you wish to prevent pregnancy. Let your body heal before inserting anything in the vagina.

The Takeaway

It is possible to get pregnant again right away after using the abortion pill, but it’s ideal to wait at least 1 normal menstrual cycle to allow the uterus to heal. Use birth control consistently until you are ready.

Track your periods, watch for ovulation signs, and get preconception care. If you have any concerns, speak to your healthcare provider about trying to conceive after your medication abortion. They can offer guidance based on your health history.

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