SynthesisContraception2021
Systemic hormonal contraception initiation after abortion: A systematic review and meta-analysis.
Synthesis in Contraception, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
9 citing papers in PubMed, 1 synthesis or guideline pooled it, 9 citations in OpenAlex.
- Immediate Versus Delayed Postpartum and Postabortion Insertion of Long-Acting Reversible Contraception: An Umbrella Review.BJOG : an international journal of obstetrics and gynaecology · 2026Pooled it
- Using updated clinical recommendations to support contraceptive decision-making: U.S. medical eligibility criteria for contraceptive use, 2024.Contraception · 2026Review
- Post-pregnancy contraception.Reproduction & fertility · 2026Review
- Evidence-Based Contraceptive Guidance for Young Women Following Induced Abortion: A Systematic Summary.Patient preference and adherence · 2026Review
- Women's Knowledge, Attitude, and Practice Regarding Oral Short-Acting Contraceptives After Induced Abortion: A Cross-Sectional Study in Beijing, China.International journal of women's health · 2026Article
- Post-abortion contraceptive uptake among women seeking care for incomplete or induced abortions in Northern Ethiopia: a facility-based cross-sectional study in a humanitarian setting.Frontiers in public health · 2026Article
- Effects of oral and transdermal estrogen on postoperative endometrial recovery after missed abortion: a retrospective longitudinal cohort study.Frontiers in medicine · 2025Article
- Postabortion contraceptive use among women in Nepal: results from a longitudinal cohort study.Reproductive health · 2024Article
- U.S. Medical Eligibility Criteria for Contraceptive Use, 2024.MMWR. Recommendations and reports : Morbidity and mortality weekly report. Recommendations and reports · 2024Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 4 institutions in 2 countries.
Funding
Abstract
backgroundImmediate contraceptive initiation, including start of a method before abortion completion, is a convenient option for women seeking abortion care.
objectivesTo evaluate the effect of systemic hormonal contraception initiation on medical abortion effectiveness and the safety of hormonal contraceptive methods following abortion. DATA SOURCES: PubMed, Popline, Cochrane Library, and Clinicaltrials.gov. STUDY ELIGIBILITY CRITERIA: Studies that assessed medical abortion effectiveness after systemic hormonal contraception initiation and the safety of hormonal contraception initiation after abortion.
participantsPregnant persons undergoing or who had recently undergone an abortion.
interventionsInitiation of systemic hormonal contraception post abortion or on the day of the first pill of the medical abortion. STUDY APPRAISAL AND SYNTHESIS
methodsWe assessed study quality using the US Preventive Services Task Force evidence grading system. We created narrative summaries and calculated pooled relative risks when appropriate.
resultsWe identified 16 studies for inclusion, 7 randomized controlled trials, and 9 cohorts. Nine studies assessed medical abortion effectiveness with hormonal contraception initiation and generally found no decreased risk of abortion success or increased risk of additional treatment. One fair-quality study reported a small increase in ongoing pregnancy rate with immediate depot medroxyprogesterone (DMPA) compared with delayed DMPA initiation (3.6% vs 0.9%, risk difference 2.7%, 90% confidence interval 0.4-5.6). We identified no bleeding-related safety concerns following hormonal contraception initiation after medical or surgical abortion. Pooled results were too imprecise to draw firm conclusions. LIMITATIONS: Included studies were poor or fair quality and primarily in high-income or upper-middle-income settings.
conclusionsAbortion effectiveness did not differ between immediate vs delayed initiation of most systemic hormonal contraceptive methods after a first trimester medical abortion. However, immediate DMPA initiation did show increased ongoing pregnancy. Bleeding effects with hormonal contraception initiation postabortion appeared minimal. IMPLICATIONS: Initiating a hormonal contraceptive method after an abortion and as early as the same day as the first pill of the medical abortion is an option if contraception is desired. The slight increase in ongoing pregnancy with immediate DMPA initiation highlights the importance of information provision during contraceptive counseling.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.