Remarks:

• This recommendation applies to the combination mifepristone plus misoprostol regimen and the use of misoprostol alone. The letrozole plus misoprostol combination regimen is not mentioned here because the included studies informing these recommendations did not assess this regimen.
• Immediate initiation of intramuscular depot medroxyprogesterone acetate (DMPA) is associated with a slight decrease in the effectiveness of medical abortion regimens (158). However, immediate initiation of DMPA should still be offered as an available contraceptive method after an abortion.
• Indirect evidence was used as a basis for decision-making on initiation of hormonal contraception as an option for individuals undergoing medical abortion with misoprostol alone.
• No data were available on the use of combined hormonal contraception (pills or injections) by those undergoing medical abortion.
• Individuals who choose to initiate the contraceptive ring should be instructed to check for expulsion of the ring in the event of heavy bleeding during the medical abortion process.

KEY HUMAN RIGHTS CONSIDERATIONS RELEVANT TO POST-ABORTION CONTRACEPTION

• Contraception should be provided only where the person has given free and informed consent to receive it.
• States must ensure availability of the full range of contraceptive options, including a wide range of modern, safe and affordable methods.
• States must ensure adequate access to essential medicines, including contraceptives, in an affordable and non-discriminatory manner.
• Everyone has a right to evidence-based information on all aspects of SRH, including contraceptives.
• Contraceptive information and services must be provided without discrimination, coercion or violence.
• Everyone has a right to privacy and confidentiality in the receipt of contraceptive information and services.
• Post-abortion contraceptive information and services should be available and accessible to adolescents without requiring parental or guardian authorization.
• States must guarantee that practices of conscientious refusal/objection do not infringe on the right to contraceptive information and services.