When to start taking contraceptive pills after miscarriage

16 August, 2014

I recently had a very early miscarriage. I in fact only knew about the pregnancy for a few days before it happened. My doctor recommended that we use hormonal contraceptives for 2 cycles before trying to conceive again. She stated that this was only a recommendation, and that it is ultimately up to us. I should probably add that we have been married for less than two years, and have a 9 month old baby.

My problem is that I feel very conflicted over using the birth control (I don't want to), as I am feeling physically and emotionally ready for another baby. So my question is, halachically would it even be permissible for us to use the birth control? According to Halacha, does one have to listen to a doctor's recommendation about using birth control, if she doesn't see any serious problems in me becoming pregnant before 2 cycles of waiting?

Answer:

We are sorry to hear of your miscarriage.

Halachically it would be permissible to use birth control, certainly for the short period of time recommended by your doctor to allow your body to recover from the miscarriage.

Since this waiting period was recommended by your doctor but not strictly required, if you feel physically and emotionally ready to try again to conceive, you would not be halachically required to follow your doctor's recommendation. However, keep in mind that you are still in the first year after a birth, and your body may need this time to recover from that pregnancy and childbirth, as well as from the miscarriage. Giving yourself a little more time before trying to conceive will help your body regain the strength necessary to carry a healthy pregnancy. 

If you do choose to use birth control for the next two months, we advise against using hormonal birth control, since it is common to experience irregular bleeding during the first 1-3 cycles. The best type of halachically acceptable birth control for short term use is spermicide, with or without a diaphragm. While spermicide is not a very effective birth control method, it is sufficient in cases where it is not absolutely critical to prevent pregnancy. 

Please feel free to get back to us with any further questions.

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Having an abortion doesn’t change your chances of getting pregnant in the future. In fact, you can get pregnant again pretty quickly after an abortion. So, if another pregnancy isn’t in your plans soon after your abortion, it’s a good idea to talk with your provider about starting birth control. Here are some common questions about starting a method after an abortion:

How soon after an abortion can you start birth control?

It depends on what type of abortion you have. If you have an abortion procedure, it’s totally safe (and often convenient!) to start birth control on the same day as your abortion. That means you can get an IUD, an implant, or the shot in the clinic, or start using the pill, the patch, or the ring that same day.

If you have a medication abortion (sometimes called “the abortion pill”), you’ll be able to start hormonal birth control methods like the pill, the shot, the patch, and the ring immediately after your abortion is complete (that is, as soon as you’ve finished the heavier bleeding that starts after the last pills). You can get other methods—like an IUD—as soon as you have your follow up visit, usually 1-2 weeks after you take the abortion pills.

For methods that you only use at the time you’re having sex, like condoms, internal condoms, the sponge, the diaphragm, the cervical cap, and spermicide, you can start using those whenever you’re ready to start having sex again after any type of abortion.

How do you pick the best birth control to use after an abortion?

Picking a method to use after an abortion is just like picking a birth control any other time. Think about what matters most to you in your method. Is your top priority using the method that will be the most effective at preventing pregnancy? Something easy to use? Something that makes your period lighter? Something that you can stop and start without seeing a provider? There are good birth control options for all of these. Check out Bedsider’s method explorer for help choosing and speak to your provider before your abortion to make a birth control plan.

Does birth control work right away if you start it on the same day as your abortion?

It does! Actually, if you start birth control within a week of your abortion, you’ll be protected against pregnancy right away. This means that when you feel ready to have sex again, you don’t need to use a back-up method like condoms or internal condoms.

If you wait more than a week after your abortion procedure or finishing your medication abortion pills to start a birth control method with hormones (like the pill, the patch, the ring, or the hormonal IUD), you will need to either wait to have sex or use a back-up method (like condoms or internal condoms) during sex for the first 7 days after starting your method. If you’re not quite sure if you need back-up, ask your provider.

What if you’re not ready to choose a birth control method on the day of your abortion?

It’s totally okay (and normal!) if you’re not ready to choose a birth control method on the day of your abortion. If you need a little more time to think, consider making a visit to follow up 1-2 weeks after your abortion (if you have the medication abortion, you will need to have a follow up anyway to make sure the abortion is complete). Make sure to use a back-up method, like condoms or internal condoms, if you have sex before starting your new method.

What if you were on birth control before your abortion and you want to switch?

Switching methods is always a legit move, whether it’s after an abortion or at any other time. Your provider can help you think through what you did and didn’t like about methods you’ve used in the past and explore your options.

What if you can’t get birth control at the place where you get your abortion?

No problem! There are lots of places where providers can help you get started on a birth control method. Check out our clinic finder to find a provider who can help you get the birth control you want. If an in-person appointment doesn’t fit your schedule, you can also check out these telemedicine companies where you can get birth control online!

Should I use contraception after a miscarriage?

Do you have to wait for your period to start birth control?

Can I take emergency pill after abortion?

How will I know if miscarriage is complete?