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This table provides guidance on starting a progestogen-only injectable for women who are postpartum (both breastfeeding and non-breastfeeding) and after a first or second-trimester abortion based on guidance by CKS
| Condition/Time | Action | Additional Advice |
|---|---|---|
| Women Postpartum (Breastfeeding & Non-Breastfeeding) | ||
| Up to day 21 postpartum | Give injection immediately | No additional precaution |
| After day 21, menstrual cycles returned, no pregnancy risk | Start as for women having menstrual cycles | |
| After day 21, menstrual cycles returned, with pregnancy risk | - Assess need for EC | Avoid sexual intercourse or use condoms for 7 days; Take pregnancy test ≥3 weeks after unprotected intercourse |
| - Quick start injection (5-day delay if ulipristal EC given) | ||
| After day 21, no menstrual cycles, reasonably certain not pregnant | Give injection immediately | Avoid intercourse or use condoms for 7 days |
| After day 21, no menstrual cycles, with pregnancy risk | - Assess need for EC | Avoid intercourse or use condoms for 7 days; Take pregnancy test ≥3 weeks after unprotected intercourse |
| - Quick start injection (5-day delay if ulipristal EC given) | ||
| Women Post First- or Second-Trimester Abortion | ||
| Days 1–5 of the menstrual cycle | Give injection immediately | Ideally, start on the day or the day after abortion |
| At any other time, reasonably certain not... |
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