Unintended pregnancy remains a major public health concern, and improving continuation of effective contraception is a key prevention strategy. This randomized sub-study examined whether early initiation of combined hormonal contraception after medical abortion improves short-term continuation. Women requesting the pill, patch, or ring were randomized to supervised initiation at the one-week follow-up visit (“Observed Start”) or traditional “Sunday Start.” Continuation at six weeks was high in both groups, with no significant difference between initiation methods. Bleeding duration and partner knowledge did not differ by group. These findings suggest that supervised early initiation does not improve short-term continuation following medical abortion.
