How long after an abortion should you wait to have sex?

Dear Cindy, 

Your friend is lucky to have you to support them! After an abortion—a procedure that ends a pregnancy by removing tissues from the uterus—a person may return to their normal activities (exercise, work, school, etc.) once they feel ready and able. Currently, there’s no medical consensus on when it’s safest or recommended to have sex after an abortion. Your friend might’ve been told to wait two to three weeks out of an abundance of caution. For example, if their cervix remained open for some time after their procedure, their body could have potentially been exposed to bacteria or other microorganisms that can cause infection. However, for most people, the cervix closes quickly after the procedure is done, making the risk of infection much lower. 

Physically speaking, sex after an abortion shouldn’t hurt, as the pelvic floor muscles aren’t affected. There is, however, the possibility of hormonal and physiological changes following an abortion, such as the inability to produce natural lubrication. If penetrative sex isn’t comfortable, your friend may still choose to engage in other kinds of sexual activity including oral, anal, or manual sex. It’s important to recognize that there is the possibility that having an orgasm may produce uncomfortable cramping sensations. If this is the case for your friend, they may decide to postpone any sexual pleasure until they are more healed and feeling more comfortable. 

Listening to their body and establishing boundaries with any partners about sex can be a helpful step in reengaging in sexual activity. Even if their body has physically healed, waiting until they feel mentally and emotionally healed and comfortable can help to make for a more pleasurable experience. 

During the aftercare period following an abortion, there are some signs and symptoms to watch out for that could alert you to potential dangers. Some signs of infection post–abortion include fever, chills, abdominal pain, or heavy vaginal discharge (though some people may experience abdominal cramps and vaginal bleeding without infection). A person can typically expect their first regular period within six weeks of the abortion. If they notice signs of infection, or if they don't get their period within six weeks after the procedure, they should consider visiting their health care provider before having sex. If they experience excessive bleeding post–abortion (soaking two maxi pads per hour for two hours), have cramps that aren't relieved by pain medication, or have a fever over 100.4 degrees Fahrenheit, they should reach out to a medical provider for further guidance. 

Additionally, if your friend had a late-term abortion, a urine infection, a uterine injury during the procedure, or any other complications, it's recommended that they wait at least two weeks or until their follow-up visit to have sex. Often, there’s is a follow-up visit scheduled between two to four weeks after the abortion to ensure that the healing process is going smoothly. Whether their abortion was done via medication or surgery, most people can get pregnant again almost immediately after an abortion if they have begun ovulating. So, if your friend chooses to have sex soon after and wants to avoid another pregnancy, they should consider speaking to a health care professional to discuss what birth control methods will serve them best. 

It’s great that you’re staying informed and helping your friend to find answers to these important health questions.