Any time of the month

• If she is starting within 7 days after the start of her monthly bleeding, no need for a backup method.
• If it is more than 7 days after the start of her monthly bleeding, she can start injectables any time if it is reasonably certain she is not pregnant. She will need a backup method^* for the first 7 days after the injection.
• If she is switching from an IUD, she can start injectables immediately (see Switching From an IUD to Another Method, in Chapter 10 – Copper-Bearing Intrauterine Device).

• Immediately, if she has been using the hormonal method consistently and correctly or if it is otherwise reasonably certain she is not pregnant. No need to wait for her next monthly bleeding. No need for a backup method.
• If she is switching from another injectable, she can have the new injectable when the repeat injection would have been given. No need for a backup method.

• Delay her first injection until 6 months after giving birth or when breast milk is no longer the baby's main food—whichever comes first.

• If her monthly bleeding has not returned, she can start injectables any time if it is reasonably certain she is not pregnant. She will need a backup method^* for the first 7 days after the injection.
• If her monthly bleeding has returned, she can start injectables as advised for women having menstrual cycles.

• Delay her first injection until at least 6 weeks after giving birth.

• If her monthly bleeding has not returned, she can start injectables any time if it is reasonably certain she is not pregnant.^† She will need a backup method^* for the first 7 days after the injection.
• If her monthly bleeding has returned, she can start injectables as advised for women having menstrual cycles.

• She can start injectables at any time on days 21–28 after giving birth. No need for a backup method. (If additional risk for VTE, wait until 6 weeks. See Question 2.)

• If her monthly bleeding has not returned, she can start injectables any time if it is reasonably certain she is not pregnant.^† She will need a backup method^* for the first 7 days after the injection.
• If her monthly bleeding has returned, she can start injectables as advised for women having menstrual cycles.

• She can start injectables any time if it is reasonably certain she is not pregnant. She will need a backup method^* for the first 7 days after the injection.

• Immediately. If she is starting within 7 days after first- or second-trimester miscarriage or abortion, no need for a backup method.
• If it is more than 7 days after first- or second-trimester miscarriage or abortion, she can start injectables any time if it is reasonably certain she is not pregnant. She will need a backup method^* for the first 7 days after the injection.

After taking progestin-only or combined ECPs:

• She can start or restart injectables on the same day as taking the ECPs. There is no need to wait for her next monthly bleeding to have the injection.
• She will need a backup method^* for the first 7 days after the injection. 
• If she does not start immediately, but returns for injectables, she can start  at any time if it is reasonably certain she is not pregnant.

After taking ulipristal acetate (UPA) ECPs:

• She can start or restart injectables on the 6th day after taking UPA-ECPs. No need to wait for her next monthly bleeding. Monthly injectables and UPA interact. If an injectable is started sooner, and thus both are present in the body, one or both may be less effective.
• Make an appointment for her to return for the injection on the 6th day after taking UPA-ECPs, or as soon as possible after that. 
• She will need a backup method* from the time she takes UPA-ECPs until 7 days after the injection.
• If she does not start on the 6th day but returns later for injectables, she may start at any time if it is reasonably certain she is not pregnant.