criteria for excluding pregnancy if considering change in (or starting) contraception

Last edited 03/2020 and last reviewed 08/2022

Healthcare practitioners can be reasonably certain that a woman is not currently pregnant if any one or more of the following criteria are met and there are no symptoms or signs of pregnancy:

  • she has not had intercourse since the start of her last normal (natural) menstrual period, since childbirth, abortion, miscarriage, ectopic pregnancy or uterine evacuation for gestational trophoblastic disease
  • she has been correctly and consistently using a reliable method of contraception. (For the purposes of being reasonably certain that a woman is not currently pregnant, barrier methods of contraception can be considered reliable providing that they have been used consistently and correctly for every episode of intercourse.)
  • she is within the first 5 days of the onset of a normal (natural) menstrual period
  • she is less than 21 days postpartum (non-breastfeeding women)*
  • she is fully breastfeeding, amenorrhoeic and less than 6 months postpartum*
  • she is within the first 5 days after abortion, miscarriage, ectopic pregnancy or uterine evacuation for gestational trophoblastic disease
  • she has not had intercourse for >21 days and has a negative high-sensitivity urine pregnancy test (able to detect human chorionic gonadotrophin (hCG) levels around
    20 mIU/ml).

* See UKMEC 2016 and FSRH Guideline Contraception After Pregnancy for recommendations regarding use of combined normonal contraception after childbirth.

A negative pregnancy test, if available, adds weight to the exclusion of pregnancy, but only if >=3 weeks since the last episode of unprotected sexual intercourse (UPSI).

NB. In addition to the conditions mentioned above, health professionals should also consider whether a woman is at risk of becoming pregnant as a result of UPSI within the last 7 days

Reference: