OBJECTIVES: To examine possible differences in postabortion long-acting reversible contraception (LARC) preference and initiation among clinic-based medication abortion and telemedicine medication abortion patients. STUDY DESIGN: We examined electronic medical records among 576 medication abortion patients at one health system in California between 2020 and 2022. RESULTS: Overall, 25% of patients preferred LARC and 21% initiated LARC. Among those who preferred LARC, 77% initiated LARC. No statistically significant differences were found in LARC preference or initiation across medication abortion modalities. CONCLUSIONS: In this health system, clinic-based medication abortion and telemedicine medication abortion patients did not differ in postabortion LARC preference or initiation.