Emergency Contraception should be used after unprotected
intercourse if pregnancy is not planned or desired.
Types
COCs, POPs, Antiprogestins (mifepristone) and IUDs (copper-releasing)
Benefits
- All are very effective (less than 3% of women become pregnant during that cycle).
- IUDs also provide long-term contraception.
Limitations
- COCs are effective only if used within 72 hours of unprotected intercourse.
- COCs may cause nausea, vomiting or breast tenderness.
- POPs must be used within 48 hours but cause much less nausea and breast tenderness.
- Antiprogestins are effective only if used within 72 hours of unprotected intercourse;
currently are expensive and available only in a few countries.
- IUDs are effective only if inserted within 5 days of unprotected intercourse.
- IUD insertion requires minor procedure performed by a trained service provider and
should not be done in women at risk for STDs (e.g., HBV, HIV/AIDS).
Who Can Use Emergency Contraception
- Clients in need of emergency protection (e.g., unplanned, unprotected intercourse;
broken condom or leakage from condom)
Who Should Not Use Emergency
Contraception
- Women who are pregnant or suspected of being pregnant
Client Instructions
| COCs: |
Take four tablets of a low-dose COC (30–35 µg ethinyl
estradiol) orally within 72 hours of unprotected intercourse. Take four more
tablets in 12 hours.
(Total = 8 tablets)
OR
Take two tablets of a high-dose COC (50 µg ethinyl estradiol) orally within 72
hours of unprotected intercourse.
Take two more tablets in 12 hours.
(Total = 4 tablets) |
| POPs: |
Take 10 Postinor® tablets (75 µg of
levonorgestrel each) or 20 Ovrette® tablets (75 µg norgestrel
each) orally within 48 hours of unprotected intercourse. Take 10 or 20 more
tablets in 12 hours.
(Total = 20 Postinor or 40 Ovrette tablets) |
| IUDs: |
Insert within 5 days of unprotected intercourse.
|
| Antiprogestins: |
Take 600 mg mifepristone within 72 hours of unprotected
intercourse. |
For all methods, if no menses (vaginal bleeding) within 3 weeks, the client should consult
the clinic or service provider to check for possible pregnancy.
Management of Side Effects
SIDE EFFECT |
MANAGEMENT |
| COCs and POPs: Nausea, Vomiting |
Counsel client about this side effect. If vomiting
occurs within 1 hour after taking first or second dose, client may need to repeat the
dose. |
| Bleeding/spotting |
About 8% of women using COCs for emergency
contraception will have spotting during the treatment cycle. About 50% will get their
menses at the expected time and most others will start menses earlier than expected. |
| IUD |
Same as for interval insertion. |
Who Can Provide
- Physicians
- Nurses, Midwives, Paramedics
Where It Can Be Provided
- Hospitals
- Clinics
- Health Posts
- Private Offices
 
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