Recommendations for Contraceptive Use
		Oral Contraceptives as Emergency Contraceptive Pills

Recommendations

Rationale

Any woman who is concerned because she has had unprotected intercourse and who does not desire pregnancy may use ECPs. Use by women who are known to have an established pregnancy is not recommended, as evidence indicates that it will have no effect.

According to World Health Organization (WHO), International Planned Parenthood Federation (IPPF), the International Consortium for Emergency Contraception, Program for Appropriate Technology in Health (PATH) and most clinical guidelines, "established pregnancy" is the only medical contraindication for ECP use. "Established pregnancy" is technically defined by most specialists as an implanted embryo. Because ECPs will not disrupt an implanted embryo, ECPs will not have an effect on an established pregnancy. Further, the best evidence indicates that there are not any teratogenic effects from ECP exposure in utero. Beyond pregnancy, there are no other contraindications to ECP use, because the amount of steroids in the Yuzpe regimen and the duration of use are not considered substantial enough to have a clinically significant effect. A study of the effects of the Yuzpe method found no significant changes in clotting factors following treatment. Thus, the usual COC contraindications are not applicable. World Health Organization. Improving access to quality care in family planning: medical eligibility criteria for contraceptive use. Geneva: WHO, 1996. International Medical Advisory Panel, IPPF. Statement on emergency contraception. Planned Parenthood in Europe 1995;24(2):5-6. Consortium for Emergency Contraception. Emergency contraceptive pills. Welcome, Maryland: The Consortium, 1996. Program for Appropriate Technology in Health. Emergency contraception: a resource manual for providers. Seattle: PATH, 1997. Webb A. How safe is the Yuzpe method of emergency contraception? Fertility Control Reviews 1995;4(2):16-8. Bracken M. Oral contraception and congenital malformations in offspring: A review and meta-analysis of the prospective studies. Obstetrics and Gynecology 1990;76:552-7. Simpson JL, Phillips OP. Spermicides, hormonal contraception and congenital malformations. Advances in Contraception 1990;6:141-67.

Any part of Recommendations for Updating Selected Practices in Contraceptive Use may be reproduced or adapted to meet local needs without prior permission from the TG/CWG Secretariat, provided the TG/CWG is acknowledged and the material is made available free of charge or at cost.