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Barrier methods and other non-hormonal methods may be initiated immediately after ECP use.
Oral contraceptives may be initiated immediately after ECP use (with routine screening). With routine screening, some providers also provide depo-medroxyprogesterone acetate (DMPA) immediately, because of the low risk of pregnancy (2%) following ECP use, and the low risk of teratogenic effects; other providers await the start of menses before providing injectable contraceptives.
Long-term methods, such as an IUD or NORPLANT® Implants, can be initiated when menses return.
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There are no clinical data indicating that one method is more appropriate than another for use after ECPs. The choice should be made by the client and the provider. If the client was a pill user when she came in for ECPs, the reason for her missed pills should be discussed.
It is always recommended that a pregnant woman avoid unnecessary medication. However, if the woman is already pregnant or becomes pregnant due to failure of ECPs, and chooses a hormonal method, the best evidence indicates no increased risk of birth defects for the fetus.
- 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.
- Webb A. How safe is the Yuzpe method of emergency contraception? Fertility Control Reviews 1995;4(2):16-28.
- World Health Organization. Improving access to quality care in family planning: medical eligibility criteria for contraceptive use. Geneva: WHO, 1996.
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