Emergency Contraception
CURRENT GUIDANCE UPDATE
Copper IUD Emergency Contraception
The Copper IUD is the most effective form of emergency contraception, providing more than 99% protection when inserted within 120 hours after unprotected intercourse and in selected cases beyond this timeframe.
Ulipristal Acetate
Ulipristal acetate is more effective than levonorgestrel for emergency contraception when taken between 72 and 120 hours after unprotected sexual intercourse.
How Emergency Contraception Works
Emergency contraception prevents pregnancy primarily by delaying or preventing ovulation and does not terminate or affect an existing pregnancy.
Timely Access
Emergency contraception should be accessed as soon as possible after unprotected intercourse to maximize effectiveness and should be accompanied by contraceptive counselling.
Introduction
Emergency contraception, commonly called the morning-after pill, refers to methods used after unprotected sexual intercourse to prevent pregnancy. It is an important component of reproductive healthcare that is widely misunderstood and underutilised. Emergency contraception does not cause abortion; it prevents fertilisation or implantation before pregnancy is established.
Emergency Contraception
Emergency contraception helps prevent pregnancy after unprotected intercourse or contraceptive failure. The sooner it is used, the more effective it is, with the Copper IUD remaining the most reliable option throughout the recommended time window.
Emergency Contraceptive Options
- Copper IUD: Over 99% effective when inserted within 120 hours and provides ongoing long-term contraception.
- Ulipristal Acetate: Oral medication effective for up to 120 hours and more effective than levonorgestrel in the later window.
- Levonorgestrel: Best taken within 72 hours and may be less effective in women weighing 70 kg or more.
How It Works
Copper IUDs prevent fertilisation through a spermicidal effect. Ulipristal acetate and levonorgestrel primarily delay or inhibit ovulation and therefore must be taken before the LH surge to achieve maximum effectiveness.
Time Matters
The effectiveness of oral emergency contraception decreases as time passes after unprotected intercourse. The Copper IUD maintains very high effectiveness throughout the full 120-hour window, making it the most reliable emergency contraceptive method.
Important Guidance
- Take oral emergency contraception as soon as possible.
- After ulipristal acetate, use barrier contraception for 14 days when starting hormonal contraception.
- If vomiting occurs within 2 hours, repeat the dose or consider a Copper IUD.
After Emergency Contraception
- Choose and start a reliable ongoing contraceptive method.
- Take a pregnancy test if the next menstrual period is more than 7 days late.
- Arrange STI testing if there is any concern about possible exposure.
Frequently Asked Questions
Can I use the morning-after pill as regular contraception?
Emergency contraception is significantly less effective than regular contraceptive methods and is not designed for regular use. Women using it frequently should be supported to choose an appropriate ongoing method.
Does emergency contraception cause an abortion?
No. Emergency contraception prevents fertilisation or implantation. It cannot terminate an established pregnancy.
Conclusion
Emergency contraception is a critical safety net in reproductive healthcare. Rapid access to the most appropriate method, based on time since intercourse and individual factors, is essential for maximum effectiveness.
Sources & References
This article draws on guidance current at the time of writing from the following bodies and publications:
FSRH
2017, updated 2023ACOG
2022 GuidelinesWHO
2021 Guidelinesβ IMPORTANT DISCLAIMER
This article is provided for general knowledge and reference purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. No medication, treatment, or change to your healthcare should be undertaken based on this content without first consulting a qualified doctor. Always seek the advice of your physician or another qualified health provider with any questions you may have regarding a medical condition.
