Emergency Contraceptive Pills
The emergency contraceptive pill (ECP) is an important pregnancy prevention option for women in cases when contraception failed, was not used, was used incorrectly, and in cases of non-consensual intercourse.
ECP has often been referred to as the "morning after pill," however it is effective in preventing pregnancy if taken within 120 hours of unprotected sexual intercourse.
ECP is not an abortifacient (that is, it is not a process or substance that induces an abortion). ECP prevents pregnancy by preventing or delaying ovulation, interfering with fertilization, and/or preventing implantation (similar to other hormonal contraceptives).
There are currently two types of pills marketed specifically as emergency contraception: progestin-only ECP (Plan B), and combination estrogen and progestin ECP (Preven). Where both ECP formulations are available, practitioners recommend Plan B. It is more effective than combined ECP (89% reduction in pregnancy, compared to 75%), and it rarely produces the nausea and vomiting that may be associated with combined ECP.
Emergency contraception alone is not considered a primary method of birth control, because it is not as effective as other methods. However, repeated use of emergency contraception is not harmful.
ECP eligibility should be assessed at all reproductive health visits, and, if the woman is eligible, it should be provided along with a highly effective birth control method for ongoing use.
ECP is widely available for purchase over the counter in urban areas. In much of the developing world, however, education about appropriate use is often lacking. The use of ECP in some regions of the world may be related to the lack of availability of adequate family planning services.
IUDs as Emergency Contraception
Emergency contraception can also be obtained through the insertion of a copper IUD within five days of unprotected intercourse. This method is an excellent option for women who are interested in using the IUD an as on-going method of contraception. The copper IUD is about 99% effective in preventing pregnancy after unprotected intercourse.