Family Planning: What You Should Know About Emergency Contraception

What is emergency contraception?

Emergency contraception (EC) refers to methods of birth control that can be used to prevent pregnancy after sexual intercourse. It is also called ‘post-coital contraception’, post-coital means ‘after sexual intercourse’.

According to the WHO , emergency contraception methods can prevent 95% of pregnancies when used within 5 days after intercourse; the sooner it is used, the more effective it will be. However, if fertilization and implantation have already occurred, EC will not interrupt the pregnancy – it cannot cause abortion.

How does it work?

Emergency contraception can prevent pregnancy by stopping:

• ovulation (the release of an egg from your ovaries),
• sperm from fertilizing an egg,
• implantation of an already fertilized egg – it prevents the egg from attaching to the wall of the uterus. This is more common with the IUD method.

Who can use it?

Any female of reproductive age can use emergency contraception to avoid unwanted pregnancy.

When should emergency contraception be used?

EC is not recommended as a regular birth control method, as the name implies, it is designed to be used in ’emergencies’.

Some of these situations include:

• unprotected sexual intercourse;
• sexual intercourse after consecutively missing 2 or more birth control pills;
• barrier contraceptive failure, e.g. slipping off or breakage of condom during intercourse;
• dislodgment, breakage, tearing, or early removal of a diaphragm or cervical cap;
• failed withdrawal (e.g. ejaculation in the vagina or on external genitalia);
• sexual assault when the woman was not protected by any form of contraception.

Types of emergency birth control

Emergency contraception comes in two types: pill form and intrauterine device (IUD).

The Emergency Contraception Pills

Emergency contraception in pill form (ECPs) are commonly called ‘the morning after pills’; however, women do not need to wait till the morning after to take the ECP. The ECP should be taken as soon as possible after unprotected sex. There are 3 types of ECPs available-

• Pills containing a hormone called levonorgestrel, usually available over-the-counter;

• Combined Oral Contraceptive pills (COC) can also be used as emergency pills, but they have to be taken at a higher dosage. It is less effective than levonorgestrel ECP.

• Pills containing ulipristal acetate (the only non-hormonal ECP). These pills can only be gotten with a prescription, and are most effective when taken 72-120 hours after sexual intercourse.

ECPs are less effective in obese women (whose body mass index is more than 30 kg/m2).

Intrauterine Devices

An intrauterine device (IUD) is the other type of emergency birth control. It involves a doctor placing a tiny T-shaped device into the womb, within 5 days after sexual intercourse. This is the most effective form of emergency contraception available.

Once inserted, women can continue to use the IUD as an ongoing method of contraception, or may choose to change to another contraceptive method. Unlike ECPs, its effectiveness is not affected by weight.

Are there side effects of emergency contraception?

There are few side effects associated with using EC, however, they do not happen to everyone.

• Nausea
• Abdominal pain
• Fatigue
• Headache
• Menstrual changes
• Tender breasts

These symptoms are usually not very severe and only last for a few days.

Where can I get emergency birth control?

• Primary care doctor’s office
• Family planning clinic
• Women’s health centers
• Public health departments
• Hospital emergency departments

A Word from HealthFacts

Emergency contraception can prevent up to 95% of pregenancies when used early enough. Although effective, emergency methods do not replace the need for a more stable family planning plan.

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