|Fact sheet No 244: Emergency Contraception - June 2000 (WHO, 2000, 2 p.)|
Emergency contraception refers to contraceptive methods that can be used by women in the first few days following unprotected intercourse to prevent an unwanted pregnancy. Emergency contraceptive methods are effective and safe for the majority of women who may need them, as well as being simple to use.
Who may need emergency contraception?
Any woman of reproductive age may need emergency contraception at some point to avoid an unwanted pregnancy. It is meant to be used in situations such as:
· after voluntary sexual intercourse that took place with no contraceptive protection;
· after incorrect or inconsistent use of regular contraceptive methods or when there has been an accidental failure of other contraceptive methods such as:
· condom breakage or slippage;
· miscalculation of the infertile period when using periodic abstinence or failure to abstain from sexual intercourse during the fertile days;
· expulsion of an intrauterine device (IUD);
· failed coitus interruptus, when ejaculation has occurred in the vagina or on the external genitalia;
· failure to take oral contraceptives for more than 3 days;
· being late for a contraceptive injection;
· when a woman has been a victim of sexual assault and has had no contraceptive protection.
Methods of emergency contraception
The most common methods of emergency contraception are:
· high doses of combined oral contraceptives (COCs) containing ethynyl estradiol and levonorgestrel (Yuzpe regimen).
· high doses of progestogen-only pill containing levonorgestrel.
Mode of action
Emergency contraception pills (ECPs) are thought to prevent ovulation, fertilization, and/or implantation. ECPs are not effective once the process of implantation has begun, and will not cause abortion.
After a single act of unprotected sexual intercourse, the Yuzpe regimen fails in about 2 percent of women who use it correctly (the chances of pregnancy are approximately four times greater when no emergency contraceptive is used). The progestogen-only regimen is equally effective.
The World Health Organization (WHO) has drawn up medical eligibility criteria for the use of emergency contraception pills based on the relative health risks and benefits of the method for women with given conditions.
The sole contraindication for the use of emergency contraception pills is pregnancy. Emergency contraception pills should not be given to a woman who has a confirmed pregnancy primarily because they will not be effect. Experts believe there is no harm to a pregnant woman or fetus if emergency contraceptive pills are inadvertently used during early pregnancy. Emergency contraceptive pills are for emergency use only and not recommended for routine use because of the higher possibility of failure compared to regular contraceptives and the increase in side effects such as nausea and vomitting. However, their repeated use poses no known health risks.
1. Consortium for Emergency Contraception. Emergency Contraceptive Pills. A resource packet for health care providers and Programme Managers. 1996.
2. Wells E, Crook B, Muller N. Emergency Contraception: A resource Manual for Providers. PATH, 1997
3. World Health Organization. Emergency Contraception: A guide for service delivery. WHO/FRH/FPP/98.19
World Health Organization. Improving Access to Quality Care in Family Planning: Medical Eligibility Criteria for Contraceptive Use. WHO/FRH/FPP/96.9.
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