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close this bookEmergency Contraceptive Pills (WHO - OMS, 1998, 44 p.)
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View the documentEmergency Contraceptive Pills: What you need to know
View the documentA Resource Packet for Health Care Providers and Programme Managers
View the documentAdapting Resource Packet Materials for Local Use
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Open this folder and view contentsEmergency Contraceptive Pills: Medical and Service Delivery Guidelines
View the documentAbout the Consortium for Emergency Contraception

Emergency Contraceptive Pills: What you need to know

[Sample client brochure for local adaptation by programmes providing high-dose combined ECPs. If low-dose pills are used, change the client instructions to 4 tablets for each dose (8 tablets total).]

[Sample illustration. Replace with locally pretested illustration.]

What is Emergency Contraception?

Emergency contraception is a way of preventing pregnancy if you have had sex without using contraception or if you had a contraceptive accident (such as a broken condom).

The most common method is Emergency Contraceptive Pills (ECPs). In some cases, a copper intrauterine device (IUD) also can be used as emergency contraception.

All emergency contraceptive methods must be used within several days of unprotected sex. They are effective and safe for most women. Your health care provider can help you choose the method that is best for you.

[Sample illustration. Replace with locally pretested illustration.]

Emergency Contraceptive Pills

What are Emergency Contraceptive Pills (ECPs)?

ECPs are the same as pills used for regular contraception, but they are taken differently and in higher amounts than daily contraceptive pills.

How do ECPs work?

Depending on when you use ECPs during your monthly cycle, ECPs will either stop or delay an egg from being released from the ovary or, possibly, stop a fertilized egg from attaching to your uterus. ECPs will not work once a pregnancy has started.

When can I use ECPs?

The first ECP dose must be taken within 72 hours (3 days) after unprotected sex. A second dose is taken 12 hours after the first dose.

How effective are ECPs?

ECPs prevent most pregnancies, but they are not 100 percent effective. The treatment fails in approximately 2 percent of women using ECPs correctly. If a woman uses ECPs frequently, her chance of becoming pregnant is higher than if she uses regular contraceptives. This is why ECPs are not a substitute for regular contraceptives.

Are ECPs safe?

Most women can use ECPs safely. Health care providers have safely prescribed ECPs since the mid-1970s. Talk to your health care provider about ECPs to learn whether there is any reason you cannot use them.

Do ECPs cause side-effects?

ECPs often cause temporary side-effects such as nausea and vomiting. Sometimes they can cause headaches, dizziness, cramping, or breast tenderness. These side-effects generally do not last more than 24 hours.

What should I do after using ECPs?

You will not see any immediate signs showing whether or not the ECPs worked. Your menstrual period should come on time (or a few days early or late). If your period is more than a week later than expected or if you have any cause for concern, see your health care provider.

If the ECPs do not work, and I become pregnant, will the pregnancy be normal?

Based on available information, there is no reason to believe that the pregnancy would be abnormal or the baby hurt in any way.

Important: If you have unprotected sex after using ECPs, they will not protect you. Use a regular contraceptive method to prevent pregnancy in the future.

How do I use ECPs?

1) Take 2 tablets with milk or water as soon as convenient after unprotected sex. Make sure to take the first dose at a time when it will be convenient to take the second dose 12 hours later. Do not delay treatment unnecessarily as effectivenss may decline with time.

Take the tablets after eating a meal or snack. This may reduce nausea.

Important: If more than 72 hours (3 days) have passed since you had unprotected sex, do not start using ECPs. See your health care provider as soon as possible to discuss other options.

2) Take the remaining 2 tablets with milk or water 12 hours after taking the first 2 tablets. Take the tablets after eating if you can.

3) If you vomit within 2 hours of taking a dose, take another 2 tablets as soon as possible. If the vomiting occurred after the first dose, you will still need to take the second dose 12 hours later. To reduce the nausea, take the tablets after eating.

If you vomit more than 2 hours after taking the pills, do not worry. The medication is already in your system.

For Emergency Use Only

Emergency Contraceptives should not be used routinely to prevent pregnancy. Regular contraceptives (condoms, pills, injectables, IUDs, sterilization, etc.) are more effective and have fewer side-effects. If you want more information about regular contraceptives, or if you are having trouble using a method, ask your health care provider for help choosing a method that works for you.

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Hours of Service

Other Emergency Contraceptive Methods

Several other types of emergency contraception may be available from your health care provider. Your provider can advise you about which method is best for you.

Copper T IUD

A copper T IUD can be inserted by a trained health care provider within 5 days of unprotected sex to prevent pregnancy. This method is very effective: the treatment fails in one out of every 100 women. Because an “emergency” IUD can be used for many years as a regular contraceptive, it may be an option for women seeking emergency contraception who want long-lasting contraceptive protection. The IUD is not appropriate for all women, however, particularly those who have reproductive tract infections or who may be at risk of sexually transmitted diseases.

Progestin-only pills

Certain pills containing only a progestin (and no estrogen) also can be used for emergency contraception. The first dose of these progestin-only ECPs must be taken within 72 hours (3 days) of unprotected sex, followed by a second dose 12 hours later. The effectiveness of progestin-only ECPs is similar to ECPs that contain estrogen, but progestin-only ECPs generally cause less nausea and vomiting.

Emergency Contraception and Sexually Transmitted Disease (STD)

ECPs and the IUD do not protect against AIDS and other sexually transmitted diseases (STDs or VD) like syphilis, gonorrhea, chlamydia, and herpes. If you are worded about whether you may have been infected with AIDS or other sexually transmitted diseases, talk to your health care provider about your concerns and ask how you can protect yourself in the future.