Emergency Contraception

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DEFINITION

• Seeking information about emergency contraception (morning after pill) after unprotected sexual intercourse
• Female patient
• Not pregnant

General Information

• Emergency contraceptive pills (ECP) are very effective in preventing pregnancy after unprotected sexual intercourse. Emergency contraceptive pills can reduce the pregnancy rate by 75-88%. They are also sometimes called "morning after pills". But you do not have to take them just in the morning.
• The sooner the pills are started, the better they work. The pills must be started within 120 hours (5 days) and ideally within 72 hours (3 days) of the unprotected sexual intercourse.
• Emergency contraceptive pills are less effective than ongoing contraception in preventing pregnancy.
• Emergency contraceptive pills do not prevent sexually transmitted diseases.
• The typical cost of ECP is $20-30.

What are some situations in which emergency contraception might be considered?

• Not using any birth control method (unprotected sexual intercourse).
• Condom broke or slipped off penis
• Diaphragm or cervical cap was taken out too early
• Failed coitus interruptus (ejaculated inside vagina, or onto female external genitals)
• Spermicide was used alone during second or third week of menstrual cycle
• Missed more than 2 oral contraceptive pills, or started pill pack more than 2 days late
• Delay in getting scheduled contraceptive injection
• Sexual assault (not on oral contraceptive pill; no IUD)

Where can I get emergency contraceptive pills?

• Your doctor is the person you should contact first.
• Local public health clinic.
• Local Planned Parenthood office.

Do I need a prescription?

• In most states in the U.S., you need to get a prescription in order to get emergency contraceptive pills. In the States of California, Alaska, Washington State, New Mexico and Hawaii, some pharmacies will provide emergency contraceptive pills, if you talk with the pharmacist.
• In Canada, you can get Plan B (levonorgestresl) without a prescription at many pharmacies. Contact your local pharmacy to determine if they have and provide this pill. Not all pharmacies have it in stock and some pharmacies may not dispense this medication.

See More Appropriate Topic (instead of this one) If

• MENSTRUAL PERIOD, MISSED OR LATE
• VAGINAL BLEEDING, ABNORMAL

WHEN TO CALL YOUR DOCTOR

Call Your Doctor Now (night or day) If

• You were forced to have sex (sexual assault or rape)

Call Your Doctor Within 24 Hours (between 9am and 4pm) If

• You think you need to be seen 
• Unprotected sexual intercourse within past 72 hours (3 days)
• Unprotected sexual intercourse within past 72-120 hours (3-5 days) (ECP is less effective)

Call Your Doctor During Weekday Office Hours If

• You have other questions or concerns

Self Care at Home If

• Unprotected sexual intercourse occurring more than 120 hours (5 days) ago, and you don't think you need to be seen
• Questions about emergency contraceptive pills

HOME CARE ADVICE FOR EMERGENCY CONTRACEPTION

1. General Information on Emergency Contraceptive Pills (ECP):
   • Emergency contraceptive pills are just for emergencies.
   • Emergency contraceptive pills are less effective than ongoing contraception in preventing pregnancy.
   • Emergency contraceptive pills do not prevent sexually transmitted diseases.
2. How effective are ECPs? The following are some example statistics for women having unprotected intercourse in second or third week of their menstrual cycle:
   • No ECP treatment - 8 out of 100 women will get pregnant
   • ECP Treatment 72-120 hours after intercourse - 3-4 out of 100 women will get pregnant
   • ECP Treatment within 72 hours after intercourse - 1-2 out of 100 women will get pregnant.
3. Do ECP's have any side effects? Yes they do
   • Nausea - 30-60 % of women
   • Vomiting - 5-20 %
   • Abdominal pain - 10-20%
   • Fatigue and headache - 10-20%
   • Change in menstrual bleeding onset or amount - 50%
4. Emergency Contraception Hotline
   • Managed by the Association or Reproductive Health Professionals
   • Hotline provides information.
   • Hotline provides phone numbers of ECP providers.
   • Tollfree phone number: 800-584-9911
   • Their website has a lot of information on ECP: http://ec.princeton.edu/providers/index.html
5. Pregnancy Test When In Doubt:
   • If there is any possibility of pregnancy, obtain and use a urine pregnancy test from the local drug store.
   • Follow the instructions included in the package.
6. Call Your Doctor If:
   • Pregnancy test is positive; or if you have difficulties with the home pregnancy test
   • You become worse

And remember, contact your doctor if you develop any of the "Call Your Doctor" symptoms.

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