Professional Documents
Culture Documents
Contraception
Emergency Contraception (EC)
• “This can happen to anyone.”
• There are safe methods to • Let client tell her story now if she wishes.
• Offer support without judging the client.
prevent pregnancy after
unprotected sex • Client may want to consider EC if:
— no method was used
— a method was used incorrectly (for example, missed pills, late for injection)
— method failed (for example, broken condom, expelled IUD)
• How long ago did you have • If she can answer “yes” to any of the questions in Appendix 1, she is probably not
fertile and would not need EC. However, if she is worried, she can still use EC.
unprotected sex?
Emergency contraceptive pills:
• She should take pills as soon as possible after unprotected intercourse. They
— Up to 5 days ago? can be taken up to 5 days after. See next page.
• Counsel as appropriate.
• Could you have been exposed to • If she had unprotected intercourse where circumstances suggest HIV or STI
STIs/HIV? transmission, offer and start post-exposure prophylaxis (PEP) for HIV immediately
(within 72 hours) and/or presumptive STI treatment, if available, or refer for further
counselling, support and treatment.
Next Move:
Does client want to use emergency contraception?
For EC pills information For emergency copper IUD information
go to next page. go to page EC4. EC
1
Emergency Contraceptive Pills
• Need to be taken as soon as possible
after unprotected sex
Levonorgestrel-only ECPs
• Work better and cause less nausea and vomiting than combined ECPs.
• Dosage: Take 1.5 mg of levonorgestrel in a single dose.
Combined estrogen-progestogen ECPs
• Use if levonorgestrel-only pills are unavailable.
• Dosage: Take 2 doses of 100 mcg of ethinylestradiol plus 0.5 mg of
• Do not cause abortion levonorgestrel, 12 hours apart.
• “ECPs prevent pregnancy. They do not cause abortion.” They work mainly
by stopping ovulation (see Appendices 4 & 5).
• Might cause nausea, vomiting, spotting or
bleeding • If she is taking combined estrogen-progestogen pills, she can take
antinausea medicine (meclazine hydrochloride) to prevent nausea.
• If she vomits within 2 hours after taking ECPs, she should return for
• Do not prevent pregnancy the another dose as soon as possible.
next time you have sex • She may have spotting or bleeding a few days after taking pills.
• Can you always choose when you • Use Appendix 9 to discuss communication
with partners.
have sex? • If story suggests coercion or violence, refer
for more help if possible. See Appendix 13.
• Do you have a regular method? • Can start another method straightaway, including pills.
Are you satisfied with it? • If client chooses no regular method now, offer ECPs and
condoms with instructions for use.
Next Move:
Next Move:
If she chooses emergency copper IUD, go to Copper IUD tab to check medical
eligibility for IUD use (page IUD2) and for information on IUD insertion. EC
4
Copper IUD
• Small device that fits inside the womb
• Very effective
• Keeps working up to 10 years, depending on type
• We can remove it for you
whenever you want
• Very safe
• Might increase menstrual
bleeding or cramps
• No protection against STIs or HIV/AIDS