Emergency contraception – a review

Abstract

Emergency contraception (EC) can be used as a backup contraceptive to help prevent unintended and unplanned pregnancies after unprotected sexual intercourse. These methods include the use of emergency contraceptive pills (ECPs) or copper containing intrauterine devices (IUD). These ECPs should not be used as regular contraception. Mifepristone (not available in South Africa as EC) and levonorgestrel are very effective, with few adverse effects, and are preferred to combined oestrogen and progestogen administration. Levonorgestrel can be used in a single dose (1.5 mg) instead of two doses (0.75 mg) 12 hours apart. A Copper IUD can be retained for ongoing contraception. Despite the proven efficacy of ECP, increased access to ECPs enhances use but has not been shown to reduce unintended pregnancy rates at a population level. Further research is needed to explain this finding and to define the best ways to use EC to produce a public health benefit. Efforts should be targeted at vulnerable groups such as adolescents and women presenting for urgent care. At the time of the visit regular contraception should be promoted and initiated.

Key words: Emergency contraception; South Africa; bridging