Emergency contraception

INTRODUCTION

Emergency contraception (also known as postcoital contraception and the morning-after pill) refers to the use of drugs or a device as an emergency measure to prevent pregnancy. Women who have had recent unprotected intercourse, including those who have had a failure of another method of contraception, are potential candidates for this intervention. It is intended for occasional or back-up use, not as a primary contraceptive method for routine use. (See "Overview of contraception".)

Health professionals should inform women about use of emergency contraception and the available options. This discussion should include the advantages and disadvantages of each method, including efficacy and side effects. In addition, males should be aware of emergency contraception as a method of preventing pregnancy.

INDICATIONS

As discussed above, candidates for emergency contraception are women who have had recent unprotected intercourse (including sexual assault), or who have had a recent possible failure of another method of contraception. A detailed list of potential indications is shown in the table (table 1).

ACCESS

Emergency contraception utilizing progestin-only pills is available without a prescription for individuals (men or women) age 17 and older; proof of age is required (government issued photo or nonphoto identification) [1]. Adolescents 16 years and under still require a prescription; however, some states allow specially trained pharmacists to dispense this type of emergency contraception to these women as long as the pharmacist has a standing agreement with a physician to provide these prescriptions as needed. Limited data suggest adolescents use this type of emergency contraception appropriately and tolerate the drug about as well as adults [2-5].

Clinicians should be aware of the potential barriers to access and should encourage women to obtain emergency contraceptives in advance of a need for them [6,7]. In 1973, Congress passed the Church Amendment which allowed health care providers (physicians, nurses, pharmacists, etc) to cite religious grounds for refusing to provide abortion or sterilization services. Over time, refusal clauses have passed in most states and have been extended to include contraception and emergency contraception, assisted reproductive technologies, human embryonic or fetal research, and stem cell research. Ideally, professionals who object to providing such services should forewarn their patients and refer them promptly so that their health is not threatened, or care compromised.

                               

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Literature review current through: Apr 2013. | This topic last updated: Mar 22, 2013.
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