Emergency Contraception

What is emergency contraception?

Emergency contraception is used after unprotected sex. You may decide to use emergency contraception if:

• you didn't use any contraception
• you had sex without a condom or the condom broke
• you forgot to take your usual contraceptive pills
• you were sexually assaulted

What emergency contraception is available in Australia?

There are three types of emergency contraception.

• the levonorgestrel emergency contraceptive pill - available without a prescription from pharmacies. There are lots of different brand names
• the ulipristal acetate emergency contraceptive pill - available without a prescription from pharmacies. It is called EllaOne
• a copper intrauterine device (IUD) - inserted within 5 days of unprotected sex by a trained doctor or nurse

How does emergency contraception work?

Emergency contraceptive pills work by stopping or delaying the release of an egg from a woman's ovaries (ovulation). Emergency contraception pills do not cause an abortion. Emergency contraception pills do not cause harm if you accidentally take them when you are already pregnant.

The copper IUD mainly works by interfering with sperm movement, which stops them fertilising an egg. Sometimes it works by preventing implantation of a fertilised egg, but it has no effect after implantation. The copper IUD does not cause an abortion.

How soon do I have to use the emergency contraceptive pill?

Emergency contraceptive pills work better the sooner you take them. This is why they used to be called 'morning after pills'.

• the levonorgestrel emergency contraceptive pill should be taken within 72 hours (3 days) after unprotected sex. It might still have some effect up to 96 hours (4 days). It can be used more than once in a cycle
• the ulipristal acetate pill should be taken within 120 hours (5 days) after unprotected sex
• the levonorgestrel emergency contraceptive pill should not be used in the same menstrual cycle as ulipristal acetate

Some women feel sick after taking the emergency contraceptive pill. If you vomit within 2 hours of taking the levonorgestrel emergency contraceptive pill or 3 hours of the ulipristal acetate pill it might not work, so taking another one is recommended. Since some medications can reduce how well the emergency contraceptive pill works, be sure to discuss any medications you are already taking with your pharmacist or doctor.

How effective is emergency contraception?

• emergency contraceptive pills prevent about 85% of expected pregnancies. Ulipristal acetate is slightly more effective than the levonorgestrel emergency contraceptive pill. They work best if they are taken as soon as possible after unprotected sex
• a copper IUD is the most effective emergency contraceptive method (more than 99%)

Remember, no method of emergency contraception is 100% effective at preventing pregnancy. The emergency contraceptive pill will not protect against pregnancy if you have unprotected sex again in the same menstrual cycle. You may need a follow-up pregnancy test to check if the emergency contraception pill has worked and you are not pregnant. You can discuss a follow-up test with the pharmacist or doctor.

Emergency contraception does not protect against sexually transmitted infections (STIs).

Do the emergency contraception pills have any side-effects?

They are very safe with no serious or long-lasting side-effects. There is a small chance of nausea, breast tenderness or headache.

When should I expect my period after taking an emergency contraceptive pill?

Most women have a period at the usual time but sometimes your next period can start earlier or later than expected. You should do a pregnancy test if:

• your period is more than a week late
• your period is light or unusual in any way
• you get any other unusual bleeding

Who can take the emergency contraceptive pill?

Most women can take the emergency contraceptive pill. Tell the pharmacist or doctor about any medical conditions and allergies you have as well as any medications or herbal medications you are taking. There are some differences between the two pill types that might mean one is more suitable for you than the other.

Can I use emergency contraception if I'm breastfeeding?

You can continue breastfeeding when you take the levonorgestrel emergency contraceptive pill. Women who choose the ulipristal acetate pill are advised to express the breast milk and throw it away for one week after. Breastfeeding women may prefer to use the levonorgestrel emergency contraceptive pill or a copper IUD.

Where can I get emergency contraception?

Emergency contraceptive pills are available from a pharmacy without a prescription, Family Planning NSW clinics and some GPs.

For a copper IUD, contact your nearest Family Planning NSW clinic or Family Planning NSW Talkline to get information about having an insertion in the 5-day timeframe. It is recommended that you take the emergency contraceptive pill while arranging your copper IUD.

Ongoing contraception

The emergency contraceptive pill only helps to prevent pregnancy from the unprotected sex you have just had. Your doctor or pharmacist can advise you about starting or restarting contraception after taking the emergency contraceptive pill. It is important to think about what you will use in the future. The long acting reversible contraception (LARC) methods, including the contraceptive implant and IUDs, are suitable for most women and are very effective. If you choose a copper IUD it can be kept in place for up to 10 years if needed or you can have it taken out at any time before this.

For more information

Family Planning NSW Talkline – www.fpnsw.org.au/talkline or 1300 658 886
National Relay Service (for deaf people) – 13 36 77
TIS National's interpreting service – 131 450
Visit your nearest Family Planning NSW clinic – www.fpnsw.org.au/clinics
Family Planning NSW client factsheet – The copper IUD
Family Planning NSW client resource on contraception – What suits me?