Emergency contraception

What is emergency contraception?

Emergency contraception can be used by people who have had sex where there's a risk of pregnancy (for example, if they've had penis-in-vagina sex but haven't used contraception, or they think the contraception might have failed). There are two types of emergency contraception:

1. The copper IUD (sometimes known as the 'copper coil')
2. The emergency contraceptive pill.

If you need emergency contraception, see your doctor or local sexual health clinic. Find a local clinic here. Some pharmacies provide the emergency contraceptive pill over the counter without you having to see a nurse or doctor.

What is the Emergency Copper Intrauterine device (copper IUD)?

The copper IUD is a small, T-shaped plastic device which contains copper. It is placed in the uterus. A Copper IUD does not contain hormones. It is more than 99% effective – one of the most effective forms of contraception. The IUD prevents the egg from being fertilised by sperm by;

• Preventing the sperm from surviving inside a woman’s body as copper is toxic to sperm.
• Stopping a fertilised egg implanting in the uterus.
• It can stay in place and prevent pregnancy for between 5 and 10 years, depending on the type, or until you have it taken out.
• An IUD can be put in at any time, once the chance of pregnancy is reasonably excluded.
  
• The copper IUD can be used as emergency contraception for up to 5 days after unprotected sex.

The IUD is fitted in the uterus by a trained nurse, midwife or doctor. 

What is the Emergency Contraceptive Pill (ECP)?

The ECP is a high-dose birth control pill containing a hormone called progesterone. The ECP stops pregnancy by preventing the release of an egg from the ovary. It may also cause changes in the lining of the uterus (womb) that discourages implantation of a fertilised egg.

The ECP can be taken up to three days following unprotected sexual intercourse. It prevents the majority of pregnancies and is most effective if taken within 24 hours. The ECP can be used at any time during the menstrual cycle. If the unprotected sex occurred more than three days ago, it is advisable to talk to your nurse, doctor or sexual health clinic as there may be other options.

Which option is risk for me - the copper IUD or emergency contraceptive pill?

The copper IUD is recommended for those who:

• Weigh over 70kg
• Aren't able to have the emergency contraceptive pill within 3 days of having unprotected sex
• Want the most effective emergency contraception

About the emergency contraceptive pill:

• Needs to be taken within 72 hours (3 days after unprotected sex), though the earlier the better.
• Is 98% effective at preventing pregnancy in those under 70kg if taken within 72 hours after unprotected sex.
• For those who weigh under 70kg: the ECP is 98% effective at preventing pregnancy
• For those who weigh over 70kg or have a BMI of more than 26 or more: getting a copper IUD is the best option. The ECP can be less effective and there is a risk that it won't work. In this situation, taking two ECPs might provide more protection against pregnancy, but there is limited evidence at this time.
  

Your healthcare professional will be happy to have a conversation with you about the options.

What happens with a Copper IUD insertion?

An appointment will typically include:

• A few questions about your medical and family history, to work out what method would suit you best.
• Before the IUD is fitted, you will need to have a vaginal examination. The doctor, midwife or nurse will pass a small instrument into your womb (uterus) to check its size and position.

Fitting the IUD (shouldn’t take longer than 5-10 minutes):

• You’ll be asked to lay on the bed.
• Remove the lower half of your clothing (e.g. trousers/skirt and underwear).
• Open your legs and bend your knees so the nurse, midwife or doctor can use a speculum to slightly widen your vagina to help insert the Copper IUD into your uterus.
• The IUD is fitted using a small plastic insertion device. The arms on the IUD are flexible and fold inside the insertion device.
• The nurse, midwife or doctor may discuss painkiller tablets/using local anaesthetic to make the fitting more comfortable.
• If the Copper IUD is being used as a form of emergency contraception it could then be
  left in your uterus (womb) and be used as ongoing contraception.
  

How do you take the Emergency Contraceptive Pill?

Take the ECP as soon as possible. It helps to take it with food as some people feel sick after taking the ECP. If you vomit within three hours of taking the pills, you should return to your doctor or clinic as you may need to take it again.

If you are already using a regular method of contraception such as the oral contraceptive pill, continue to take this as you would regularly.

What happens after you take it?

After taking the ECP, some people may experience bleeding or spotting and some may experience an early or later start to the next menstrual period.

It is important to take a pregnancy test three to four weeks after taking the ECP to make sure that you are not pregnant, even if you have a period. There is no evidence that the ECP will affect the unborn baby if you do become pregnant

Does emergency contraception stop you from getting pregnant again?

The ECP does not give you any ongoing protection against pregnancy - it is important to use condoms or another form of contraception for ongoing protection against pregnancy. However, the copper IUD will provide an ongoing method of contraception.

Does emergency contraception prevent STIs?

Neither the emergency contraceptive pill nor the copper IUD protects against sexually transmitted infections (STIs). If you have had unprotected sex, you should get tested by your doctor, nurse or sexual health clinic to ensure you have not contracted an STI.