Emergency Contraception

WOMEN REQUESTS EMERGENCY CONTRACEPTION-Initial assessment and Indications

Reassure about confidentiality UPSI → when and how many episodestime elapsed ( approx hrs ) Check if emergency contraception is indicated Exclude pregnancy LMP STI- risk assessment Assess risk of abuse , rape and non-consensual sex Follow up ( for eg what happens if she vomits after taking hormonal emergency ) Offer regular method of contraception

Check if on any medications - may interact with hormonal contraception ( eg Liver enzyme inducing drugs as rifampicin , phenytoin and carbamezapine ) Breastfeeding -○ Cu-IUD is suitable from 4 weeks or more post-partum○ Levonergestrel can be taken- advice to take immediately after breastfeeding and avoid nursing for 8 hrs following that ( minimize exposure to baby )○ Avoid breastfeeding for 1 week after taking ulipristal acetate

Levonorgestrel- Precise mechanism not understood but possibly works by inhibition of ovulation To take LNG as soon as possible after UPSI Pregnancy occurring after LNG failure are not associated with any major congenital malformations or adverse outcomes Can be used more than once in a cycle ( may disturb menstrual cycle- manufacturer does not recommend ) If UPSI occurs within 12 hrs after taking LNG- further EC is not...