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Pregnant - What to do?

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Side Effects!

Side effects associated with the use of emergency contraception pills (ECPs) usually taper off one or two days after the second dose has been taken.

Nausea, usually mild, is experienced by 50 percent of women who use ECPs. Up to one out of three women experience vomiting. Breast tenderness, irregular bleeding, fluid retention, and headaches may also occur. Frequent use of ECPs may cause periods to become quite irregular and unpredictable.

How long after unprotected sex can emergency contraceptive pills be taken?

The current treatment schedule is one dose within 72 hours after unprotected intercourse, and a second dose 12 hours after the first dose. A recent large study by the World Health Organization found that effectiveness declined significantly with increasing delay between unprotected intercourse and the initiation of treatment. This finding suggests that ECPs should be taken as soon after unprotected intercourse as is practical. When taking the second dose 12 hours later would be difficult, the timing of the second dose might be altered; for example, a woman who took her first dose at 3 p.m. immediately following discovery of a burst condom might delay taking the second dose until 7 a.m.

There have been no studies of the effectiveness of ECPs when taken later than 72 hours after unprotected sex. It is biologically implausible that efficacy would abruptly plummet to zero after 72 hours. Therefore, clinical protocols that deny treatment beyond 72 hours seem excessively restrictive, particularly if the alternative of emergency insertion of a copper-T IUD is not immediately available or appropriate. Taking ECPs on day 4 or even day 5 after unprotected intercourse will do no harm and may reduce the risk of pregnancy.

Copper-T IUD as Emergency Contraception

The copper-T intrauterine device (IUD) can be inserted up to five days after unprotected intercourse to prevent pregnancy. Insertion of a copper-T IUD is much more effective than use of ECPs or minipills, reducing the risk of pregnancy following unprotected intercourse by more than 99%. And a copper-T IUD can be left in place to provide continuous effective contraception for up to ten years Or, if you prefer, the IUD can be removed after your next menstrual period, when it is certain that you are not pregnant.
But IUDs are not ideal for all women. Women at risk of sexually transmitted infections because they or their partners have other sexual partners may not be good candidates for IUDs because insertion of the IUD can lead to pelvic infection, which can cause infertility if untreated. The risk of pelvic infection from insertion of an IUD is slight among women not at risk of sexually transmitted infections.

IUD insertion for emergency contraception is not recommended for:

• women who are at risk for sexually transmitted infection.

• women with more than one sex partner or whose partners have more than one partner.

• women with new partners.

• women who have been raped.

Uterine cramps may be uncomfortable during insertion. Some women feel a bit dizzy, and rarely a woman may faint.

If you have an IUD inserted, you may want to have someone with you to escort or drive you home. You should plan to rest there until you are comfortable.

The side effects, advantages, and disadvantages of using IUDs for emergency contraception are the same as those associated with using IUDs for ongoing contraception.

How Well Emergency Contraception Works?

ECPs reduce the risk of pregnancy by 75 percent. For example, eight out of 100 women will become pregnant after having unprotected intercourse once during the second or third week of their cycles. But only two out of 100 will become pregnant after taking ECPs.

Emergency IUD insertion reduces the risk of pregnancy by 99.9 percent. Only one out of 1,000 women will become pregnant after emergency IUD insertion.

ECPs do not, after use, continue to prevent pregnancy during the rest of the cycle. Other methods of birth control must be used.
Emergency contraception offers no protection against sexually transmitted infections. Consider testing for sexually transmitted infections if there is a possibility that your experience of unprotected intercourse put you at risk.

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