Emergency contraception and the morning after pill

What is it about ?

After you have had unprotected sex, you can use emergency contraception (post-coital contraception) to prevent possible pregnancy.

You are at risk of unwanted pregnancy if:

• you forget to take the pill ;
  • at least twice in a row;
  • the 1^D pill after pill-free week;
  • regularly, 1 or more pills from the same pack.
• the condom broke;
• you have not used contraceptives or you have not used them correctly.

Types of emergency contraception

The options available for avoid unwanted pregnancy after unprotected sex (post-coital contraception) are:

• a hormonal contraception (emergency pill or morning-after pill);
• a copper IUD.

Hormonal contraception (emergency pill)

For the hormonal contraception, the doctor is currently prescribing the “Emergency pill” (morning after pill). This pill contains levonorgestrel (Levodonna®, Norlevo® or Postinor®) or ulipristal acetate (EllaOne®).

How does the emergency pill work?

The emergency pill delays ovulation. If you have just ovulated, the emergency pill is no longer effective. But the copper IUD good. So take the emergency pill as soon as possible, preferably within 12 hours that follow unprotected sex. One tablet is enough.

How to use the emergency pill?

• The emergency pill that contains levonorgestrel must be taken at the latest 3 days (72 hours) after unprotected sex.
  • Slight nausea are a common side effect of this emergency pill.

• The emergency pill that containsulipristal acetate is an alternative that can be used in 5 days (120 hours) who follow unprotected sex.
  • This pill can also cause gastrointestinal side effects.

You naturally cannot take these emergency pills. if you are pregnant.

Emergency pill and breastfeeding

• If you are using the emergency pill which contains levonorgestrel, it is sufficient wait 8 hours after taking it to start breastfeeding again.
  • In the meantime, you can express your milk and throw it away.
  • In the meantime, you can feed your baby the expressed milk before taking the morning after pill.

• If you are taking the emergency pill which contains ulipristal acetate, it is best to wait one week before starting to breastfeed again.

Copper IUD

The doctor can insert a copper IUD in your uterus for up to 5 days after unprotected sex. The device can then remain in place as a contraceptive.

To insert it, the doctor passes the IUD through the vagina and through the opening of the cervix. It can be a bit unpleasant. After placement, some women experience discomfort in the lower abdomen. They usually have some bleeding.

If the doctor suspects inflammation of the cervix, he or she may still have the IUD, but he will immediately prescribe antibiotics and take samples. These samples are intended, among other things, to detect sexually transmitted infections (STIs).

What is the likelihood of an unwanted pregnancy?

If you are taking the emergency pill within 3 days (72 hours) following unprotected sex, you limit the risk of unwanted pregnancy to a level between 1 and 2.5%. The earlier you take the emergency pill, the lower the risk.

What can you do ?

• Use contraception correctly.

• Keep in mind that you can get pregnant if you’ve had unprotected sex.

• You suffer from vomiting or diarrhea within 4 hours of taking the emergency pill? Contact the doctor again. Indeed, the effectiveness of the pill is no longer guaranteed.

Pregnancy test

After taking an emergency pill, your period may start on a different day than usual. Ask the doctor for a pregnancy test in the following situations:

• you are more than 7 days late;
• you lose much less blood than usual;
• you still think you are pregnant.

STI

Remember that having unprotected sex puts you not only at risk of pregnancy, but also at risk of contracting an STI (sexually transmitted infection).

Do you have any doubts? Consult the doctor.

What can your doctor do?

Emergency pill

You do not have no prescription needed for the morning after pill. You can buy it freely in pharmacies. However, if you have a doctor’s prescription, reimbursement is provided in many cases, reducing the cost of the pill. Thus, a pill that contains levonorgestrel costs around 10 euros without a prescription, against 1 euro with a prescription. As for EllaOne, it costs 25 euros without a prescription, against 16 euros with a prescription.

Copper IUD

For a copper IUD you always need a arrangement general practitioner. Some general practitioners place the IUD themselves, others refer you to a gynecologist.

advice

Contact the doctor if you need interview, advice or support in complete confidentiality. Take the opportunity to discuss the possibilities of contraception for the future.

Source

Foreign clinical practice guide ‘Post-coital contraception’ (2000), updated on 08/21/2017 and adapted to the Belgian context on 03/23/2019 – ebpnet