Emergency Contraception

As a woman, if you find yourself in the situation where your regular method of contraception has failed – perhaps you have vomited soon after taking the daily dose of your oral contraceptive, or the condom being used has broken, or you have had unprotected sexual intercourse - you may become pregnant. In these situations, you can reduce the possibility of a pregnancy by taking the emergency contraceptive pill (ECP).

Another name by which the ECP is known is the "morning after pill” but this term is misleading as you can take the ECP up to 72 hours (or 3 days) after a failed contraceptive, or unprotected intercourse incident. However, taking it as soon as possible after such an incident is best as the sooner it is taken the more effective it is at preventing pregnancy. You can buy the ECP from pharmacies (but only on the advice of accredited pharmacists who have undertaken relevant training) so it is quite widely available to assist women in reducing the chance of pregnancy in these situations.

The ECP is thought to work in a number of ways, depending on when in the menstrual cycle a woman takes the medicine. It can delay the release of an egg from the ovary, and it can affect migration of sperm so that a released egg is prevented from being fertilized. The ECP is not effective once the process of implantation of a fertilized egg has begun.

The ECP is for emergency purposes only and is not a form of regular birth control. It can disrupt the normal cycle if used too often within a menstrual cycle. Within a cycle, ECP use does not prevent pregnancy from subsequent missed pill or unprotected intercourse situations and other methods of contraception must be used. The accredited pharmacist would explain this in more detail. Another important consideration is that the ECP provides no protection against sexually transmitted infections. Where this is a possibility, women are advised to visit their doctors 3 weeks after taking the ECP, to rule-out such infections.

The ECP cannot prevent pregnancies 100% of the time and women need to see their doctors if, after taking it, their periods are late, or unusual in any way. If pregnancy is confirmed, having taken the ECP will not harm the foetus – but the doctor needs to rule-out ectopic pregnancy (you would probably have symptoms of lower-tummy pain in that situation).

There are very few side effects from taking the ECP, or clinical reasons why it cannot be used to prevent pregnancy in situations of contraceptive failure or unprotected sexual intercourse. Certain medicines taken at the same time as the ECP can reduce its effectiveness (some epilepsy, TB and antifungal medicines, and some herbal products such as St John’s wort). Also, there are some medicines that are, themselves, affected by the ECP (e.g. cyclosporin) but before providing you with the product the accredited pharmacist would discuss these things with you.

Taking the ECP at the earliest opportunity after an incident of contraceptive failure or unprotected sexual intercourse is the best way to prevent an unplanned pregnancy. Women in these situations can receive confidential advice and useful information from their local Self Care pharmacists. Ask about theECPSelf Care fact card.

Prepared by Pharmacy Self Care, Pharmaceutical Society of NZ Inc, 124 Dixon St, Wellington