Emergency Contraception

We have established this site to help you by providing you with information and answering some ‘frequently asked questions’ that you may have about emergency contraception. The more you know, the better prepared you’ll be should you ever find yourself in a situation where you need emergency contraception.

After reading through the information on this site, you will be able to:

• Understand what an emergency contraceptive pill is;
• Weigh the benefits and the risks associated with taking an emergency contraceptive pill;
• Understand what side effects you may experience after taking an emergency contraceptive pill;
• Know what to do and expect in the days after taking an emergency contraceptive pill.

When used as directed, emergency contraception provides you with a safe and effective method of preventing an unplanned pregnancy after sexual intercourse, particularly in the following situations:

• When a birth control method fails (such as when a condom breaks or slips)
• If you don't take your birth control pills as directed;
• You did not use any method of birth control;
• When a sexual assault occurs.

Even though emergency contraception is a safe and effective method of preventing an unplanned pregnancy, it should never replace regular birth control methods. Always consult a healthcare professional to discuss the method of birth control that is best for you.

Emergency contraception doesn’t prevent sexually transmitted diseases (STD’s) such as HIV/AIDS.

Questions 

Answers

What is emergency contraception or the “morning after pill”?

Emergency contraception (also known as “the morning after pill”) is a safe and effective method of preventing an unplanned pregnancy after sexual intercourse.

Emergency contraceptive pills are often called the ‘morning after pill’. However, the term ‘morning after’ can be misleading as emergency contraception does not only have to be taken the morning after unprotected sex. Emergency contraception is effective if taken up to 72 hours after unprotected sex, however, the earlier you take it, the better. Emergency contraception is most effective if taken within the first 12 hours after sex.

How does emergency contraception work?

Emergency contraception prevents a pregnancy by one of several mechanisms such as:

• Preventing ovulation i.e. stops or delays an egg from being released from the ovary;
• Thickening of cervical mucus, inhibiting the maturation and survival of sperm;
• Preventing fertilisation by inhibiting the transport of sperm and/or egg from the fallopian tubes to the uterus;
• Altering the lining of the uterus thereby preventing a fertilised egg from implanting itself in the uterus.
• Emergency contraception takes effect before the implantation of the egg in the uterus.
• If you are already pregnant before using emergency contraception, the pregnancy will continue normally. Emergency contraception will not work if you're already pregnant.

When and in what circumstances can you use emergency contraception?

Emergency contraception is recommended for the prevention of a pregnancy within 72 hours of unprotected sexual intercourse, particularly in the following situations:

• If you have had sexual intercourse where either you or your partner did not use a contraceptive method;
• If your partner's condom has broken, slipped or been improperly removed, or if he has forgotten to use one;
• You have missed an oral contraceptive pill;
• If you fear that your intrauterine device has been expelled;
• If your vaginal diaphragm or contraceptive cap has moved or if you have removed it too early;
• If you are afraid that the method of coitus interruptus (withdrawal) has failed or if you have had sexual intercourse during the period when you are supposed to be fertile when using the rhythm method;
• In the event of rape.

Is emergency contraception always effective?

No. Pregnancy is prevented in 58 to 95 % of cases when emergency contraception is used within 72 hours after intercourse. Efficacy is higher when emergency contraception is used as early as possible.

Remember, emergency contraception does not prevent sexually transmitted diseases (STD) such as HIV/AIDS.

Is emergency contraception safe to use?

Emergency contraception is a safe and effective method of preventing an unplanned pregnancy after sexual intercourse.

What are the possible side-effects associated with the use of emergency contraception?

Possible side effects which may be experienced with the emergency contraceptive pill include nausea and vomiting, dizziness, fatigue, headache, lower abdominal pain, breast tenderness and vaginal bleeding.

Is using emergency contraception the same as an abortion?

No. Emergency contraceptive pills do not cause abortions. If you are already pregnant and take emergency contraception you will not terminate the pregnancy. Emergency contraception takes effect before the implantation of the egg in the uterus and will therefore not work if you're already pregnant.

You should not use emergency contraception if you already have a confirmed pregnancy (a fertilised egg has attached to the wall of the uterus) because it will not be effective.

Can you use emergency contraception at any age?

Any woman, from puberty to menopause can use emergency contraception in order to prevent an unplanned pregnancy following unprotected sexual intercourse.

How does the menstrual cycle work?

One menstrual cycle is the time elapsed between the beginning of one menstrual period (bleeding) and the next one. Menstrual periods occur when a woman is not pregnant. Usually, the menstrual cycle lasts for 28 days, but it can vary widely from one woman to another. By definition, the first day of the menstrual cycle is the first day of bleeding. Usually, at the middle of the cycle, an egg (or ovum) is released by one of the two ovaries. (This event is called “ovulation”). If, at that time, sperm cells (which can fertilise the egg up to 7 days after being deposited in the vagina) are around the egg, “fertilisation” (i.e. the fusion of the egg with one sperm) can take place. After a few days, the fertilised egg is anchored (or implanted) in the womb, and pregnancy starts. Therefore, fertilisation can occur only at the time of ovulation. Although, on average, ovulation takes place at the middle of the cycle (usually 14 days after the first day of the last menstrual period), it can actually take place at other times in the cycle.

Therefore, without a contraceptive method, a woman can never be sure that she is not pregnant after sexual fertilisation, either by blocking ovulation (as with the contraceptive pill), or by preventing the sperm from meeting the egg (as with the use of a condom).

What is the likelihood of falling pregnant (fertilisation) after unprotected intercourse?

It is difficult to evaluate because the likelihood of being pregnant depends on several factors: The time of intercourse with respect to the timing of ovulation (release of egg from the ovary), the usual length of the cycle and the occurrence of other acts of unprotected intercourse in the same cycle. In general, the risk of pregnancy is higher if the unprotected intercourse took place on the day of ovulation, or on the 4 to 5 days preceding ovulation. However, most women aren’t aware when this is happening. Also, it takes several days for an egg to make its way from the ovary down the fallopian tube and an egg can be fertilised at any point during this journey. Sperm can live for up to seven days, so even if you haven’t ovulated when you have sex, the sperm could still fertilise the egg afterwards.

However, since the date of ovulation is unpredictable, any unprotected intercourse, at any time of the cycle, can lead to a pregnancy.

If you have had unprotected sexual intercourse, and have doubts about the risk of falling pregnant, emergency contraception is a safe and effective method of preventing an unplanned pregnancy.

Are there any times in the menstrual cycle where there is no risk of fertilisation (“safe” periods)?

No. Without contraception, sexual intercourse has been known to result in pregnancy at all times in the menstrual cycle.

Can you use emergency contraception at any time during the menstrual cycle?

Yes. Since the date of ovulation is not exactly predictable, you should use emergency contraception within 72 hours of any unprotected intercourse, especially if you have doubts about the risk of an unplanned pregnancy.

Can you use emergency contraception several times during the same menstrual cycle?

Yes, if necessary. However, remember that multiple acts of unprotected sexual intercourse increase the risk of an unplanned pregnancy, even if you use emergency contraception each time.

After having taken an emergency contraceptive pill, you should use a barrier contraceptive method (condom, spermicide, cap, diaphragm) for each act of intercourse until the next menstrual period. It is advised that you speak to a healthcare professional about starting a regular contraceptive method that’s suited to you.

Can I use emergency contraception as a regular method of contraception?

Emergency contraceptive pills are for emergency use only and should not replace regular contraception as they are not as effective as regular birth control methods and have more side effects than regular contraception. If you are having sexual intercourse on a regular basis, it is advisable that you speak to a healthcare professional about the most suitable contraceptive method for you.

If I use emergency contraception, will it protect me from pregnancy for the next 72 hours?

No. This is why, after having used emergency contraception, it is necessary that you use a barrier contraceptive method (condoms, spermicides, diaphragm, cap) for each act of sexual intercourse until you start using a method of regular contraception most suitable for you.

Does emergency contraception protect against STD's including HIV/ AIDS?

NO. The use of emergency contraception does not offer protection against STDs and therefore precautions need to be taken to prevent them. Condoms offer the most effective protection against sexually transmitted diseases such as HIV/ AIDS, and should be used every time you have sex. If you think that you might have a STD, it is advisable to speak to your healthcare professional to arrange the necessary tests

Will emergency contraception affect my fertility?

There is no evidence that emergency contraception has any effect on a woman’s future ability to become pregnant. However, it is not advisable to use emergency contraception repeatedly because it is not efficient enough to make it a regular contraceptive method, not because there are concerns about its safety.