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Family Planning: A Global Handbook for Providers

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Family Planning

A GLOBAL HANDBOOK FOR PROVIDERS

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Planning Ongoing Contraception

  1. Explain that ECPs will not protect her from pregnancy for any future sex—even the next day. Discuss the need for and choice of ongoing pregnancy prevention and, if at risk, protection from STIs including HIV (see Sexually Transmitted Infections, Including HIV).
  2. If she does not want to start a contraceptive method now, give her condoms or oral contraceptives and ask her to use them if she changes her mind. Give instructions on use. Invite her to come back any time if she wants another method or has any questions or problems.
  3. If possible, give her more ECPs to use in the future in case of unprotected sex.

When to Start Contraception After ECPs Use

Method When to start
Combined oral contraceptives, progestin-only pills, combined patch, combined vaginal ring

Can begin the day after she takes the ECPs. No need to wait for her next monthly bleeding.

  • Oral contraceptives and vaginal ring:
    • New users should begin a new pill pack or ring.
    • A continuing user who needed ECPs due to error can resume use as before.
  • Patch:
    • All users should begin a new patch.
  • All women need to use a backup method* for the first 7 days of using their method.
Progestin-only injectables
  • She can start progestin-only injectables on the same day as the ECPs, or if preferred, within 7 days after the start of her monthly bleeding. She will need a backup method for the first 7 days after the injection. She should return if she has signs or symptoms of pregnancy other than not having monthly bleeding (see common signs and symptoms of pregnancy).
Monthly injectables
  • She can start monthly injectables on the same day as the ECPs. There is no need to wait for her next monthly bleeding to have the injection. She will need a backup method for the first 7 days after the injection.
Implants
  • After her monthly bleeding has returned. Give her a backup method or oral contraceptives to use until then, starting the day after she finishes taking the ECPs.
Intrauterine device (copper-bearing or hormonal IUDs)
  • A copper-bearing IUD can be used for emergency contraception. This is a good option for a woman who wants an IUD as her long-term method (see Copper-Bearing IUD).
  • If she decides to use an IUD after taking ECPs, the IUD can be inserted on the same day she takes the ECPs. No need for a backup method.
Male and female condoms, spermicides, diaphragms, cervical caps, withdrawal
  • Immediately.
Fertility awareness methods
  • Standard Days Method: With the start of her next monthly bleeding.
  • Symptoms-based methods: Once normal secretions have returned.
  • Give her a backup method or oral contraceptives to use until she can begin the method of her choice.

* Backup methods include abstinence, male and female condoms, spermicides, and withdrawal. Tell her that spermicides and withdrawal are the least effective contraceptive methods. If possible, give her condoms.

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