Emergency Contraception

Charlotte Ellertson, Ph.D., Director of Reproductive Health for Latin America and the Caribbean, The Population Council -- Mexico, Col. Villa Coyoacan, México; James Trussell, Ph.D., Professor of Economics and Public Affairs, Associate Dean, Woodrow Wilson School of Public and International Affairs, and Faculty Associate, Office of Population Research, Wallace Hall, Princeton University, Princeton, New Jersey; Felicia Stewart, M.D., Co-Director, Center for Reproductive Health Research & Policy, University of California, San Francisco, California; Jacqueline Koenig, M.S.B., Assistant Director, Online Outreach and Partnerships, The Henry J. Kaiser Family Foundation, Menlo Park, California; Elizabeth G. Raymond, M.D., M.P.H., Associate Medical Director, Biomedical Affairs Division, Family Health International, Research Triangle Park, North Carolina; Tara Shochet, M.P.H., Research Assistant, Office of Population Research, Wallace Hall, Princeton University, Princeton, New Jersey.

Semin Reprod Med. 2001;19(4) 

In This Article

Abstract and Introduction

Emergency contraceptives are methods that prevent pregnancy when used shortly after unprotected sex. Three different emergency contraceptive methods are safe, simple, and widely available in the United States. These are: (1) ordinary combined oral contraceptives containing ethinyl estradiol and levonorgestrel taken in a higher dose for a short period of time and started within a few days after unprotected intercourse; (2) levonorgestrel-only tablets used similarly; and (3) copper-bearing intrauterine devices inserted within approximately 1 week after unprotected intercourse. Emergency contraceptive use is best known for women who have been raped, but the methods are also appropriate for women who have experienced condom breaks, women who did not use any method because they were not planning on having sex, or women who had unprotected intercourse for any other reason. Unfortunately, few women know about emergency contraceptives, and few clinicians think to inform their patients routinely about the option. A nationwide toll-free hotline (1-888-NOT-2-LATE) and a website (http://not-2-late.com) can help women learn about these options. Sharing "family planning's best-kept secret" widely with women could prevent as many as a million unwanted pregnancies annually in the United States.

Half of all pregnancies in the United States are unintended; there were 3.0 million in 1994 alone, the last year for which data are available.[1] Emergency contraception, which prevents pregnancy after unprotected sexual intercourse, has the potential to reduce significantly the incidence of unintended pregnancy and the consequent need for abortion.[2] Emergency contraception is especially important for outreach to the 3.1 million women at risk of pregnancy but not using a regular method[3] by providing a bridge to use of an ongoing contraceptive method. Although emergency contraceptives do not protect against sexually transmitted infection, they do offer reassurance to the 7.9 million women who rely on condoms for protection against pregnancy in case of condom slippage or breakage. Emergency contraceptives available in the United States include combined oral contraceptive tablets, levonorgestrel-only contraceptive tablets, and the copper-T intrauterine device (IUD).[4,5,6]

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