(Published March 2011)
Clinical Consultation
Even with progestin-only emergency contraception pills (ECPs) available over-the-counter for those aged 17 years and older, there is still a role for clinicians to counsel patients about emergency contraception and increase awareness and possibly use.
ECP Counseling Points for Clinicians
- How to obtain them – Progestin-only ECPs are available behind the pharmacy counter or at family planning clinics without a prescription for those 17 and older, sometimes for a reduced cost. Those 16 years old and younger must obtain a prescription for progestin-only ECPs from their clinician or from their pharmacist in pharmacy-access states. Women of all ages need a prescription for ulipristal acetate (UPA) emergency contraception (EC).
- Why it is a good idea to keep them on hand – Advance provision is recommended so that EC can be taken as soon as possible after unprotected sex.
- How they work – ECPs most likely prevent pregnancy by stopping or delaying ovulation.
- They are safe and benefits outweigh risks – ECPs are proven safe for all women.
- There are more effective long-term and reversible methods of contraception – Women should be counseled on other more effective reversible contraceptive methods.
Case study: Marisa
Marisa is a 22-year-old woman who presents for a primary care visit with a chief complaint of vaginal discharge.
While encouraging future attempts at condom use, health professionals should also remember to:
- Discuss emergency contraception (EC) as an option if/when condom use is not possible
- Encourage her to purchase EC today to keep at home just in case
- Discuss use of a highly-effective reversible form of contraception in addition to condoms
Case study: Heather
Heather is a 25-year-old woman who presents for a primary care visit expressing her desire to start on a birth control pill to prevent pregnancy.
Health professionals should:
- Discuss EC as an option if/when she takes longer than she expected to pick up a refill Rx, or she misses 2 or more pills
- Encourage her to purchase EC today to keep at home just in case
- Clarify that highly-effective reversible options such as IUDs and the implant are typically more effective than an oral contraceptive
- Encourage condom use to prevent sexually transmitted infections
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