Emergency Contraception

Abstract

Despite significant declines over the past 2 decades, the United States continues to have teen birth rates that are significantly higher than other industrialized nations. Use of emergency contraception can reduce the risk of pregnancy if used up to 120 hours after unprotected intercourse or contraceptive failure and is most effective if used in the first 24 hours. Indications for the use of emergency contraception include sexual assault, unprotected intercourse, condom breakage or slippage, and missed or late doses of hormonal contraceptives, including the oral contraceptive pill, contraceptive patch, contraceptive ring (ie, improper placement or loss/expulsion), and injectable contraception. Adolescents younger than 17 years must obtain a prescription from a physician to access emergency contraception in most states. In all states, both males and females 17 years or older can obtain emergency contraception without a prescription. Adolescents are more likely to use emergency contraception if it has been prescribed in advance of need. The aim of this updated policy statement is to (1) educate pediatricians and other physicians on available emergency contraceptive methods; (2) provide current data on safety, efficacy, and use of emergency contraception in teenagers; and (3) encourage routine counseling and advance emergency-contraception prescription as 1 part of a public health strategy to reduce teen pregnancy. This policy focuses on pharmacologic methods of emergency contraception used within 120 hours of unprotected or underprotected coitus for the prevention of unintended pregnancy. Emergency contraceptive medications include products labeled and dedicated for use as emergency contraception by the US Food and Drug Administration (levonorgestrel and ulipristal) and the “off-label” use of combination oral contraceptives.

Recommendations for Providing Quality Sexually Transmitted Diseases Clinical Services, 2020

“…Services for preventing STDs and related conditions, including HIV, consist of eight strategies. These are 1) condom provision (17,70,75); 2) hepatitis A vaccination (17,76); 3) hepatitis B vaccination (17,77); 4) human papillomavirus (HPV) vaccination (78,79); 5) emergency contraceptive pills (17,80,81); 6) STD/HIV prevention counseling (brief, moderate intensity, or high intensity) (17,82-84); 7) PrEP for HIV prevention risk assessment, education, counseling, provision, and linking or referral, or both (85); and 8) nonoccupational postexposure prophylaxis (nPEP) of HIV risk assessment, education, counseling, provision, and linking or referral, or both, to HIV care (86).…”

Forensic Nurses' Understanding of Emergency Contraception Mechanisms

“…Leading health-related professional associations and organizations around the world support EC, including the World Health Organization (2021), the International Federation of Gynecology and Obstetrics (Jina et al, 2010; Schenker & Cain, 2004), the United Nations Population Fund (2008), and the American Academy of Pediatrics (Upadhya et al, 2012). Their endorsements of EC reflect confidence not only in EC's safety and efficacy but also in the belief that greater access to EC is vital.…”

Contraception for HIV-Infected Adolescents

“…More information on emergency contraception can be found in the AAP policy statement on emergency contraception. 86 Plan B One-Step (levonorgestrel) is approved by the Food and Drug Administration as a nonprescription product for all women of childbearing potential, 87 and generic versions are approved as nonprescription products for adolescent females and women aged ≥17 years, even though proof of age is not required for purchase. 1 Counseling and advance provision of emergency contraception should be a part of anticipatory guidance for adolescents.…”