Introduction

What's New

No interruption of breastfeeding is necessary following a single dose of Ulipristal Acetate when given for Emergency Contraception.

Decision Making Tool (see Pathway)

Offer all clients Cu-IUD as 1st line choice

If client declines Cu-IUD or it is unsuitable, prescribe UPA-EC unless contraindicated or quick starting**

When UPA-EC contraindicated or quick starting prescribe LNG-EC

If prescribing UPA-EC or LNG-EC check BMI and weight as the dose and choice may need to be adjusted (see relevant section in protocol)
                                                                                       
*Contraindications to UPA-EC: Asthma controlled by oral glucocorticoids

**In some circumstances where the benefits of immediate quick start of hormonal contraception potentially outweigh the risk of pregnancy from unprotected sex which has already taken place, LNG-EC and ‘quick starting’ a hormonal method is preferred over UPA-EC                                                

If weight > 70 kg or BMI > 26 Cu-IUD remains the 1st choice. If not acceptable, offer UPA-EC. If not
appropriate offer double dose LNG-EC

Indications for Use

EC is appropriate for women who do not wish to conceive following:

• Unprotected sexual intercourse (UPSI)
• Failure or potential failure of a contraceptive method (see Indications for Emergency Contraception...)
• UPSI following Day 21 after childbirth (unless the criteria for lactational amenorrhoea are met)
• UPSI from Day 5 after abortion, miscarriage, ectopic pregnancy or uterine evacuation for gestational trophoblastic disease (GTD)