Many of us have been there, the condom broke or in the heat of the moment you forgot you were on no contraception at all.

Would you know what to do?

The most important thing here is not that it happened or how it happened, its knowing what to do next. Many women haven’t explored the idea of this anxiety provoking situation, why would we? we just want to enjoy ourselves – right?

Statistics in the UK tell us that 1 in 3 women have at least one abortion in their lifetime, could many of these have been prevented? You bet they could.

So to avoid the panic, the pondering of when your next period is due, the googling of when you would be ovulating and then buying 100 pregnancy tests…… Better prepare yourself for what you should do if you find yourself in this dilemma.

! Emergency Contraception !

Because it is an emergency if you are not planning to be a mum just yet, and you want to try and avoid the option of abortion. Yes, this is always an option and does have its place in reproductive health, but should be a last resort.

Whether google tells you that you are in your fertile days or not, or if you track your own ovulation – this is not always accurate as our cycle can change for a number of reasons at any time! So you do need to acquire some emergency contraception for your best chance at avoiding an unplanned pregnancy.

What is available?

The Morning After Pill and the IUD (copper coil)

The Morning after pill – Levonelle and EllaOne

These are known as the morning after pill which is a little misleading however, as you actually have more time to take these pills than you realise. Levonelle should be taken within 72hrs (3 days) of having unprotected sex. EllaOne gives you a little more time and should be taken within 120hrs (5 days) of having unprotected sex. Both of these work by either preventing ovulation or delaying ovulation for that current cycle. Both of these pills are available at most GP surgeries, most pharmacies though at a cost, sexual health clinics and family planning/contraception clinics. You can also obtain these pills at abortion clinics and usually at a lower cost than a pharmacy.

When is the morning after pill a good option?

When you are in need of one off cover. For example, you realise that the condom broke, you used no contraception at all, you realise that you missed a dose of your normal contraceptive pill or replaced your patch/vaginal ring late. In the case that you are already taking a contraception and you need to use the morning after pill, the clinician/pharmacist will advise you of how to carry on with your normal contraception in that cycle.

Important things to consider:

If you vomit within 2 hours of taking the morning after pill you should seek advice from the clinic or health professional you obtained it from, as you may need to take a repeat dose if you are still within the timeframe. These pills are not guaranteed to be 100% effective and so you should still be vigilant in looking out for the signs of a pregnancy, such as a missed period or an abnormally light and short period. Taking a dose of the morning after pill does not mean that you will be protected from pregnancy for the whole of that month and other methods of contraception should be considered if there are likely to be more episodes of sexual intercourse.

The IUD – Copper coil

The IUD can be fitted up to 5 days after having unprotected sex. This will work by preventing fertilisation or implantation and is much more effective than the morning after pill. It is slightly more invasive as this is a device that needs to be fitted into the womb. Before you say “I absolutely cannot!” hear me out. It is a very simple, quick procedure that can be carried out by a GP, Practice Nurse or any trained health professional in a sexual health or contraception clinic. This involves the use of a speculum (the device used to separate the vaginal walls during smear tests) and the passing of a fine tube (which contains the cooper coil IUD) through the cervix, where the coil will be released into the womb and the fine tube taken away. This can cause a little discomfort and some period type cramps which will settle soon after, taking paracetamol and ibuprofen before and after the fitting can be very useful. Some women will have ongoing cramping on and off after the fitting and may need a little more time for this to settle.

When is the IUD a good option?

If you simply want the most effective method of emergency contraception, you are likely to be or have already ovulated as then the morning after pill will have no effect. Or, if you would like the benefit of your emergency contraception continuing to work as a very good method of ongoing contraception for you – the IUD is a well known and very effective method of contraception and can be kept in place effectively for up to 10 years, although, it can be removed at any point when you decide.

Important things to consider:

If you have reason to believe that you may have an STI that has not yet been treated, having the coil fitted could put you at risk of introducing this infection to the womb. If you have any concerns about this but would still like to consider the option of the IUD discuss this with a health professional as you may be able to obtain antibiotic treatment at the same time.

So ladies, store this in your brains! Knowledge is power. I hope this has helped you to understand the options available to you. It is useful to know what is available in advance of this kind of event happening. Having this knowledge can help to reduce the panic and stress of the situation so that you can deal with this confidently and easily.

And remember girls, if you are at risk of pregnancy, you are also at risk of STI’s. Best to get a full sexual health screen to be on the safe side, as many STI’s don’t always display symptoms. Visit your local sexual health clinic for screening.

Lots of love,

Nurse Denise.