Contraindications for Emergency Contraception
Contraindications for Emergency Contraception
- UPA and levonorgestrel have no major contraindications.
- Cu-IUD contraindications (UKMEC 4):
- Post-abortion or postpartum sepsis
- Initiation during PID, gonorrhoea, chlamydia, or purulent cervicitis o Endometriosis o Unexplained genital bleeding
- UKMEC 3 for Cu-IUD:
- 48 hours to 4 weeks postpartum
Distortion of the uterine cavity due to large uterine fibroids o HIV with CD4 count <200 (initiation only)
Breastfeeding and Emergency Contraception
- Cu-IUD is suitable if offered before 48 hours or >4 weeks postpartum.
- For oral contraceptives, you can use levonorgestrel, but avoid breastfeeding for 1 week with UPA.
Starting Contraception After Emergency Contraception
- After UPA:
- CHC: Wait 5 days before starting, use additional protection and do a pregnancy test at 21 days. o POP: Like CHC. o Cu-IUD: Can be inserted within 5 days of unprotected intercourse.
- After levonorgestrel:
- Like starting after UPA, but can start CHC and POP more quickly.
- Use additional protection until contraception is effective.
- After Cu-IUD:
- Can be left in place for ongoing contraception.