Contraception - emergency contraception

About emergency contraception

Emergency contraception is used to prevent unplanned pregnancy if you had sex without contraceptive protection. Such as:

• where the condom broke
• you missed or were late in taking the pill (combined) or progestogen only (mini) pill
• you didn’t use any contraception.

Using emergency contraception is not an abortion.

Emergency contraception does not protect you from sexually transmissible infections (STIs).

Types of emergency contraception

Emergency contraception can be taken up to 5 days after unprotected sex. You can choose between 2 types in Australia:

• the copper intrauterine device (or non-hormonal IUD) – can be inserted by specially trained doctors or nurses
• emergency contraceptive pills (sometimes called the ‘morning after pill’).

Emergency contraceptive pill (or morning after pill)

The emergency contraceptive pill (or morning after pill) is available in 2 types:

• ulipristal acetate (sold as EllaOne®) – can be taken within 5 days after unprotected sex
• levonorgestrel (multiple brands) – can be taken within 4 days after unprotected sex.

The emergency contraceptive pill is not recommended for ongoing contraception.

When to use emergency contraception

Depending on the type of emergency contraception you use:

• the copper IUD must be inserted within 120 hours (5 days) of unprotected sex. You will need to see a specially trained GP or nurse at a sexual health clinic to have it inserted
• the emergency contraceptive pill should be taken as soon as possible (up to 4 or 5 days) after unprotected sex. The pill can be bought over-the-counter at a pharmacy without a prescription.

Emergency contraception effectiveness

The effectiveness of emergency contraception in preventing pregnancy is:

• copper IUD – more than 99% and can last up to 5 to 10 years. It must be inserted within 120 hours (5 days) of unprotected sex
• emergency contraceptive pills – depending on the type approximately 85% (Ulipristal acetate is more effective than levonorgestrel).

Emergency contraceptive pills may be less effective if you:

• are late taking them
• vomit within 3 hours of taking them
• weigh over 70 kg or have a body mass index (BMI) more than 26 kg/m2
• are taking certain medications (check with your doctor, nurse or pharmacist).

Speak to a doctor, nurse or pharmacist for further information.

How emergency contraception works

Each form of emergency contraception works differently in preventing pregnancy:

• The copper IUD stops sperm from reaching and fertilising an egg. It also changes the lining of your uterus (womb), so a fertilised egg won’t stay in it to start a pregnancy.
• The emergency contraceptive pill prevents or delays the ovaries releasing an egg. If you have unprotected sex again you may need another dose.

Where to get emergency contraception

Copper IUD

Talk to your GP or nurse about a copper IUD. You need to make an appointment to have it inserted.

Emergency contraceptive pills (morning after pills)

You can buy emergency contraceptive pills at a pharmacy without a prescription.

The pharmacist may ask you a few questions to determine the best type of emergency contraception pill. This may depend on:

• your weight and body mass index (BMI) – a double dose of levonorgestrel emergency contraception pill is recommended for those who weigh more than 70 kg (or have a BMI greater than 26 kg/m2)
• whether you are taking certain types of medication (including other contraceptives)
• whether you are breastfeeding.

Be sure to ask the pharmacist about whether the emergency contraceptive pill is a suitable option for you.

Cost of emergency contraception

The cost of emergency contraception can vary depending on the type you use, the brand and where you buy it from.

The cost of emergency contraception or a copper IUD is no cheaper for those with a concession or health care card.

The emergency contraception pill costs between $15 and $50 depending on the type and brand. Some pharmacies are cheaper than others.

The copper IUD may cost around $70 to $120 outside a public hospital setting.

If you have a copper IUD inserted or see a doctor for emergency contraceptive pills, you may also need to cover the cost of a medical appointment. These costs may vary between clinics and whether they bulk bill or you have a health care card.

Emergency contraception possible side effects

Copper IUD

A few weeks after the copper IUD is inserted you may experience:

• abdominal pain
• irregular bleeding between periods
• heavier periods
• painful periods.

As the copper IUD does not contain hormones, there are no hormonal side effects.

Emergency contraceptive pills

Emergency contraceptive pills may:

• change the amount of bleeding for your next period
• make your period late or earlier.

If your period is more than 7 days late, lighter than usual or unusual in any other way, take a pregnancy test as soon as you can.

Other possible effects for a small number of people can include:

• nausea
• headaches
• bloating
• sore or tender breasts.

Potential risks of emergency contraception

As with all medications, there are potential risks.

Copper IUD

There is a small risk of:

• infection at the time the copper IUD is put in and for the first 3 weeks after it has been inserted
• perforation, which is when the IUD makes a hole in the wall of the uterus when it is put in.

Emergency contraceptive pills

There are no known serious risks from taking emergency contraceptive pills.

The doctor, nurse or pharmacist will recommend the best type of emergency contraception depending on your circumstances.

Starting other contraception after using emergency contraception

The copper IUD can remain in place and will provide very effective ongoing contraception for up to 10 years.

Levonorgestrel emergency contraceptive pill

After taking the levonorgestrel emergency contraceptive pill, you can start the pill, implant, vaginal ring and injection immediately.

Ulipristal acetate emergency contraceptive pill

Other forms of contraception such as the pill, implant, vaginal ring and injections can make ulipristal acetate less effective at preventing pregnancy. Do not start them until 5 days after taking the ulipristal acetate emergency contraceptive pill.

You will need to have a pregnancy test 3 to 4 weeks after taking emergency contraception if you do start the pill, implant, vaginal ring or injection any time within the next 3 weeks.

Pregnancy while using emergency contraception

Copper IUD and pregnancy

If you find that you are pregnant on the copper IUD, see a doctor or nurse to have the IUD removed immediately. The doctor or nurse will also need to rule out a pregnancy in your fallopian tubes.

Removal of the copper IUD will not harm your pregnancy and you can then weigh up your options.

If the IUD cannot be removed and you continue with the pregnancy, there is a high risk of miscarriage or having a premature delivery.

Emergency contraceptive pill

If you find that you are pregnant after taking the emergency contraceptive pill, it is safe to continue the pregnancy or to end it by having a medical or surgical abortion.

Taking emergency contraception after birth

The copper IUD can be inserted any time once your baby is 4 weeks old. In some circumstances it can be inserted soon after giving birth. Your doctor or nurse will advise you on the best timing for you.

Emergency contraceptive pills are safe to take at any stage after having a baby.

Emergency contraception and breastfeeding

The copper IUD and levonorgestrel emergency contraceptive pill are safe to use if you are breastfeeding – your breastmilk will not be affected.

The ulipristal acetate emergency contraceptive pill is safe to take at any time after having a baby. It has not been well studied during breastfeeding, but it is generally thought to be safe.

Speak to your doctor, nurse or pharmacist about whether you should express and throw out your breast milk for 24 hours after taking ulipristal acetate.

Where to get help

• Your GP (doctor)
• Pharmacist
• Your school nurse or school welfare coordinator
• Some secondary schools provide access to an adolescent health trained GP on site
• Your local community health service
• 1800 My Options Tel. 1800 696 784 – for information about contraception, pregnancy options and sexual health in Victoria
• Sexual Health Victoria (SHV) – book an appointment online or call Melbourne CBD Clinic: Tel. (03) 9660 4700 or Box Hill Clinic: Tel. (03) 9257 0100 or (free call) Tel. 1800 013 952 (Monday-Friday 9 am to 5 pm). Confidential services are available for young people under 23
• Thorne Harbour Health (formerly Victorian AIDS Council) Tel. (03) 9865 6700 or 1800 134 840 (toll free)
• The Centre Clinic, St Kilda Tel. (03) 9525 5866
• Equinox Gender Diverse Health Centre (Monday to Friday 9 am - 5 pm) Tel. (03) 9416 2889 or email: equinoxadmin@thorneharbour.org
• Ballarat Community Health Sexual Health Clinic – book online or Tel. (03) 5338 4541
• Bendigo Community Health Sexual Health Clinic – book online or Tel. (03) 5406 1200 or (03) 5448 1600
• Gateway Health Sexual and Reproductive Health Clinic 35, Wodonga (Monday to Friday 9 am - 5 pm) Tel. (02) 6022 8888 and Wangaratta Tel. (03) 502 5444 or email: info@gatewayhealth.org.au
• Sunraysia Community Health Services, Mildura (Monday to Friday 8:30 am - 5 pm) Tel. (03) 5022 5444 or email: schs@schs.com.au
• Barwon Health Sexual Health Clinic (no referral, walk-in service on Tuesdays 2 pm - 6:30 pm) Tel. (03) 5226 7489
• Victorian Aboriginal Health Service, Fitzroy, Epping and Preston, Tel. (03) 9419 3000, (Monday to Thursday 10 am – 5 pm, Friday 10 am – 4 pm) and after-hours locum service Tel. 13 26 60
• Sexual Assault Crisis Line Tel.1800 806 292