Use of effective contraception six months after emergency contraception with a copper intrauterine device or ulipristal acetate – a prospective observational cohort study

Abstract

Introduction: Emergency contraception must be followed by the use of an effective method of contraception in order to reduce future risk of unintended pregnancies. Provision of long acting reversible contraception (LARC) is highly effective in this regard. The aim of our study was to compare use of an effective method of contraception 6 months following insertion of a copper intrauterine device (Cu-IUD) or intake of ulipristal acetate (UPA) for emergency contraception (EC).

Material and methods: Women (n=79) presenting with need for EC at an outpatient midwifery clinic chose either Cu-IUD or UPA according to preference. Follow up was three and six months later through telephone interviews. Primary outcome was use of an effective contraceptive method at the six-month follow up. Secondary outcomes included use of an effective contraceptive method at three months follow-up and acceptability of Cu-IUD.

Results: A total of 30/36 (83.3%) women who opted for Cu-IUD for EC had used an effective contraceptive method 6 months after their first visit compared to 18/31 (58.1%) woman who opted for UPA (p=0.03). In the Cu-IUD group 28/36 (77.8%) were still using Cu-IUD at six months and 31/36 (86%) stated that they would recommend the Cu-IUD to others as an EC method.

Conclusions: Significantly more women who chose Cu-IUD for EC used an effective method for contraception at the six-month follow up. The results of this study support increased use of Cu-IUDs for EC. This article is protected by copyright.

Comment: We mentioned earlier that an IUD is a very effective method of emergency contraception, with the added benefit that contraceptive protection continues. This nice study again shows that the chance of having reliable contraception is indeed high after EC with an IUD. (HMV)