Emergency contraception

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 or 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.

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 Table 1 in Appendix)
• 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)