The fourth edition of the clinical summary of emergency contraceptive pills (ECP) provides a two-page overview of ICEC’s Medical and Service Delivery Guidance. New information on the hormone UPA and new studies on the influence of BMI on effectiveness are briefly discussed, as well as how ECP regimens work, their efficacy and safety, guidelines on repeat use, and considerations for starting or resuming regular contraceptives following ECP regimens.
This section contains fact sheets, blog posts, technical statements, clinical guidelines, journal articles and publications focusing on policies and access. Several publications focus on sexual assault and humanitarian settings. For more information on specific themes, please visit the EC Issues Pages. Many of our publications are available in multiple languages.
Updated in 2018, the Medical and Service Delivery Guidance is ICEC’s most widely distributed publication. Designed to serve as a key reference and training document for service provision, it includes a range of medical and service delivery issues in an easy to use format, from screening, dosages, and counseling to EC pill regimens. Local programs can adapt this guidance as necessary to comply with national or other requirements. Available in English, Spanish, and French
When no products marketed specifically for emergency contraception are available, combined oral contraceptives – regular birth control pills – can also be used as EC. This is known as the “Yuzpe” method. The Yuzpe method offers critical EC access for women without access to dedicated ECPs.
Women’s access to ECPs is significantly influenced by the availability of EC products in their country. Many dedicated products – those that are packaged and labeled for EC use specifically – exist, but are only accessible to women if at least one product is registered and/or imported in their country. The ECP Registration Status fact sheet provides an overview of ECP availability by country based on three designations – at least one product registered, no registered product but current or previously imported product, and no registered or imported product.
For women wanting to prevent pregnancy, timely access to ECPs is crucial, since the sooner they are taken, the more likely they are to be effective. Regulatory limitations on the sale of ECPs (including prescription requirements and age restrictions) impede a woman’s ability to get ECPs when she needs them. This fact sheet addresses why unrestricted, over-the-counter (OTC) access to ECPs is essential and safe for women of all ages.
Although certain levonorgestrel-alone emergency contraceptive pills (LNG-ECPs) contain two 0.75 mg pills that are indicated to be taken 12 hours apart up to 72 hours after intercourse, labels for these ECPs do not reflect current scientific information. This short regimen update provides evidence-based conclusions for dosage and timing and recommends that women take LNG-ECPs in a single dose of 1.5 mg LNG — if the package contains two pills of 0.75 mg LNG, women should take both at the same time. Moreover, while ECPs are more effective the sooner they are used, they can provide some protection from unwanted pregnancy as many as five days (120 hours), not just up to 72 hours, after unprotected intercourse.
The clinical summary of emergency contraceptive pills (ECP) provides a one-page overview of ICEC’s Medical and Service Delivery Guidelines by briefly discussing how ECP regimens work, their efficacy and safety, guidelines on repeat use, and considerations for starting or resuming regular contraceptives following ECP regimens.
Unmet need for family planning remains high globally, and women and men face challenges accessing both accurate information about contraception and contraceptive supplies. Contraceptive social marketing programs offer creative, effective and successful strategies to provide reproductive health (RH) products and services. Yet, the peer-reviewed literature contains few evaluations of social marketing of contraceptives, particularly those focused on emergency contraception (EC). These programs have the potential to reach women with affordable, quality emergency contraceptive products when and where they need them, and they can contribute substantially to women’s ability to access a range of contraceptive options. Authors: Elizabeth Westley, Tara Shochet
Although dedicated EC products have been on the market for close to 20 years, access remains limited, particularly for women in low-resource settings. This article reviews relevant policies, regulations and other factors related to EC access worldwide. While supportive policies and regulations are in place and EC products are registered in many countries around the world and included in many countries’ essential medicines lists, analysis of demographic data and health provider surveys shows that accessibility remains limited. Authors: Elizabeth Westley, Nathalie Kapp, Tia Palermo, and Jennifer Bleck
Twenty years of global partnerships have resulted in a dramatic increase in the availability of emergency contraception products, yet closer examination reveals that access remains limited, especially in developing countries. This brief describes current access to EC, identifies access gaps and barriers, and investigates root causes of these gaps. Eight recommendations are made for advocates, policymakers and other partners working to improve access to EC.
ICEC’s Emergency Contraceptive Pills Medical and Service Delivery Guidelines have been adapted by the Latin American Consortium for Emergency Contraception (CLAE) and the Latin American Federation of Societies of Obstetrics and Gynecology (FLASOG) to reflect the cultural and political environment in the region. The guidelines address EC pill regimens including levonorgestrel and ulipristal acetate, and also the Yuzpe method, which is still the only choice available in many communities in Latin America and the Caribbean.
Emergency contraception is a critical component of comprehensive post-rape care for women. However, sexual assault survivors often face obstacles in accessing EC products and information. Not all public health care systems or police stations, where women often report sexual violence, stock EC. Nor do many front-line rape responders, such as law enforcement officers and social workers, receive training on EC. Global guidance from international policy-making bodies suggests that failure to ensure on-site EC provision to rape survivors jeopardizes women’s health and violates their human rights. In order to increase access to EC in these situations, governments should implement and enforce policies that guarantee EC provision in post-rape care, health care facilities and training institutes should support EC for sexual assault survivors, and where appropriate non-health professionals should be authorized to provide ECPs or referrals.