As we know, no method of contraception is 100% safe. Many pregnancies are unplanned and maybe subsequently unwanted either due to contraceptive failure or lack of contraceptive use.

Emergency or postcoital methods are used after intercourse takes place. They are back up methods if there has been UPSI (unprotected sexual intercourse) or potential contraceptive failure. We have already looked at the postcoital IUD but emergency contraception is most commonly given as a tablet (Postinor 1) containing the progestogen levonorgestrel. Women can access the emergency contraceptive pill (ECP) by obtaining a prescription from a GP or Family Planning Clinic. It is useful to know the cost ( $5 at the pharmacy) but in most cases the women will also have to pay for her practitioner visit . Actually, many pharmacies supply the same ECP as a pharmacy medicine without the need for a script. The cost now though varies from $20 - $45. Nurses who have been specially trained can also supply the emergency pill. The Nursing Council of NZ has details of the training required.

Look through the reading on the emergency contraceptive pill. It works mainly by delaying ovulation to later in the cycle -at this time the sperm from the unprotected sex will no longer be present to fertilise the egg. If used after ovulation it is not effective -though we would give it if a woman insisted that she really wished to have it. It is not effective for women who have a BMI >30 and these women should be offered a postcoital IUD.The other thing we need to think about is -if the intercourse was unprotected is the woman at risk of having picked up a STI -if so she will need to come back for swab test in about 3 weeks -sooner if she develops any symptoms. At this time -if she has not had her period after the ecp -she will need a pregnancy test to make sure that it has worked.

As you go through this section you might like to think about why the ECP is able to be available through pharmacies without a script.