Use of effective contraception 6 months after emergency contraception with a copper intrauterine device or ulipristal acetate - a prospective observational cohort study

Acta Obstet Gynecol Scand. 2016 Aug;95(8):887-93. doi: 10.1111/aogs.12916. Epub 2016 May 17.

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 3 and 6 months later through telephone interviews. Primary outcome was use of an effective contraceptive method at the 6-month follow up. Secondary outcomes included use of an effective contraceptive method at 3 months follow up and acceptability of Cu-IUD.

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

Conclusion: Significantly more women who chose Cu-IUD for EC used an effective method for contraception at the 6-month follow up. The results of this study support increased use of Cu-IUDs for EC.

Keywords: Acceptability; contraception; copper intrauterine device; emergency contraception; long-acting reversible contraception; ulipristal acetate; unintended pregnancy; unwanted pregnancy.

Publication types

  • Comparative Study
  • Observational Study

MeSH terms

  • Adolescent
  • Adult
  • Contraception / methods
  • Contraception / statistics & numerical data
  • Contraception, Postcoital / methods*
  • Contraceptive Agents*
  • Female
  • Follow-Up Studies
  • Humans
  • Intrauterine Devices, Copper* / statistics & numerical data
  • Logistic Models
  • Norpregnadienes*
  • Patient Acceptance of Health Care / statistics & numerical data*
  • Patient Satisfaction / statistics & numerical data
  • Prospective Studies
  • Young Adult

Substances

  • Contraceptive Agents
  • Norpregnadienes
  • ulipristal acetate