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


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.


CONCLUSIONS
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.
Swedish Association for Sexuality Education, Stockholm, Sweden.|Department of Women's and Children's Health, Division of Obstetrics and Gynecology, Karolinska Institute, Stockholm, Sweden.
Niklas
http://orcid.org/0000-0003-2813-7642
N
Envall
Department of Obstetrics and Gynecology, Danderyd Hospital, Stockholm, Sweden.
Nina
http://orcid.org/0000-0001-6565-1451
N
Groes Kofoed
Department of Women's and Children's Health, Division of Obstetrics and Gynecology, Karolinska Institute, Stockholm, Sweden.|Department of Obstetrics and Gynecology, Danderyd Hospital, Stockholm, Sweden.|Department of Clinical Sciences at Danderyd Hospital, Division of Obstetrics and Gynecology, Karolinska Institute, Stockholm, Sweden.
Helena
H
Kopp-Kallner
D000293:Adolescent; D000328:Adult; D003267:Contraception / Q000379:methods / Q000706:statistics & numerical data; D044363:Contraception, Postcoital / Q000379:methods*; D003270:Contraceptive Agents; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007435:Intrauterine Devices, Copper / Q000706:statistics & numerical data; D016015:Logistic Models; D009649:Norpregnadienes; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D011446:Prospective Studies; D055815:Young Adult
D003270:Contraceptive Agents; D009649:Norpregnadienes; C555622:ulipristal acetate
Acceptability; contraception; copper intrauterine device; emergency contraception; long-acting reversible contraception; ulipristal acetate; unintended pregnancy; unwanted pregnancy