Emergency Contraception Path: Sexual Health and Contraception
Emergency Contraception
Overview Emergency contraception (EC) reduces the risk of pregnancy after unprotected sexual intercourse (UPSI) or contraceptive failure.
In the emergency department (ED) the priorities are rapid assessment of pregnancy risk and timing, offering the most effective option available (or interim oral EC if definitive care is delayed), addressing safeguarding/forensic needs (for example after sexual assault), and arranging follow‑up for ongoing contraception.
Local commissioning arrangements and Patient Group Directions (PGDs) determine which products can be supplied without an individual prescription - ED staff must know their local PGD and referral pathways (NICE QS129; GOV.UK).
Key service principles
- Present the copper intrauterine device (IUD) as the most effective EC and arrange same‑day insertion or rapid referral; if insertion cannot be arranged immediately, supply oral EC as an interim measure (NICE QS129).
- Use PGDs to supply oral EC promptly where available; check the local PGD for eligibility, exclusions and practical details (GOV.UK).
- Include EC in the immediate package of care after sexual assault and follow local SARC/forensic/safeguarding pathways (RCEM).
- Check for medicines that may reduce the effectiveness of oral hormonal EC (for example enzyme‑inducers, St John’s Wort) and follow MHRA/local guidance when choosing methods.
- Link EC encounters to an offer of ongoing contraception, including rapid referral for long‑acting reversible contraception (LARC) (NICE QS129).