Emergency Contraception in Canada: An Overview and Recent Developments (Research Update) (Report‪)‬

Abstract: Emergency contraception (EC) is used to decrease the risk of pregnancy after unprotected sexual intercourse. There are two types of EC: emergency contraceptive pills (ECPs), and the post-coital copper intrauterine device (IUD). ECPs are more commonly used and can reduce the risk of pregnancy by 75- 89%. Although they may be effective if used up to 5 days after intercourse, ECPs are more effective the sooner they are used. This medication is extremely safe and will not harm an existing pregnancy. Repeated use of ECPs poses no known health risks; however, ongoing forms of birth control will be more effective. ECPs do not provide protection against sexually transmitted infections. Improving access to ECPs is a priority for health care advocates. In Canada in 2005, the regulatory status of Plan B[R], the most commonly used ECP, changed to enable access without a prescription. As a Schedule II medication, a woman needs only to request it from a pharmacist. Although this has removed one barrier, in some provinces it has resulted in a new barrier; increased cost due to the addition of a fee for counselling by a pharmacist. Some have advocated further deregulation to "on the shelf" (which would not require consultation with a pharmacist), while others maintain that the assessment and counselling by a pharmacist are essential for safe and appropriate use. To further promote appropriate use of emergency contraception, strategies are needed to eliminate barriers to use, increase emergency contraception knowledge and awareness, and assist women to identify their risk for pregnancy. Introduction