Emergency contraception: preventing unintended pregnancy.

Approximately 60% of all pregnancies are unintended at the time of conception, either unwanted or mistimed. Emergency contraception (i.e., use of a birth control method after intercourse has occurred) is a preventive treatment that has been underutilized. Six brands of oral contraceptives have recently been found by the U.S. Food and Drug Administration to be safe and effective as emergency contraceptive pills. These pills have been shown to reduce the likelihood of pregnancy occurring by at least 74%. Treatment with emergency contraceptive pills should be initiated within 72 hours of unprotected intercourse. Adverse effects include nausea, vomiting headache, and a change in menstrual bleeding patterns. Postcoital insertion of an intrauterine device is also highly effective as a postcoital contraceptive, but only in a select group of patients at low risk for sexually transmitted diseases. Promotion of access to emergency contraception includes educating both patients and providers about the method and making emergency contraceptive pills available to patients even before the need arises.