Emergency contraception and breast-feeding

Vanessa Chapman, Associate Professional Lead for Medicines Information, Midlands & East, Midlands and East Medicines Advice Service (Midlands site) & UK Drugs in Lactation Advisory ServiceSource Trent Medicines Information ServicePublished
  • It is possible for a woman to get pregnant again very soon after the birth of a baby, even if breastfeeding, and even if periods have not returned. If emergency contraception is required, women can be advised that progestogen-only emergency contraception (levonorgestrel or ulipristal acetate) can be used from day 21 postpartum and the emergency copper intra-uterine device from day 28 postpartum.
  • A copper intra-uterine device can be inserted up to 120 hours (5 days) after unprotected intercourse or contraceptive failure. No restriction on breastfeeding is required. The copper IUD has the additional benefit of providing long term, reversible contraception to women who wish to prevent pregnancy. The Faculty of Sexual and Reproductive Healthcare recommend that the copper IUD be offered to women first line in the majority of cases where emergency contraception is indicated, including breastfeeding women.
  • A single dose of 1.5mg levonorgestrel is licensed to be taken within 72 hours (3 days) of unprotected intercourse or contraceptive failure. No restriction on breastfeeding is required.
  • A single dose of 30mg ulipristal acetate is licensed to be taken within 120 hours (5 days) after unprotected intercourse or contraceptive failure. Ulipristal is not the preferred emergency contraceptive during breastfeeding, however, based on pharmacokinetic data, UKDILAS do not consider it necessary to withhold breastfeeding if a single dose has been taken.

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