Emergency Contraception

Plan B is levonorgesterel, and is provided in either a 1.5 mg (one time dose) or 0.75mg (2 doses given 12 hours apart, or can both be taken at the same time).  Both are also available over the counter for women (and men) age 17 and older.  Plan B is most effective within the first 72 hours, but can be given up to 120 hours post-exposure.

Click on this link to see a unique video describing how Plan B works:   http://www.youtube.com/watch?feature=player_embedded&v=7Vozr9vHeMo

Even if a woman has been on oral contraception or been taking Depo-Provera, it is ok to offer Plan B after a sexual assault.    Some women do not take their pills consistently on time, or get their Depo shots on time.  If you do not give Plan B in a case of vaginal/penile penetration, please document that you offered it, and patient declined (and why).  Plan B is safe to give women who are breastfeeding.  To minimize the infant's exposure to levonorgesterel, advise the woman to avoid nursing her infant for 8 hours. 

Patient Teaching Points:

• It is possible to become pregnant after a sexual assault.
• The medication is most effective when taken as soon as possible.
• Only contraindication is pregnancy.
• Most common side effect is heavier menstrual flow.
• Routine use of antiemetics is usually not necessary.
• Plan B will not protect against STI's.
• Plan B can be used safely more than 1 time during a menstrual cycle, but should not be considered first line of defense against pregnancy.  A visit to a primary care clinic is advised for education and contraception planning.