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Emergency contraception


  • Wash hands
  • Introduce self
  • Ask Patient’s name and what they like to be called
  • Explain
  • Establish patient’s age

History of presenting complaint

  • Details of sexual intercourse: when, with whom (regular partner, how old are they, check it was consensual) 
  • Current contraception: type (none/barrier/pill), reason for failure (e.g. missed pill, split condom etc.)
  • Menstrual history: last menstrual period, cycle length, estimated day of ovulation (2 weeks before next menstrual period is due)
    • NB: the fertile period is on the day of ovulation and the 5 days before it (but it is possible to conceive at any time).
  • Any possibility they could already be pregnant/have they already taken emergency contraception this cycle?


  • Reasons: why they want emergency contraception/the impact of pregnancy
  • Emergency contraceptive optionssee table below, all must be given ASAP
  • Future contraception options: hormonal contraception can be started immediately after Levonelle or 5 days after ellaOne – barrier methods should be used until contraception has become effective (after 7 days for COCP; after 2 days for progestogen-only pill)
  • Risk of STIs: advise screening as appropriate (consider taking a more detailed sexual history)


  • Pay attention to their concerns (remember ICE – Ideas, Concerns, Expectations)
  • Give them a leaflet about the emergency contraception they’ve taken
  • Advise them to come back in 3 weeks for follow-up/to take a pregnancy test

Emergency contraception options

Please note OSCEstop content is for educational purposes only and not intended to inform clinical practice. OSCEstop and authors take no responsibility for errors or the use of any information displayed.Β 

Here’s some questions

A patient who is breastfeeding requires emergency contraception. She would like a pill rather than an intrauterine device due to a tear sustained in labour. What would you advise?

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After administering a patient emergency contraception, she asks about some appropriate long-term contraception options. She was on the combined pill but works nights and regularly forgets to take it.

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