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Appendix B: EC Patient Information Informed Consent Patient Information for Informed Consent:
Before you take emergency contraceptive pills (ECPs), be sure you understand both the benefits and the possible problems of using ECPs. If you have any questions as you read, we will be happy to talk about them with you. Emergency contraceptive pills (ECPs) are hormonal pills (similar to birth control pills) that you take to try to prevent pregnancy after you have unprotected vaginal intercourse. Unprotected sex means either your birth control method failed (for example your condom broke) or you didn’t use a method. The pills can keep the ovary from releasing an egg, thicken cervical mucus or change the lining of the uterus in such a way that a fertilized egg may not attach and develop into a pregnancy. There are alternatives to ECPs. When a copper intrauterine device (IUD) is inserted within 7 days of a single act of unprotected intercourse, it may prevent pregnancy. It may also be left in place for ongoing contraception. Or you can choose to “wait and see.” Discuss all of the choices with your health care provider. The sooner ECPs are taken, the better they work to prevent pregnancy. It is best to start the pills within 72 hours (3days) of unprotected vaginal intercourse. When taken within the first 72 hours after intercourse, emergency contraception pills prevent pregnancy about 75-89% of the time. Studies have shown that even if ECPs are taken as late as 120 hours (5days) after unprotected intercourse they may prevent pregnancy. ECP appears to be less effective the later it is used. How well the pills work depends on how soon after intercourse they are started and what day in your menstrual cycle unprotected intercourse takes place. This method fails to prevent pregnancy in some cases, because: A fertilized egg has already implanted in the uterus (ECP will NOT cause an abortion)
Too much time passed since unprotected vaginal intercourse You will get the Food and Drug Administration (FDA) approved information provided by the pill manufacturer. You should read this information and ask questions about anything you do not understand. You should not use ECPs if you are (or think you are) already pregnant. However if you are pregnant or if the pills fail and pregnancy occurs, there have not been any reports of serious side effects to the woman or to the fetus from taking the pills. Rare but serious problems or complications, particularly with blood clots, can occur with the regular use of birth control pills, as stated in the FDA information. It is not known whether blood-clotting problems (or other complications) can also occur when birth control pills are used for emergency contraception, but medical experts do not think so because the exposure to the medicine in the pills is so short. Some reactions to these pills (for about 24 hours) may include: After taking ECPs, your next period could be early or late, or could be lighter or heavier, or could be the same as usual. If you use ECPs more than once in a monthly cycle, the chances of having problems with your next period will be greater. Appendix B: EC Patient Information Informed Consent If you see a clinician for any reason before you get your next period, you should tell him/her that you have taken ECPs. If you do not want to become pregnant, it is important to think of a more reliable form of ongoing birth control. After using ECPs, some women continue on birth control pills or use an IUD. Ask about the options at your clinic. Having unprotected sex may have put you at risk for Sexually Transmitted Diseases (STDs); you should talk to the clinician about getting tested. Call the clinic or your healthcare provider for a pregnancy test after taking ECP If your period is 2
weeks late, if you feel like you could be pregnant, or if you have any early signs of pregnancy (such
as feeling sick to your stomach, feeling very tired, breast swelling or tenderness)

How to Take the Emergency Contraception Pills
1. You have been given pills named _________________________________. 2. You should swallow ____ pill(s) as soon as possible within 120 hours (5 days) after unprotected intercourse. The sooner you take them, the better they work to prevent pregnancy. 3. Then, swallow ____ more pill(s) 12 hours after you take the first pills. To prevent feeling sick to your stomach or throwing up: Do not take the pills on an empty stomach (eat something) You can get something for nausea at the drugstore without a prescription (like Dramamine or Bonine) to take about an hour before taking ECPs if you want to If using Option 1, try to time the pills so that you take the second dose before going to bed. Think you have a problem or that you might be pregnant • Are so sick to your stomach or are throwing up so much that you can’t take the second dose of pills (if Using ECP does not protect against sexually transmitted diseases. If you or your partner have other sexual partners, you also should use latex condoms to prevent infections. Regular physical examinations for routine health care and for screening for sexually transmitted infections (including HIV) and cancer are strongly recommended.


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