The researchers did this study to encourage clinicians to assess risk and to offer a copper IUD as a first-line choice with hormonal methods as a second-line choice.
UPA was the second-line choice for presentations up to 120 hours after high-risk episodes. At lower risk, women were offered UPA if the production was between 72 and 120 hours after unprotected intercourse unless the threat was shallow. Levonorgestrel 1.5 mg was the second-line choice.
Only half of women before the protocol was offered an IUD compared with 61.6% afterward. IUD offering improved further in the subgroup of women at high risk, where 93.3% were offered an IUD compared with 59% initially. After introducing UPA, the percentage of women accepting the IUD fell from 30% to 14.1%. 14.5% of women received UPA compared to 7.8% receiving an IUD.
The study concluded that introducing a standardized protocol for the provision of emergency contraception has significantly increased the proportion of women offered an IUD as postcoital contraception, particularly in women at high risk of conception. The introduction of UPA has seen a halving of the number of women accepting the IUD.
Reference: https://srh.bmj.com/content/39/3/201
