Absence, forgetting of contraception or failure of the contraceptive method… So many causes at the origin of the occurrence of an unwanted pregnancy. Several methods are used to prevent the onset of pregnancy or to stop it. The main thing to know.

Have you had a contraceptive accident (torn condom, forgotten pill, etc.)? Unexpected sex without contraception? It is to prevent pregnancy by taking so-called emergency contraception. It is a method of “catching up” which makes it possible to avoid the occurrence of an unwanted pregnancy. It should be put in place as soon as possible after risky intercourse, regardless of the time of the menstrual cycle. There are two types of emergency contraception: hormonal and non-hormonal.

Hormonal contraception is called the “morning after pill”. This involves taking a tablet as soon as possible after unprotected intercourse and at the latest within 3 days of intercourse. How does it work to prevent unwanted pregnancy? The morning after pill delays ovulation. Note: the earlier the morning-after pill is taken, the more effective it is. The effectiveness is 95% when the tablet is taken before 24 hours; effectiveness drops to 58% when done between 48 hours and 72 hours. If you don’t have your period within 5-7 days of the due date, take a pregnancy test. If you are pregnant and do not wish to continue this pregnancy, you can resort to voluntary termination of pregnancy (abortion).

Be careful, the morning after pill does not protect against sexually transmitted infections (STIs). If you do not know your partner well, it is important to discuss the possible risks with your doctor. Preventive treatment after exposure to HIV (AIDS) is possible and screening may be advised. This medical appointment also allows you to take stock of your contraception.

Morning after pill: how to get it?

The morning after pill can be prescribed by a doctor or obtained from a pharmacy without a prescription. In this case, it is not reimbursed. For minors, the morning-after pill can be dispensed anonymously and free of charge in pharmacies. All women can get this emergency contraception free of charge at family planning and education centers.

This hormonal emergency contraception cannot replace regular contraception. It is less effective than this one.

The second type of emergency contraception is non-hormonal: it involves having an intrauterine device (IUD) or copper IUD placed within 5 days of having sex.

Its mode of action? The IUD prevents fertilization by making the sperm inactive. It also prevents implantation of the possibly fertilized egg.

Emergency contraception with a copper IUD is the most effective method of emergency contraception. Its efficiency is almost 99%. It also has the advantage of being a continuous method of contraception. The copper intrauterine device can be left in place for 5 years.

Like hormonal emergency contraception, the IUD does not protect against sexually transmitted diseases.

Copper intrauterine device for emergency contraception: in practice

The IUD should be prescribed and inserted by a doctor or midwife. Specify when making an appointment that it is an emergency. If you have no contraindications, you can buy your copper IUD from a pharmacy on prescription. It costs around thirty euros and is reimbursed at 65%.

You can also go to a family planning and education center (CPEF).

If you have a period delay of more than 5 days, it is better to take a pregnancy test. If you are pregnant and you do not want this pregnancy, you can have voluntary termination of pregnancy (abortion)

Are you pregnant and do not want to or cannot continue with this pregnancy? It is possible to terminate a pregnancy in France up to the twelfth week of pregnancy (i.e. 14 weeks of amenorrhea, which means 14 weeks after the last period): this is the voluntary termination of pregnancy (abortion). If your cycles are irregular or if you don’t know the date of your last period, an ultrasound may be done to date the pregnancy.

The abortion can be done in two ways, depending on the age of pregnancy and your preference:

• a surgical abortion by suction
• a medical abortion

Surgical abortion

Surgical abortion is an instrumental method that involves aspirating the contents of the uterus under local or general anesthesia. This method can be performed up to 12 weeks of pregnancy.

In practice: surgical abortion is performed in a hospital environment for a stay of a few hours or a day. It consists of dilating the cervix to introduce a suction cannula, under local or general anesthesia.

Medicated abortion

Medical abortion consists of terminating a pregnancy by taking two drugs.

In practice: the first drug is mifepristone which stops pregnancy, the second drug, administered 36 to 48 hours later, is based on prostaglandins. It can be taken orally or administered vaginally. It causes contractions of the uterus. After taking the second drug, the pregnancy is expelled naturally. It is manifested by bleeding heavier than that during menstruation. The first medication is taken at home and may cause bleeding. The taking of the second drug accompanied by an anti-pain treatment is generally done in short hospitalization (a few hours), in a city office or in a planning center. If you live near the hospital center, you may be allowed to take a second medication at home.

This method of voluntary termination of pregnancy can only be used up to the fifth week of pregnancy (7 weeks of amenorrhea). Some centers practice it up to 7 weeks of pregnancy, with hospitalization.

After a voluntary termination of pregnancy, a check-up is scheduled within 2 to 3 weeks. Its purpose is to check that the termination of pregnancy has been complete and that there are no complications. It happens that in a very small number of cases (about 5%), the pregnancy continues to progress.

A voluntary termination of pregnancy is a heavy act, not trivial physically and psychologically. Two consultations are mandatory before an abortion with a mandatory reflection period between the two of a week. You may be offered a psycho-social interview between these medical appointments (it is mandatory if you are a minor).

Different structures can welcome you to give you information and help you make your decision:

• regional information hotlines on contraception and voluntary termination of pregnancy
• family planning or education centers;
• health centers;
• family information, consultation and counseling establishments

A psycho-social consultation is offered to you systematically after an abortion: do not remain alone with your questions, your anxieties, your possible feeling of guilt. It is also important to be able to confide in a loved one: member of the family, friend..