Nurses should advise women asking for emergency contraception that the “coil” is more effective than the pill, according to latest clinical standards published today.
The National Institute for Health and Care Excellence has published a quality standard setting out the key areas where advice to women on contraception needs to improve.
“Women are often surprised by how soon after birth they can become fertile again”
It advises that women requesting emergency contraception should be told that a copper intrauterine device – IUD or “coil” – is more effective than the pill.
The institute highlighted that the coil was effective for up to five days after unprotected sex or within five days of expected ovulation.
Practitioners unable to fit IUDs at presentation should refer women to a service that can and offer them an oral emergency method in the interim, added the institute.
Women should also be informed about long-acting reversible (LARC) methods such as the coil when asking for contraception, said NICE.
In 2014-15 95% of emergency contraception issued by sexual and reproductive health services was for the pill.
“We know that the coil is the most effective method of emergency contraception available”
Oral contraceptives also remain the most common form of contraception, but the uptake of LARC has been increasing and in 2014-15 accounted for 37% of all women making contact with sexual and reproductive health services.
In addition, the new standard highlighted that fertility may return quickly after birth, including among women who are breastfeeding.
To avoid unplanned pregnancy, midwives should give women information about, and offer women, a choice of all contraceptive methods within seven days of delivery, it said.
Midwives should refer women to a contraceptive service if their chosen contraceptive cannot be provided immediately, it added.
Professor Gillian Leng, deputy chief executive of NICE, said: “We want to empower women with the best information about all methods of contraception and their effectiveness.
“For instance, women are often surprised by how soon after birth they can become fertile again so we have included a statement ensuring midwives speak to them about contraception,” she said.
“We also want to ensure women are told the coil is more effective than the pill as emergency contraception,” she added.
Sue Burchill, head of nursing at Brook, which provides sexual health services for young people, said: “We believe all young people should be provided with accurate information about the different methods of emergency contraception available.
“We know that the coil is the most effective method of emergency contraception available, so we must all continue to ensure that ease of access to this method is increased and maintained across services from a variety of providers,” she said.
“It is really encouraging to see an increase in the uptake of LARC in general,” added Ms Burchill.
While approximately one in five pregnancies is unplanned, conceptions among under 18s is falling, noted NICE.
In 2014 conceptions in women aged 15-17 was the lowest since records began in 1969, and from 2013 to 2014 the estimated number of under-18 conceptions fell by 6.8% to 22,653.