The copper IUD is the most effective emergency contraceptive (EC).

The copper IUD is nearly 100% effective as emergency contraception. In comparison, EC pills have been shown to be less than 90% effective. However, the majority of women requesting EC in the US are not offered the copper IUD as an option.

An important benefit of the copper IUD is that it can also work as a highly effective birth control.

Following insertion as EC, the copper IUD can continue to be used as a regular birth control method for up to 12 years. One study found that women who opted for the IUD as EC verses EC pills were more likely to be using an effective contraceptive method six months later. Another study found that women who chose an IUD for EC had half the number of pregnancies within a year than women who chose EC pills. Researchers have found one year continuation rates following insertion to be about 80%.

The copper IUD as EC is almost 100% effective.

Almost any woman can get an IUD.

  • The copper IUD can be inserted up to 5 days after unprotected intercourse.
  • The copper IUD is the most effective option for women of any weight. Levonorgestrel pills, like Plan B One-Step®, may be less effective if a woman weighs over 165 pounds, and the ulipristal acetate pill, ella®, may be less effective if a woman weighs over 195 pounds. The copper IUD maintains effectiveness at all weight ranges.

Download or order free copies of this chart and other tools and materials here
 

How can a clinic start offering the copper IUD as EC?

Provider and staff awareness and education about the IUD as EC is an important initial step to offering this EC method. Several studies found that many providers, particularly those outside of reproductive health specialties, were unaware of the copper IUD as an EC option. These studies also found that providers were less likely to offer IUDs as EC compared to EC pills, even if they already provided the copper IUD in clinic.

Potential barriers to offering the copper IUD as EC routinely in clinic include: the possible expense that an IUD can pose to the patient or the clinic, the need for providers to be trained in the insertion procedure, and concerns about unexpected insertions disrupting clinic flow.

If a woman is interested in getting a copper IUD as EC, the clinic should try to place the IUD that same day, as returning to the clinic can pose a challenge.

 

Video: Using the Copper IUD as Emergency Contraception

We designed the following video for providers and clinics interested in learning more about using the copper IUD as EC. The video includes information on who can get a copper IUD and suggestions on how to incorporate it into clinic practice.

 

 

Selected literature for further reading:

  1. Batur P, Cleland K, Mcnamara M, Wu J, Pickle S. Emergency contraception: A multispecialty survey of clinician knowledge and practices. Contraception 93(2):145-15, 2016.
  2. Envall N, Kofoed NG, Kopp-Kallner H. Use of effective contraception 6 months after emergency contraception with a copper intrauterine device or ulipristal acetate - a prospective observational cohort study. Acta Obstetricia et Gynecologica Scandinavica 95(8):887-893, 2016.
  3. Kohn JE, Nucatola DL. EC4U: results from a pilot project integrating the copper IUC into emergency contraceptive care. Contraception 94(1):48-51, 2016.
  4. Sanders JN, Howell L, Saltzman HM, Schwarz EB, Thompson I, Turok DK. Unprotected intercourse in the two weeks prior to requesting emergency intrauterine contraception. American Journal of Obstetrics and Gynecology, (in press), 2016.
  5. Schubert FD, Bishop ES, Gold M. Access to the copper IUD as post-coital contraception: results from a mystery caller study. Contraception (in press), 2016.
  6. Trussell J, Raymond EG, Cleland K. Emergency contraception: A last chance to prevent unintended pregnancy. Contemporary Readings in Law and Social Justice 62(2):7-38, 2016.
  7. Baird AS, Trussell J, Webb A. Use of ulipristal acetate and levonorgestrel for emergency contraception: a follow-up study. Journal of Family Planning and Reproductive Health Care, 41:116-121, 2015.
  8. Raymond EG, Cleland K. Clinical practice: Emergency contraception. New England Journal of Medicine 372(12):1342-1348, 2015.
  9. Schwarz EB, Papic M, Parisi SM, Baldauf E, Rapkin R, Updike G. Routine counseling about intrauterine contraception for women seeking emergency contraception. Contraception 90(1):66-71, 2014.
  10. Turok DK, Jacobson JC, Dermish AI, et al. Emergency contraception with a copper IUD or oral levonorgestrel: an observational study of 1-year pregnancy rates. Contraception 89(3):222-8, 2014.
  11. Turok DK, Godfrey EM, Wojdyla D, Dermish A, Torres L, Wu SC. Copper T380 intrauterine device for EC: highly effective at any time in the menstrual cycle. Human Reproduction 28(10):2672-6, 2013.
  12. Belden P, Harper CC, Speidel JJ. The copper IUD for emergency contraception, a neglected option. Contraception 85:338-339, 2012.