Future Contraception either before or after onset of period: Ongoing contraception: -- Ongoing Contraception:

Choice is theirs!! After proper counseling the couple should be asked to initiate contraceptive immediately on the following day or else they can delay the initiation of regular contraceptive after next period has commenced and they are anxiety free. If a new contraceptive is initiated on the day after ingestion of emergency tablet then such methodology is termed as Quick Start Method.

            By and large, two options are offered to the woman concerned. A) Quick Start Method: Many experts recommended the first as preferable because the method is initiated sooner which may reduce subsequent pregnancy risk. Oral contraceptives, hormonal contraceptive injection, patch, or vaginal ring may be started on the following day the client may begin using the method the day after taking the ECPs. If she is newly starting that particular method: - She should begin with a new pill pack, patch or ring. But if she was previously using the method (e.g. lodgment of the patch or ring):- she may resume using the pill pack, patch. Or ring that she was previously using. In this case, she should be reminded that the patch or ring will not be effective past the original date on which it was scheduled to be removed. All clients starting hormonal methods immediately after using ECPs should use a barrier method if they have intercourse in the next seven days after starting or restarting the method. Clients may have some irregular bleeding until the onset of menses.

1.      Quick-Start of another regular contraceptive is of utmost importance. Future contraception should be discussed and offered along with emergency Pills. Failure to do so will invite the coupe in a similar situation by couple of month depending on the sexual habit of the couple or the female partner. Firstly, the couple should be advised either to refrain from sexual act in that cycles after consumption of EC Pills or should use barrier methods for the rest of the cycle.

Between two methods in timing of initiation of contraceptives :- better advice , according to author will be Quick Start Method which means the female partner should be advised to take either combined oral contraceptive 1 tablet to be taken daily, preferably at bedtime × 21 days / 28 days depending on the pill pack choiced. Or else she can start taking progesterone only pill (Cerazette/Zerogen / Intimacy   ) on daily basis. But pregnancy test has to be done after 7 days have elapsed after the expected day of period. Because occasionally emergency Pill may fail. In that cases if urine test is +ve then she may opt for termination of pregnancy by medical methods along with acceptance of permanent method (Tubectomy). But as quick start method Injectables (Depo- as quick-start method as such agents can rarely induce Teratogenecity if pregnancy is not prevented by the emergency pill.

Contd-From Prof Dr. Srimanta Kumar Pal.