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Nurses should discuss benefits of coil as emergency contraception

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Women should be advised on the most effective Women should be advised on the most effective contraception

Nurses should advise women requesting emergency contraception that a copper intrauterine device (‘coil’) is more effective than the pill, according to a new quality standard released by NICE.

In 2014/15 95% of emergency contraception issued by sexual and reproductive health services was for the pill. 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.

‘We want to empower women with the best information about all methods of contraception and their effectiveness so they can make an informed decision,’ said Professor Gillian Leng, deputy chief executive of NICE. ‘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. We also want to ensure women are told the coil is more effective than the pill as emergency contraception.’

The standard also recommends that women should also be told about the benefits of using long acting reversible contraception. The guidance notes that, coinciding with increased usage of LARCs, conceptions amongst under 18s is falling. In 2014 conceptions in women aged 15-17 was the lowest since records began in 1969, and between 2013 and 2014 the estimated number of under-18 conceptions fell by 6.8%4 to 22,653.

‘The advantage of the coil, on top of being more effective is that it can be retained and used as long term contraception, some can even be left in place for 10 years,’ said Dr Jan Wake, GP and member of the guideline development group. ‘Timing however is essential and women deciding on the coil should make contact with the clinic they have been advised to attend as soon as is possible.’

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The problem is that in a busy gp practice those clinicians that can insert iucds are already booked up for days and it is hard to fit an emergency iucd fit in !
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