Commentary Contraception

The Copper IUD: A Better Plan B

Peter Belden

The copper IUD, known as Paragard in the US, is an overlooked option which offers a number of benefits over EC pills.

The increase in the use of emergency contraceptive (EC) pills highlighted in Ellen Chesler and Andrea Flynn’s post, Emergency Contraception Use Spreads, but Many Women Are Still Left Out, is great news indeed. However, the little known secret is that there is an alternative form of emergency contraception that is ten times better than EC pills, and yet medical providers rarely tell women about this more effective option. 

The copper IUD, known as Paragard in the US, is an overlooked option which offers a number of benefits over EC pills. A systematic review of over 40 studies found an overall failure rate of less than 1 in 1,000 (0.09 percent) for the copper IUD when used as EC, compared to failure rates over ten times higher, 1.4 percent for UPA and 2 percent for oral LNG, two common types of EC pills.  

When women seek medical care they expect and believe that their medical provider is telling them about the most effective treatment for their condition as well as the reasonable alternatives.  For women who have recently had unprotected sex this means telling women that the copper IUD is the most effective option, and that EC pills offer a reasonable alternative. 

A recent study documented that when women were offered the choice of a copper IUD as EC, a significant proportion, 40 percent, chose the copper IUD over EC pills. The Hewlett Foundation has supported a pilot project to help document the practical steps other health centers can take to effectively offer this option. 

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As members of a movement that stresses the importance of reproductive choice and patient autonomy we can celebrate the increased access to emergency contraceptive pills. However, it is essential that we also speak out and insist that our health centers, which still see large numbers of women seeking EC, inform women about the copper IUD as EC. When talking to their medical provider, women have a right to this information so that they can make an informed choice. 

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