Only a few years ago, emergency contraception (EC) was virtually unknown in most countries of the world. The development of improved methods has contributed to the increase in interest and EC is now becoming an important part of family planning services. The speed with which emergency contraceptives have been approved by national authorities demonstrates that there was, indeed, a need for back-up methods; in less than three years emergency contraceptives have been registered in over 40 countries.

EC clearly fills the gap as the only contraceptive method that offers a ‘second chance’ in the prevention of unwanted pregnancy when unprotected intercourse has already taken place. EC is very valuable for women in need and thus should be easily available. Whether the introduction of emergency contraception can have an influence on abortion rates in a country will, however, depend on a number of factors. In our enthusiasm about the potential of EC, we should not forget that, in the prevention of unwanted pregnancy, it is the use of regular family planning methods that plays the key role as the most effective means. The role of EC is much more modest; it will contribute to that aim if it is used as a back-up, not as a primary method. If EC starts replacing more effective contraceptives, the situation may switch from bad to worse.

This means that the way emergency contraceptives are introduced into family planning services is crucial. The providers also face a challenge as to how best to bring the correct information to users. Because emergency contraceptives are not as effective as regular methods and as they do not protect from STIs like barrier methods, ECs are best used for emergency only. In addition, repeated use of EC causes cycle disturbance and exposes the woman to a higher amount of hormones than the regular use of oral contraceptives. The few studies carried out on the use of EC when it was easily available suggest that women do not misuse EC provided they have received correct information.

It seems to be worthwhile planning carefully for the introduction of these new methods into family planning services, and, perhaps, proceed, step by step, to see the reaction, rather than make mistakes which are difficult or impossible to correct afterwards. At best, the introduction of EC will increase the use of regular contraception among those who have not used any FP method. When this is the case, we can also expect to see a decrease in abortion rates.

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