Improving access to highly effective emergency contraception: an assessment of barriers and facilitators to integrating the levonorgestrel IUD as emergency contraception using two applications of the Consolidated Framework for Implementation Research

Table 1 Overview of available methods of emergency contraception

Method	Rules for use	Mechanism of action	Efficacy	Availability	Accessibility
Copper IUD	Placement within 120 h after unprotected intercourse (UPI)	Disruption of sperm and ovum function; possible interference with implantation	<0.01 pregnancies per single use cycle 0.06 pregnancies for 10 years after insertion	In-clinic insertion via healthcare provider	Free under the Affordable Care Act; >$1000 if paying out-of-pocket
Levonorgestrel IUD	Placement within 120 h after UPI	Interferes with sperm transport, capacitation	<0.03 pregnancies per single use cycle 0.07 pregnancies for 5 years^b after insertion	In-clinic insertion via healthcare provider	Free under the Affordable Care Act; Between $100->1000^a, if paying out-of-pocket
Oral levonorgestrel	Take as soon as possible within 120 h after UPI (^amost effective within 72 h)	Delays ovulation	1.7–2.6 pregnancies per single-use cycle	Over-the-counter	$5–$75 per pill
Ulipristal acetate	Take within 120 h after UPI	Delays ovulation	1.2–1.8 pregnancies per single-use cycle	Prescription-only	Free under the Affordable Care Act; Between $35–75, if paying out-of-pocket

IUD intrauterine device, UPI unprotected intercourse
^aCost is variable and dependent on both the IUD type and clinic participation in other programs, such as 340b pricing
^b Duration of use is dependent on the type of LNG IUD used; 52 mg IUDs can last up to 7 years after insertion

ISSN: 2662-2211