Sexual and reproductive health is a fundamental human right. Scientific advances provide couples with an increasingly wide range of effective and safe contraceptive methods. Emergency contraception (EC) contributes to women’s right to reproductive health, and it offers a last chance to prevent pregnancy after unprotected intercourse.

Since 2015 EC pills are more equally available and accessible than ever before in Europe: in all European Union countries, except for Malta and Hungary, both levonorgestrel (LNG) and ulipristal acetate (UPA) EC pills are authorised to be sold directly in pharmacies without prescription. In the rest of Europe EC options are also expanding, with UPA becoming progressively more available. Today women in Europe have more post-coital contraceptive options than ever before, and they need to be informed so they can exercise choice.

This template guide is based on evidence based guidelines developed by the World Health Organization (WHO), the International Consortium for Emergency Contraception (ICEC) and the International Federation of Gynecology & Obstetrics (FIGO), and the Clinical Effectiveness Unit (CEU) of the Faculty of Sexual & Reproductive Healthcare. The document is intended to facilitate the process of developing or updating national or institutional EC guidelines according to the best evidence available up to February 2016. It can also be used by pharmaceutical associations, given their important role in assisting women who will procure EC directly in a pharmacy without a clinician’s counselling.

With this tool, the European Consortium for Emergency Contraception (ECEC) promotes the harmonization of EC provision across Europe. The guide addresses key issues that should be included in clinical guidelines for health professionals providing EC. It covers LNG and UPA EC pills and the use of the copper intrauterine device (Cu-IUD) for EC. The document presents the questions that a provider should ask, and the action that should be taken, when a woman requests EC. It assumes that at least one method of EC is available but provides recommendations based on current evidence to support a decision on which method to use, should more than one be available.

The first edition of this guide was originally developed by ECEC in December 2013, with financial and scientific support from the European Society of Contraception and Reproductive Health (ESCRH). It was written by Anne Webb, with contributions from ECEC Board members (Emilio Arisi, Teresa Bombas, Christina Fiala, Medard Lech, and Ardian Paravani); ECEC Advisory Committee members (Sharon Cameron, Kristina Gemzell, Anna Glasier and Caroline Moreau); CEU members, Julie Craik and Louise Melvin; and ECEC coordinator, Cristina Puig. Anne Webb, the ECEC Board and Advisory Committee, as well as the ESCRH Internal Scientific Committee, kindly collaborated in the review of this 2nd edition. This includes updates on issues in which recent research points to new recommendations. In particular, on repeated use of UPA and interactions between UPA and progestogen-based contraceptives.