A 24-Year-Old Female Consults You for Advice

A 24-year-old female consults you for advice. She had intercourse 4 days ago and experienced condom breakage. She fears she may have conceived and would terminate a pregnancy if this occurs. Her menstrual cycle ended 3 days before the incident; she has regular cycles of 28-day intervals that last 4 days. She would also like a more reliable birth control method and would accept any method. After testing for sexually transmitted infections, you review the options for postcoital contraception. What would be the most appropriate action?

A) Wait for menses, and begin contraception of her choice. If menses delayed, return for urine pregnancy test.
B) Immediate insertion of copper IUD
C) Prescribe ulipristal to begin today
D) Prescribe levonorgestrel containing emergency contraceptive pill (ECP) to begin today