Emergency Contraception A Critical Tool for Reproductive Autonomy

Emergency contraception is a critical tool in ob-gyn health care, offering a safe and effective way to prevent pregnancy after unprotected sex or contraceptive failure. This game changer can reduce pregnancy risk significantly, depending on the method used and how quickly it’s taken. In fact, studies show the copper IUD can decrease pregnancy rates to 0 to 2%.

How was emergency contraception developed?

The path to emergency contraception spans more than half a century of research and medical innovation. In the 1960s, clinicians started using high-dose estrogen regimens to prevent pregnancy after sexual assault. Their success led to additional research in the 1970s, when Canadian physician A. Albert Yuzpe introduced a combined estrogen–progestin method that became a standard approach for decades.

The 1990s marked a major turning point. Scientists identified levonorgestrel as an effective stand alone option with fewer side effects, and international clinical trials confirmed its safety and efficacy. In 1999, the FDA approved the first dedicated levonorgestrel emergency contraception pill for use in the United States.

Since then, copper IUDs have emerged as the most effective form of emergency contraception, with a failure rate of less than 1%. Over time, guidelines from professional organizations—including ACOG—have helped integrate copper IUDs as a first-line emergency contraception option for individuals seeking immediate pregnancy prevention and long-term contraception.

Why does emergency contraception matter?

Unintended pregnancy is a significant public health challenge: In the United States, about 41% of all pregnancies are unintended. Routine contraception isn’t always available or accessible to everyone who needs it, with barriers such as cost, stigma, inconsistent use, or contraceptive failure affecting people across age groups and communities. Some people, including adolescents, those with limited access to primary care, and survivors of sexual assault, may use emergency contraception as a critical component of their health and well-being.

What impact does this game changer have—and how can it shape the future of ob-gyn health?
Hear from Eve Espey, MD, MPH, FACOG, about how emergency contraception has given her patients the power to decide and have control over their health—two foundational elements of reproductive health.

Dr. Espey has been a practicing ob-gyn for the past 35 years and is a distinguished professor at the University of New Mexico.

As we mark ACOG's 75th year, our Game Changers series will highlight breakthroughs that have reshaped ob-gyn care and explore what they mean for the future of health. Stay tuned—a new game changer will be featured each month!