Emergency contraception — CCFP MCQ
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Correct answer: D — Offer a copper intrauterine device and discuss ongoing contraception
Explanation lettering: B = shown as A · E = shown as B · D = shown as C · C = shown as D · A = shown as E
The correct answer is C. The copper intrauterine device is identified in the Canadian Contraception Consensus as the most effective emergency contraceptive method and is effective when inserted within 7 days of intercourse. This patient is at 36 hours—well within that window. Additionally, she explicitly wants ongoing contraception, and the copper IUD provides dual benefit: emergency contraception with >99% efficacy and 10+ years of continuous protection. Levonorgestrel (A) is less effective (~60–94%) and does not provide ongoing contraception. Delaying until pregnancy test positivity (B) is contraindicated: it misses the window for emergency contraception and is not evidence-based. Combined oral contraceptive pills (D) were used historically (Yuzpe regimen) but are no longer first-line in Canada since levonorgestrel became available. Statement E is false: emergency contraception is effective up to 5 days for hormonal methods and 7 days for IUD.
Reference: Society of Obstetricians and Gynaecologists of Canada. Canadian Contraception Consensus (Part 1 of 4). Journal of Obstetrics and Gynaecology Canada, 2015. Available at https://pubmed.ncbi.nlm.nih.gov/26606712/