If, while breastfeeding after childbirth, emergency contraception becomes necessary due to an unexpected situation, the first worry that comes to mind is “won’t the drug’s ingredient pass to the baby?” In the clinic, it is not uncommon to see people who, because of this worry, hesitate over taking the drug at all, let time slip by, and end up coming at a point when the effect has declined. To get straight to the point, emergency contraception is possible even while breastfeeding. It’s just that, depending on which ingredient is used, the degree of briefly postponing breastfeeding or the choice to switch the drug differs. Following the previous article, this time I’ll calmly organize the relationship between breastfeeding and emergency contraception.
Emergency contraception during breastfeeding: what can be used
The emergency contraception methods you can choose during breastfeeding are broadly two. One is the oral emergency contraceptive pill, and the other is the copper intrauterine device. The copper intrauterine device can provide both the emergency contraception effect and long-term contraception for several years afterward, so it is counted as a good method if you are also considering additional contraception. However, because of the burden of the process of placing the device in the uterus, clinically more people prefer the oral emergency contraceptive pill, which can be taken simply.
Oral emergency contraceptive pills are further divided by ingredient into the levonorgestrel class and the ulipristal acetate class. The two drugs differ in both the duration over which the effect is maintained and their compatibility with breastfeeding. If you group “emergency contraceptive pill” into one without knowing this difference, confusion easily arises in the choice during breastfeeding. If you’re curious about a wider range of contraceptive methods overall, it’s good to also refer to the item what types of contraceptive methods are there.
Emergency contraception during breastfeeding is not a contraindication
For breastfeeding women, emergency contraceptive pills are, in principle, not a contraindication. The U.S. Centers for Disease Control and Prevention’s Medical Eligibility Criteria for Contraceptive Use (2024) classifies all emergency contraception methods—including levonorgestrel, ulipristal acetate, and the copper intrauterine device—as category 1 for breastfeeding women. Category 1 means there is no reason to place restrictions on the use of that method.
The same criteria explain that even if levonorgestrel passes into breast milk, the amount is very small, and breastfeeding-related outcomes are not clearly different between breastfeeding women exposed to the drug and those not exposed. That is, the thought that “because I’m breastfeeding, I can’t do emergency contraception at all” is far from the fact. The key lies not in “whether you can” but in “which ingredient, and how you use it.”
Emergency contraception during breastfeeding is not a question of whether it’s possible but a question of ingredient choice and timing. Hesitating and letting time pass is rather a loss.
Levonorgestrel and breastfeeding timing
The levonorgestrel class is reported to be a relatively easy-to-handle ingredient in emergency contraception during breastfeeding. Because the amount passing into breast milk is small, the American College of Obstetricians and Gynecologists has advised a method of briefly postponing breastfeeding for a certain time after taking it, to minimize the infant’s drug exposure. Academic-society materials (2015, 2017) introduce a method of spacing the breastfeeding interval within a range of at least 8 hours, but no longer than 24 hours, after taking it.
The practical method I recommend in the clinic is to first breastfeed or pump right before taking the drug. Doing so avoids the period when the drug concentration is highest, and an interval naturally arises until the next feeding. If breast milk uncomfortably builds up during the postponed interval, empty it by pumping, but it is safer not to feed the pumped milk and to discard it. Even this much preparation sorts out a considerable part of the vague anxiety.
Why is ulipristal handled differently
Ulipristal acetate has clear advantages in terms of effect. The American College of Obstetricians and Gynecologists explains that ulipristal shows better contraceptive effect than levonorgestrel up to 5 days after intercourse and across a variety of body weights. By effect alone, it is an attractive choice.
However, in the breastfeeding situation, the story changes a little. This is because ulipristal and its active metabolite are detected in small amounts in breast milk, and safety data for breastfed infants is not sufficient. So several academic societies do not recommend ulipristal as the first choice when breastfeeding, and propose the direction of replacing it with the levonorgestrel class if possible. If ulipristal is used, the period of postponing breastfeeding becomes longer than with levonorgestrel. However, recent material from the UK Faculty of Sexual and Reproductive Healthcare (2025) also presents the view that, with a single dose, on pharmacokinetic grounds it is not necessary to stop breastfeeding, so it is best to decide the final judgment individually through consultation with your attending physician.
The two ingredients, compared at a glance
Organizing how the two ingredients differ in emergency contraception during breastfeeding makes the choice much clearer.
| Category | Levonorgestrel | Ulipristal acetate |
|---|---|---|
| Eligibility category during breastfeeding | Category 1 (no restriction) | Category 1 (no restriction) |
| Priority during breastfeeding | Generally recommended first | Considered as second choice |
| Period of postponing breastfeeding | Generally 8–24 hours after taking | Tends to be recommended longer |
| Effect duration | The shorter the time after intercourse, the more advantageous | Effect reported up to 5 days |
As the table shows, neither drug is a contraindication under the eligibility criteria, but the “drug to consider first” during breastfeeding is often the levonorgestrel one. However, because the judgment can differ depending on the time elapsed after intercourse, body weight, and individual circumstances, please view this table not as an absolute standard but as a starting point for consultation.
If you want to quickly confirm which drug suits you during breastfeeding, you can lightly inquire even before a visit.
Emergency contraception during breastfeeding: consult by chatTiming of taking, effect, and limits
Emergency contraceptive pills are reported to be more effective the sooner they are taken. Generally, it is known that the shorter the time after intercourse, the higher the contraceptive success rate, and the longer the time, the more the possibility of failure gradually rises. That is, “as soon as possible” is the core principle of emergency contraception. Postponing taking it for a few days for the reason of breastfeeding can rather be a loss in terms of effect.
Another important point is the fact that emergency contraceptive pills are not 100%. In cases where fertilization has already occurred, it is difficult to prevent implantation, so even after emergency contraception the possibility of pregnancy does not completely disappear. There may be a change in the schedule after taking it, but it usually sorts out to being moved up or pushed back by a few days. If you want to weigh the timing choice more carefully, the item by when must emergency contraception be taken to be effective also helps.
After taking, what you must take care of
The most important thing to remember after taking an emergency contraceptive pill is observing menstrual change. Due to the effect of taking it, the expected date may be moved up or pushed back by around 3 days, but a delay of more than a week is not common. Therefore, if menstruation is delayed by more than a week, you must do a pregnancy test.
The items below are good to self-check when you’ve done emergency contraception during breastfeeding.
- Whether you finished breastfeeding or pumping right before taking the drug
- Whether you kept the breastfeeding interval suited to the ingredient, and discarded the pumped milk
- Whether menstruation is not delayed by more than a week
- If it is delayed, whether you did a pregnancy test
If you’re in a situation that repeatedly needs emergency contraception, it’s good to remember that emergency contraception is, after all, an “emergency” measure. Stably designing everyday contraception is the more fundamental solution. A contraception plan suited to your physical condition after childbirth and whether you are breastfeeding can be discussed together at the pregnancy·contraception clinic, and an understanding of contraception overall is organized broadly in the article how should I do contraception.
Emergency contraception during breastfeeding is not a question of “can it or can’t it,” but a question of how you match ingredient and timing. Rather than searching alone and feeling anxious, if you get a consultation once before and after taking the drug, we can find the safest and most effective choice together. When prescribing the drug, a consultation with your attending physician is essential.
If you’re hesitating about emergency contraception during breastfeeding, ask first by chat
Written by: Lee Dong-hee, Director · Obstetrics and Gynecology Specialist · View medical staff profile
First published December 15, 2023 · Last reviewed May 30, 2026
References: U.S. Centers for Disease Control and Prevention Medical Eligibility Criteria for Contraceptive Use (2024), American College of Obstetricians and Gynecologists Emergency Contraception clinical guideline (2015, 2017), UK Faculty of Sexual and Reproductive Healthcare ulipristal·breastfeeding statement (2025)
This article is intended to provide general health information and does not replace individual diagnosis or treatment. If you have symptoms, please consult through a medical visit.