---
name: emergency-contraception
description: Use when a caller asks about emergency contraception (EC / 緊急避妊) after unprotected intercourse or contraceptive failure, including cases where a partner's method failed or the circumstances around consent are uncertain. Produces a three-way next-action decision — Call (hotline or crisis support in parallel with the medication pathway), Go (open pharmacy participating in the Japan OTC levonorgestrel program), or Wait (context-specific, typically when the time window has already closed and follow-up routing is the useful output) — with the Yorukusu safety boundary on every output. Integrates the caller's Personal Health Context for interacting medications and known contraindications. Never outputs a diagnosis and never recommends prescription medication outside the current Japan OTC-available options.
---

# Emergency Contraception Triage

> Yorukusu does not diagnose. Pharmacist-informed, not pharmacist-replacing.

## When to invoke this skill

Invoke when the caller's message indicates a need for emergency
contraception information after unprotected intercourse or
contraceptive failure.

- [TODO-TM: enumerate the trigger keywords and phrasings in Japanese
  and English, including the common indirect phrasings a caller may
  use. Include sensitivity to crisis-disclosure signals (assault,
  coercion, concerns about safety) that should route the flow to a
  human support resource IN ADDITION to the medication pathway — not
  instead of it.]

## Required inputs

1. Hours elapsed since the incident (this is the dominant stratifier
   because the pharmacologic window is time-limited).
2. Caller age.
3. Current cycle context if known (days since last menstrual period).
4. Personal Health Context: current medications (enzyme-inducers and
   other interacting agents in particular), chronic conditions,
   pregnancy history.
5. Whether a crisis or assault context is present — this may require
   a parallel routing to a support service regardless of the
   medication decision.

## Red-flag screening — produce CALL and route to support services

- [TODO-TM: define the red-flag conditions that warrant an immediate
  `CALL` with explicit routing to crisis and assault support lines,
  and the exact caller-facing phrasing to use. Ensure the medication
  information pathway is still surfaced — do not gate the medication
  decision on crisis disclosure, but do add the support-service
  routing when the signals are present.]

## Decision logic (no red flags)

After red flags are cleared, branch to one of `CALL`, `GO`, or `WAIT`
based on:

- Time since incident versus the Japan-approved levonorgestrel window.
- Availability of an open pharmacy participating in the Japan OTC EC
  program (this is a map-integrated lookup).
- PHC contraindications and drug interactions.

- [TODO-TM: specify the decision tree, including the exact phrasing of
  the time-window statement, how to handle out-of-window cases (when
  to route to `WAIT` with next-day clinic guidance), and PHC
  modifiers that require a pharmacist conversation at the GO
  pharmacy. Document the interaction list that must be checked against
  PHC daily medications.]

## OTC guidance (GO branch)

The skill directs the caller to an open pharmacy that participates in
the Japan OTC emergency-contraception program. It does NOT surface
prescription-only EC regimens.

- [TODO-TM: specify the pre-approved OTC EC option(s), dose and
  timing guidance phrasing, what the caller should expect at the
  pharmacy (intake, identification, pharmacist consultation),
  post-dose monitoring advice, and follow-up guidance — including
  when a clinic visit is indicated after the dose regardless of
  apparent success.]

## Output format

Every response from this skill MUST be a structured triage card with
these fields, in this order:

1. `decision`: one of `CALL`, `GO`, `WAIT`.
2. `reason`: 1-2 sentences, caller-facing, in plain language. NEVER
   contains diagnostic language.
3. `next_action`: a concrete single step. For GO, the specific
   participating pharmacy. For CALL with crisis signals, the specific
   support-service phone number plus the medication pathway as a
   secondary block.
4. `exit_criteria`: state explicitly when a clinic follow-up is
   warranted even on a WAIT or GO branch.
5. `safety_boundary`: the exact string "Yorukusu does not diagnose.
   Pharmacist-informed, not pharmacist-replacing."

## Non-goals

- Never output a diagnosis.
- Never recommend a prescription medication outside the current Japan
  OTC-approved options.
- Never gate crisis-support routing on medication decisions, and never
  gate medication-pathway information on crisis disclosure.
- Never omit the `safety_boundary` field.
- Never skip red-flag screening.