What is emergency contraception?

Emergency contraception (EC) is a backup method of birth control that a person with internal female organs  can use to prevent pregnancy after unprotected vaginal-penile sex. Even though you may have heard EC called the “morning-after pill”, there are different types of pills and an intrauterine device that can actually be used within 5 days (120 hours) of unprotected intercourse for emergency contraception. EC works better the sooner a it is taken after unprotected sex.

Names of EC you should be familiar with:

• Levonorgestrel (1.5mg pills) Plan B One-Step™, Next Choice One Dose®, My Way®, AfterPill™
  • These are available over-the-counter without a prescription. Your health care provider can also give you a prescription, and this may reduce the cost.
  • The directions say to use it within 3 days (72 hours) although it has some effect in preventing pregnancy to 5 days after unprotected intercourse.
  • EC is most effective the earlier it is taken. This method is less effective on day 5 than day 1.
• Ulipristal acetate (30mg) includes Ella™ (urlipristal acetate or UPA)
  • This is one pill (one dose) that can be taken up to 5 days (120 hours) after unprotected intercourse.
  • A prescription is often needed for this pill, but in some states/countries a pharmacist can dispense Ella™ without a prescription.
  • Some health care providers may recommend a pregnancy test before a person uses Ella™
  • Ella™ can also be purchased online after a telephone consultation; however, it is likely to be more expensive and you may need to factor in overnight shipping. Please be aware that online pharmacies cannot mail Ella™ to certain states including: Arkansas, Missouri, North Carolina, and Oregon.
• Copper Intrauterine Device: Copper T IUD ParaGard®
  • This is the most effective type of emergency contraception.
  • This is a copper intrauterine device (IUD) that can be inserted into the uterus within 5 days of unprotected intercourse for emergency contraception. You would need to see a health care provider for placement of the IUD.
  • This is the only emergency contraception that can also work as regular birth control. and then provides contraception for up to 10 years.

When should a person with internal female organs use emergency contraception?

Emergency contraception should be used if there was unprotected vaginal-penile sex and a pregnancy is not desired. Unprotected vaginal-penile sex includes:

• A condom and birth control were not used
• The condom broke or slipped off during sex
• A mistake was made with birth control use (i.e. forgot to take birth control pills, patch, or vaginal ring or late for injectable birth control)
  • Note: If levonorgestrel pills were used as EC, then other birth control methods can be restarted right away. If ulipristal acetate was used as EC, you should wait 5 days before restarting other birth control methods and should use condoms during that time.
• If you were forced to have sex (rape).

How does emergency contraception work?

The medication in EC pills works by giving a strong short burst of hormones that change a menstrual cycle and prevent ovulation. Ovulation is the time in a  menstrual cycle that an individual is most likely to become pregnant. It’s important to remember that EC pills do not continue to protect against pregnancy during the rest of the menstrual cycle.

The copper IUD works by preventing fertilization and if left in the uterus, it will continue to protect against pregnancy for 10 years or until removed by a health care provider.

It’s important to remember that EC doesn’t continue to protect against pregnancy during the rest of a person’s menstrual cycle. After using EC, it’s important to use a backup method of birth control (condoms) for at least 7 days or to not have sex for at least 7 days.

Does EC cause an abortion?

No. EC will NOT cause an abortion. EC doesn’t work if an individual is already pregnant. EC will NOT cause an abortion.

How well does EC work?

It’s important to remember that EC doesn’t always work. It doesn’t guarantee that pregnancy will be prevented. The risk of pregnancy following use of EC depends on the type of EC used and when in the menstrual cycle you had sex.

• Levonorgestrel pill (Plan B) lowers your risk of pregnancy by 75-89% if taken within 3 days after unprotected sex.
• Ulipristal acetate lowers your risk of pregnancy by 85% if taken within 5 days after unprotected sex.
• The copper IUD lowers your risk of pregnancy by 99.9% if inserted into the uterus within 5 days after unprotected sex.

If a person does NOT get their menstrual period within 3 weeks after taking EC, they should take a pregnancy test.

The best way to prevent pregnancy is to use a long acting birth control method, such as an IUD or implantable rod, or another birth control method such as the Depo-Provera shot, birth control pills, ring, or patch, or to not have sexual intercourse (abstinence).

Is EC safe?

Yes. Millions of people have used emergency contraception successfully. Even people who can’t use hormonal birth control because of a medical problem (such as migraines, heart disease, liver disease, and breastfeeding) can take EC.

Are there any side-effects with taking Emergency Contraception (EC)?

EC is usually well tolerated. If a person has side effects, they are usually mild. The most common side effects of EC include nausea and irregular menstrual bleeding. Other less common side effects may include: vomiting, breast tenderness, fatigue, dizziness, headache, and menstrual cramps, but these side effects most often go away after 1-2 days.

If an individual  throws up within 3 hours after taking any oral EC, they should call their health care provider (HCP) as they will likely need to take another dose along with another medicine to prevent vomiting.

How can I (or my partner) get emergency contraception?

In the United States, anyone (regardless of age or gender) can get Plan B One-Step™ and other brands of levonorgestrel pills at most pharmacies without a prescription. Ulipristal acetate (Ella™) usually requires a prescription from a health care provider. You may need to check many different pharmacies, because EC is not available in all pharmacies.

For a copper IUD, an individual with internal female organs will need to be seen at a medical clinic, such as their primary care provider or gynecologist’s office, or Planned Parenthood, to have the IUD placed in their uterus.

Use the EC website to:

• Find a health care provider
• Find a pharmacy that has EC available
• If you or your partner has any questions about emergency contraception.

Is it OK to use EC as a regular form of birth control?

Emergency contraception is not meant to be a regular method of birth control. It is meant to be a one-time emergency treatment. Emergency contraception can be used when a condom breaks, when a diaphragm or cervical cap gets moved, or any time when there is unprotected vaginal-penile sex.

Emergency contraception pills do not work as well as other types of birth control. This means the risk of pregnancy is higher with emergency contraception pills than with other types of birth control. That’s why it’s recommended to use other types of birth control regularly to prevent a pregnancy. For more information on birth control options.

The copper IUD can be used as BOTH emergency contraception and then as regular birth control. It’s 99.9% effective. Also, you should always use a barrier method (condom) because EC will not protect against sexually transmitted infections.

Key Points to Remember about Emergency Contraception (EC):

• Emergency contraception is a safe treatment to help prevent pregnancy in people who have had unprotected vaginal-penile sex.
• EC is available as a pill or as an copper IUD.
• Some EC pills can be purchased over the counter without a prescription. You can ask your health care provider for a prescription.
• A copper IUD needs to be inserted in a medical clinic by a health care provider.
• EC will NOT cause an abortion. Plan B One-Step® does not work after ovulation.
• EC does NOT prevent sexually transmitted infections (STIs) or HIV.
• EC does not guarantee that pregnancy is prevented. The best way to prevent pregnancy is to use a regular birth control method, such as birth control pills, long acting reversible contraception (IUD’s, injection, implants), condoms, or to abstain or not have vaginal sexual intercourse.
• Your partner should have a pregnancy test if she does NOT get her period within 3 weeks after taking EC.