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Emergency Contraception

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Updated March 06, 2014

Written or reviewed by a board-certified physician. See About.com's Medical Review Board.

Emergency Contraception

Emergency Contraception

Photo © 2014 Dawn Stacey
Emergency Contraception

Emergency Contraception

Photo © 2014 Dawn Stacey

What is Emergency Contraception?

Emergency contraception (EC) is a birth control option that women can use to reduce the risk of pregnancy after unprotected sex or contraceptive failure. Emergency contraception has been available for more than 30 years and is a safe and effective method of birth control.

Emergency Contraception is Also Known As:

  • EC
  • Plan B One-Step
  • Morning-After Pill
  • Ella
  • My Way
  • Plan B
  • Next Choice
  • Postcoital Contraception

Available Forms of Emergency Contraception

Emergency contraception is offered in the following ways ways:

How Emergency Contraception Works:

Emergency contraception typically contains the same hormone (a progestin) that is found in some birth control pills. The exact mechanism of action, though, is not clear. However, emergency contraception MAY help to reduce the risk of pregnancy by stopping ovulation or by preventing the sperm from joining the egg. Research now shows that hormonal emergency contraception does not prevent a fertilized egg from implanting into the uterine wall. The way emergency birth control works likely depends on where you are in your menstrual cycle.

Who Should Obtain Emergency Contraception?

Typically, you should obtain emergency contraception if there is a chance that pregnancy could occur due to contraception failure or unprotected sex.

Generally speaking, most women who need emergency contraception can safely use it; this even applies to women who are not good candidates to use birth control pills as their main form of contraception. Emergency contraception can also be used safely by adolescents.

You may want to use emergency contraception if:

When Should Emergency Contraception Be Started?

In order to reduce the risk of pregnancy, emergency contraception should be started up to 5 days (120 hours) after unprotected sex. The sooner it is used, the better the chances of preventing pregnancy.

With Plan B One-Step (and its generic versions, Next Choice One Dose and My Way), you only need to swallow ONE pill (Next Choice has TWO pills). You should use the morning-after pill as soon as possible. The manufacturer Plan B One-Step suggests that it should be used within 72 hours of contraceptive failure or unprotected sex -- but the sooner you take it, the more effective it will most likely be. That being said, the morning-after pill may still be useful to take (hopefully to decrease your chances of pregnancy) for up to 5 days after unprotected sex.

Misconceptions About Emergency Contraception:

Emergency contraception is not the same thing as an abortion. Plan B One-Step is often confused with the abortion pill (RU486). These two medications serve very different purposes and do not work in the same way.

Emergency contraception cannot end a pregnancy and does not affect an existing pregnancy. Scientific and medical authorities are in agreement that emergency contraception reduces the risk of pregnancy and helps prevent the need for abortion.

How to Obtain Emergency Contraception:

Due to the court case Tummino v. Hamburg, Plan B One-Step can now be purchased over-the-counter by people of any age.

Next Choice One Dose and My Way are also available with no point of sale or age requirements, meaning they can be purchased OTC to people of any age. In order to protect the three year exclusivity granted to Plan B One-Step, the FDA has required that the labeling of these generic versions to state they are intended for use in women 17 years of age or older. Keep in mind, though, that one-pill levonorgestrel emergency contraception has been shown to be safe for all ages of women.

Even though Plan B One-Step, Next Choice One Dose and My Way are all available over-the-counter, you may still need a prescription (regardless of your age) in order for your insurance to cover the cost of these medications, so be sure to check your health policy's rules.

Next Choice (the two-pill Plan B generic) is available at pharmacies without a prescription for men and women age 17 or older. You will need to present a valid ID. If you are under 17, a prescription is needed to purchase Next Choice.

Other forms of emergency contraception can only be obtained with a prescription (like Ella), so these require a doctor's appointment.

Because levonorgestrel-based emergency contraception is more effective the sooner you use it, try to save time by calling your pharmacy/drug store ahead of time to make sure that they these emergency contraceptives in stock.

 

Effectiveness:

In general, emergency contraception is meant to be a backup birth control method. It is not as effective as the correct and consistent use of other reversible prescription birth control methods. Additionally, emergency contraception does not continue to prevent pregnancy during the rest of your reproductive cycle, so other birth control methods should be used.

Two main factors influence the effectiveness of emergency contraception:

  • The amount of time that has gone by since the incident of unprotected sex/birth control failure.
  • The point in your cycle when you had sex.

Therefore, the sooner emergency contraception is used after unprotected sex, the more effective it will be. Also, the closer you are to ovulation (when having unprotected sex), decreases the effectiveness of emergency contraception. 

All methods of emergency contraception reduce the risk of pregnancy by 75-99% when they are initiated within 72 hours.

Emergency Contraception Costs:

The cost for emergency contraception varies widely and depends upon the method. Total fees can range from about $35-$65 (Plan B One-Step), anywhere up to around $400 (to obtain ParaGard IUD). Next Choice, Next Choice One Dose, and My Way are typically priced around 10-20% lower than the branded Plan B One-Step.
 

Side Effects:

These, too, vary depending on the type of emergency contraception used. You should discuss any major side effects with your doctor as well as if you are experiencing any signs of pregnancy after using emergency contraception. Some of the most common pregnancy signs include:
  • Missed menstrual period
  • Sore or enlarged breasts
  • Nausea
  • Frequent urination
  • Unexplained fatigue
  • Headaches

STD Protection:

No emergency contraception method offers protection from STDs. Women who need emergency contraception may be at more risk for these infections. Women at the most risk are those who:
  • Have had unprotected sex with infected partners
  • Are victims of sexual assault
  • Who use IV drugs or have a partner who does

The morning-after pill may be a safer choice for those women at increased risk for STDs instead of an IUD. This is because bacteria from a preexisting infection can be introduced into the uterus during IUD insertion. If this is left untreated, it can lead to pelvic inflammatory disease.

Sources:

Noé G, Croxatto HB, Salvatierra AM, Reyes R. "Contraceptive efficacy of emergency contraception with levonorgestrel given before or after ovulation." Contraception 2011;84(5:486-492. Accessed via private subscription.

Prine L. "Emergency contraception: Myths and facts." Obstet Gynecol Clin N Am 2007 March;34:127–136. Accessed via private subscription.

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