What is emergency contraception?
Emergency contraception is contraception that can prevent pregnancy after unprotected sex. If you believe your birth control method may have failed or you didn’t use one and want to prevent pregnancy, emergency contraception can help you.
Types of emergency contraception
There are two forms of emergency contraception: pills containing hormones that prevent pregnancy, and the ParaGard intrauterine device (IUD).
Morning after/Plan B pill
|Plan B One-Step|
|levonorgestrel||over-the-counter at pharmacies; no prescription or ID required||75-89%||$25-$55|
|ella||ulipristal acetate||prescription needed||85%||$50-$60|
Sometimes called “the morning after pill,” there are two different types of pills you can use for emergency contraception (EC).
The first contains levonorgestrel. Brand names include Plan B One-Step, Take Action, and AfterPill. You can buy these over the counter at most pharmacies and drugstores without a prescription and without ID. Anyone of any age can purchase them. They can lower your chance of getting pregnant by 75 to 89 percent when used correctly. Their cost ranges from $25-$55.
The second hormonal pill is made by only one brand and is called ella. It contains ulipristal acetate. You do need a prescription to get ella. If you can’t see one of your established providers right away, you can visit a “minute clinic” and get a prescription from a nurse practitioner. Call your pharmacy to make sure they have ella in stock. You can also get ella quickly online here. This pill is considered the most effective type of morning after pill, with an 85 percent efficacy rate. It typically costs between $50 and $60.
|inserted device||must be inserted by a medical professional at your doctor’s office or clinic||up to 99.9%||up to $900 (many insurance plans currently cover most or all of the cost)|
Insertion of a ParaGard copper IUD can act as both emergency contraception and continued birth control for up to 12 years. Your gynecologist, a family planning clinic, or someone at Planned Parenthood can insert the IUD. It can cost up to $900, though many insurance plans currently cover most or all of the cost. When used correctly as emergency contraception, it can reduce the chance of pregnancy by up to 99.9 percent.
All of these methods prevent pregnancy. They do not terminate a pregnancy.
When should you take it?
You can use emergency contraceptives to prevent pregnancy after you’ve had unprotected sex, or if you think your birth control may have failed. Examples of these situations include:
- the condom broke, or you missed one or more of your birth control pill(s)
- you think your birth control may have failed due to other medications you were taking
- having unexpected unprotected sex
- sexual assault
Emergency contraceptives need to be used soon after sex to prevent pregnancy. The specific time frames in which they should be used to prevent pregnancy are:
|Emergency contraception||When you should take it|
|morning after/Plan B pill||within 3 days of unprotected sex|
|ella pill||within 5 days of unprotected sex|
|ParaGard IUD||must be inserted within 5 days of unprotected sex|
You should never take more than one round of emergency contraceptives at a time.
Emergency contraceptives are generally regarded as very safe for the general population, but they can have side effects.
Common minor side effects of both types of morning after pill include:
- bleeding or spotting between periods
- vomiting or diarrhea
- tender breasts
- feel lightheaded
If you vomit within two hours of taking the morning after pill, you’ll need to take another.
Many women feel cramping or pain during insertion of the IUD, and some pain the following day. Common minor side effects of the ParaGard IUD, which can last between three and six months, include:
- cramping and backaches several days after the IUD is put in
- spotting between periods
- heavier periods and intensified menstrual cramps
There are no known serious side effects or risks associated with taking either form of the morning after pill. Most symptoms subside within a day or two.
Many women use an IUD with either no or harmless side effects. In rare cases, however, there are risks and complications. These include:
- getting a bacterial infection during or soon after insertion, which requires treatment with antibiotics
- the IUD perforating the lining of the uterus, which requires surgical removal
- the IUD can slip out of the uterus, which will not protect against pregnancy and requires re-insertion
Women with IUDs who do get pregnant are at much higher risk for ectopic pregnancies. If you think you might be pregnant after having an IUD inserted, make an appointment to see your doctor right away. Ectopic pregnancies can become medical emergencies.
You should call your doctor right away if you have an IUD and:
- the length of your IUD string changes
- you have trouble breathing
- you get unexplained chills or fever
- pain or bleeding during sex after the first few days of insertion
- you think you could be pregnant
- you feel the bottom of the IUD coming through the cervix
- you experience severe abdominal cramping or significantly heavy bleeding
Next steps after emergency contraception
Continue to use birth control and protection
Once you’ve used emergency contraception, continue to use your regular birth control methods when having sex, to prevent pregnancy. The emergency contraception should not be used as regular birth control.
Take a pregnancy test
Take a pregnancy test about a month after you take emergency contraceptives, or if you miss your period. If your period is late and the pregnancy test is negative, wait a few more weeks and take another. Doctors may use urine and blood tests to determine if you’re pregnant, as they can sometimes detect pregnancy earlier.
Get screened for STIs
If you were potentially exposed to sexually transmitted infections (STIs), call your gynecologist or a local clinic like Planned Parenthood to schedule testing. A full STI panel typically includes testing vaginal discharge for gonorrhea, chlamydia, and trichomoniasis. It also includes blood work that tests for HIV, syphilis, and genital herpes. In some cases, your doctor will recommend testing you right away, and again in six months for HIV.
What to do if emergency contraception fails
While these forms of emergency contraception have high success rates, there is the rare chance that they may fail. If your pregnancy test comes back positive, you can then consult your doctor about what’s right for you. If you decide to maintain the pregnancy, your doctor can set you up with prenatal care. If it is an unwanted pregnancy, talk to your doctor and research your options. If you decide to terminate the pregnancy, there are different types of abortions that you can choose from, depending on which state you live in. Contact your doctor to see what options are available to you. If your emergency contraception fails, you can utilize these resources for more information: