Wanna learn about Emergency Contraception? We got you. Read on.
WHAT IS IT?
Emergency contraception (EC) refers to a method of contraception you use after unprotected sex to prevent pregnancy. In the US, this is most widely known as the “morning-after pill”. There are a few different kinds, but the most commonly available EC pill is a levonorgestrel-containing pill called “Plan B”. When taken within three days of unprotected sex, it is 89% effective at preventing pregnancy. When taken one day after unprotected sex, it is about 95% effective. A copper IUD can also be used as a form of EC in some cases. According to the CDC, about 1 in 9 women* have taken EC in their lifetime – so it’s fairly common. Widespread availability, as well as ease of use, have made it very popular as a back-up form of contraception.
WHAT ARE THE DIFFERENT KINDS?
Check out this cool chart we made for ya adapted from Bedsider.
*Higher effectiveness the sooner you take it.
**Some states require a prescription.
A note on Paragard: unlike the other kinds of EC, the copper IUD stays in your body for up to 12 years and can act as your primary form of birth control as well. Since the copper IUD works by preventing or disrupting implantation of a fertilized egg, rather than preventing ovulation like EC pills do, the effectiveness should be consistently high whether it’s been one or five days.
HOW DOES IT WORK? BILL NYE ME.
Essentially, the hormones in EC will prevent you from ovulating, or releasing an egg. No ovulation means no fertilization, and no risk of pregnancy (1). The caveat is that EC only works to prevent ovulation if you haven’t already ovulated for the month. If that has already happened, it’s basically like taking a sugar pill – it won’t do much for you. But the good news is, of the whole cycle, you only ovulate once, and the egg can’t live very long, so while it is certainly possible for you to have ovulated in the day before unprotected sex, the likelihood is small. There is also a small chance that EC can prevent implantation of a fertilized egg, but the scientific community is still undecided on how often that actually happens and how much of that we can attribute to EC. (1)
HOW LONG DOES IT TAKE TO WORK AND WHEN DO YOU HAVE TO TAKE IT?
Time is of the essence here. See our handy chart above. You have up to three days after unprotected sex to take Plan B and five days to take Ella or get a copper IUD inserted. All forms are most effective if you take them ASAP, so don’t delay if you can help it! Some people purchase some EC pills in advance to have on hand just in case.
CAN YOU TAKE IT MORE THAN ONCE?
Totally! It just may not feel great. EC in pill form is basically just a really high dose of a hormone called levonorgestrel, which is also used in regular birth control pills.
EC is called Plan B for a reason- meaning that it’s good practice to have a “Plan A”, AKA a primary form of birth control. The Copper IUD functions as “Plan A” after getting it inserted as “Plan B”
WHAT IS THE EXPERIENCE OF TAKING E.C LIKE?
When you take EC, you may experience some spotting, cramping, nausea, bloating, or mood swings. This may last for a day or two. While these are all totally normal symptoms and not harmful, taking EC isn’t exactly a picnic and shouldn’t be used as your long term birth control.
Getting a copper IUD inserted can be uncomfortable (though people report a range of experiences from mild discomfort to acute cramping). Check out our Ultimate Guide to IUDs for more!
EFFECT ON FERTILITY?
None! There is no evidence that taking EC or getting a copper IUD will affect fertility in the long term. (1)
HOW TO PREPARE YOURSELF?
A lot of people handle EC without any physical or emotional complications. For many, the most stressful part about using EC is knowing whether it actually worked. Get EC as soon as you can after unprotected sex and take care of yourself! Meditation, a hot bath or shower, a good workout, a nice meal, and resting are all a good place to start.
IS THIS RIGHT FOR ME?
- Questions to ask yourself/your healthcare provider:
- Has it been five days or less since I had unprotected sex?
- How does my weight affect my options and effectiveness?
- Am I taking any medications, barbiturates or herbs like St. John’s wort? These can decrease the effectiveness of E.C pills.
- Why did my birth control fail? Am I interested in a more reliable method?
Do I need a prescription? If so, can I be prescribed a few extra doses, just in case?
FROM THE MIDWIFE- WHY PLAN B SHOULDN’T BE PLAN A
Emergency Contraception (EC) is a fantastic tool available to us if there has been a mistake, a contraception breakdown (broken condom, missed pill, etc), or a nonconsensual sexual encounter. However, it really is trying to catch the horse after it’s already run out of the barn – sperm is already in the genital tract and EC works to try to prevent ovulation from happening at that moment. Remember that while an egg is functional for just 24 hours in the whole menstrual cycle, sperm that has been ejaculated into the vagina can function for up to 5 days. So if you have unprotected penis-in-vagina sex even 5 days before ovulation, you can still get pregnant. This is when EC shines – the moment between ejaculation and ovulation. If you take EC right then, it will prevent ovulation from occurring, and you never have that issue of sperm + egg meeting. But what happens if you’ve already ovulated? That’s when you can still get pregnant even if you take EC. Using a “plan A” contraception method – any kind of birth control that is used as a preventative, not a fixer (the pill, patch, ring, IUD, implant, etc) should work to prevent that ovulation from ever happening, essentially closing the barn doors before the horse can get out.
-Chloe Lubell, Frida Care (Learn more on Chloe!)
Written by: Caitlin O’Connor, Birth control/family planning counselor at UCLA OBGYN
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