Emergency Contraception

Emergency contraception is a form of birth control. It is a pill taken after unprotected sex or contraceptive failure. For example, if your regular birth control fails (the condom breaks during sex), if you forget to take your birth control pills, or if you have sex without using any birth control, you could use emergency contraception.

How Do I Use Emergency Contraception?

There are three products on the market approved by the U.S. Food and Drug Administration as emergency contraceptives:  Plan B One-Step®, Next Choice® and ella®. All emergency contraceptives are more effective the earlier they are used and should be taken as soon as possible after intercourse.

Plan B One-Step® and Next Choice® are the most common brands of emergency contraception. Both contain only the synthetic hormone, levonorgestrel. Package labeling indicates that both of these products should be taken within 72 hours of unprotected intercourse, however data supports  that use up to 120 hours after intercourse may prevent pregnancy. No physical exam or pregnancy testing is required prior to the use of these products.

Plan B One-Step® is available for purchase at pharmacies without a prescription by those age 17 and over, and a prescription is needed for those under than 17. Plan B One-Step® consists of one pill that contains 1.5 mg of levonorgestrel.

Next Choice® is available for purchase at pharmacies without a prescription by those age 17 and over, and a prescription is needed for those under 17. Next Choice® consists of two pills with a combined 1.5 mg dose of levonorgestrel. While prescribing directions indicate that patients should take each of the 2 pills 12 hours apart, recent data suggest that both pills taken together as a single dose is equally effective and without increased adverse effect.

Ella® is available by prescription only. It is a single pill that contains 30 mg of ulipristal acetate and is indicated up to 120 hours after unprotected intercourse. Unlike with hormonal emergency contraception, pregnancy must be excluded prior to prescribing ulipristal because of the risk of fetal loss if used in the first trimester of pregnancy. There is some evidence that between 72 and 120 hours after intercourse, uilpristal may be more effective at preventing pregnancy than hormonal alternatives.

How Does Emergency Contraception Work?

Plan B One-Step® and Next Choice® can prevent your ovaries from releasing an egg, can prevent an egg from being fertilized by sperm or can prevent a fertilized egg from attaching itself to the wall of the uterus. These pills can’t end a pregnancy once a fertilized egg has attached itself to the wall of the uterus. No studies have shown that taking hormones while you are pregnant can hurt your baby. But, if you know you are pregnant, you should not take emergency contraception pills. Plan B One-Step® and Next Choice® emergency contraceptive pills are not the same as the medicine known as the “abortion pill.” The “abortion pill” is medicine that is taken in the early weeks of pregnancy to end the pregnancy.

How Effective Is Emergency Contraception?

Emergency contraception pills can be very effective if they are used in time. They can reduce the risk of pregnancy if used up to 120 hours after unprotected intercourse or contraceptive failure, and is most effective if used in the first 24 hours. If used within 72 hours of unprotected sex, only about 1 to 2 percent of women become pregnant after using them. It is important to remember that these pills will work best when taken as soon as possible after unprotected sex.

It is also important to remember that using this type of contraception on a regular basis is less effective than using ongoing methods of contraception (like contraception pills or diaphragms). Emergency contraception should not be your main type of contraception.

Are There Any Side Effects?

There are no serious side effects attributed to levonorgestrel-containing emergency contraceptives. Pregnancy must be excluded prior to prescribing ella® (ulipristal acetate) because of the risk of fetal loss if used in the first trimester of pregnancy. Some women feel sick to their stomach after they take emergency contraceptive pills. This feeling should go away in about two days. Your doctor can give you medicine that may help you feel better. Progestin-only pills may not make you feel as sick as pills containing estrogen and progestin. If you throw up within one hour of taking the pills, you may need to take another dose. Talk to your doctor.

Who Can Use Emergency Contraception?

If you can take regular birth control pills, you should be able to take emergency contraception pills. You should not use emergency contraception if you are pregnant.

When Do I Need To Start Taking My Regular Birth Control Again?

After you take emergency contraception pills, your period may come earlier or later than usual. Call your doctor if you do not get your period within 21 days after taking the pills. If your regular form of birth control is condoms, spermicides or a diaphragm, you may go back to using them right away after taking emergency contraception pills. If your regular form of birth control is the pill, contraceptive shot, contraceptive patch or vaginal ring, talk to your doctor about when to start using it again.

Where Can I Get Emergency Contraception?

Talk to your doctor about how to get emergency contraception, or about having a prescription on hand in case you need it.

Plan B One-Step® and Next Choice® are available for purchase at pharmacies without a prescription by those age 17 and over. A prescription is needed for those under 17.

You also may be able to get emergency contraception from university and women’s health centers, health departments, Planned Parenthood centers and hospital emergency departments.