Emergency Contraception: A Guide for Parents

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Girl taking a pillEmergency contraception (EC) is a treatment to prevent pregnancy in adolescent girls and adult women who have had unprotected sex. It is not meant to be used as regular birth control. Although it is often called the “morning after pill,” it can actually be used within 120 hours (5 days) of unprotected intercourse. Emergency contraception is more effective the sooner it is taken after unprotected sex.

Under what circumstances should a young woman use emergency contraception (EC)?

Emergency contraception (EC) is indicated if:

  • A young woman has unprotected intercourse, meaning, she is not using condoms or hormonal methods.
  • A young woman had intercourse and her partner’s condom broke or slipped off.
  • A young woman takes her birth control pills inconsistently.
  • A young woman was forced to have unprotected intercourse (raped).

How does emergency contraception work?

Emergency contraception (EC) uses a high dose of hormones (either progestin alone or a combination of estrogen and progestin) to give a strong, short burst that breaks the hormonal cycle that is needed for ovulation to occur.

It’s important to for young women to know that EC doesn’t continue to protect against pregnancy during the rest of the menstrual cycle.

Does emergency contraception cause an abortion?

Emergency contraception does not work if a young woman is already pregnant. EC will NOT cause an abortion.

How is emergency contraception taken?

There are three kinds of emergency contraception.

  1. The first “morning-after” emergency contraception pill methods approved in the United States are: Plan B One-Step™ and Next Choice®. Both products contain only one kind of hormone, a progestin, and it comes as 1 or 2 pills. A young woman can take the total dose of 1.5 mg levonorgestrel in Plan B One-Step™ as one pill, or use Next Choice® and take both pills (.75 mg in each tablet) at the same time or take one pill followed by the second pill twelve hours later. Both kinds of EC work best if taken within 3 days (72 hours) of unprotected sex, but can be taken up to 5 days but the earlier it is taken the more effective it is. No prescription is needed for girls 15 and older.
  2. Ella™ (urlipristal acetate or UPA) is an emergency contraceptive that works by stopping or delaying ovulation. It’s one pill (one dose) that can be taken up to 5 days or 120 hours after unprotected intercourse. A prescription is needed.
  3. Another type of emergency contraception uses regular birth control pills, which contain two hormones, estrogen and progestin. There are 2 doses. The first dose may be 2, 4, or 5 pills depending on the brand of birth control pills used, and is taken within 120 hours (5 days) of unprotected sex. The second dose is taken 12 hours after the first dose. A health care provider must prescribe how many pills should be taken for this kind of emergency contraception. This method is less effective than the other two, and is more likely to cause nausea.

How effective is emergency contraception?

It’s important to remember that emergency contraception doesn’t always work. It doesn’t guarantee that pregnancy will be prevented. Emergency contraception lowers the risk of pregnancy by  about 89%. The risk of getting pregnant depends on when in in a woman’s menstrual cycle she had sex and what kind of birth control she uses. A young woman is more likely to get pregnant around the time when the ovary releases an egg (ovulation).

On August 13, 2010, the U.S. Food and Drug Administration (FDA) approved a new emergency contraception pill, Ulipristal Acetate (Ella™). It became available to women in the United States on Dec. 1, 2010, however, it’s been used in parts of Europe since 2009. A prescription is needed to buy it in the United States.

The biggest differences between Ella also called UPA (short for Ulipristal Acetate) and other emergency contraception methods are:

  • Ella™ is equally effective for 5 full days after unprotected intercourse unlike the other EC methods that are less effective after the first 48-72 hours following unprotected intercourse.
  • Ella™ is likely to be covered by insurance because a prescription is necessary. However, the co-payment may be high and it’s not carried by all pharmacies.

The best way to prevent pregnancy is for a young woman to use a regular birth control method such as condoms, or birth control pills, or not have sexual intercourse.

Is emergency contraception safe?

Yes. There have been no reports of serious complications among the millions of young women who have used EC. Emergency contraception is not recommended if a young woman knows she is pregnant because in this situation, it will not work.

Does emergency contraception cause birth defects?

Emergency contraception does not cause birth defects or affect the health of future children.

Are there any side effects of emergency contraception?

EC is tolerated well and side effects are usually absent or mild. A few percent of young women may have nausea, dizziness; headache and/or stomach pain, temporary irregular menstrual periods, and breast tenderness with Plan B One Step™, Next Choice® or Ella™. Some young women may complain of moderate nausea and vomiting if regular birth control pills are used (for EC). Side effects from emergency contraception (when using regular birth control pills) most often go away after 1-2 days. There are over-the-counter medicines such as Dramamine II or Bonine for nausea.

Where can my daughter get emergency contraception?

In the United States women 15 and older can get (progestin-only) EC at pharmacies without a prescription. For teens under the age of 15, EC requires a prescription. Your daughter may need to check many different pharmacies, because not all pharmacies stock EC.

Your daughter should be ready to answer the following questions:

  • When was the first day of your last menstrual period?
  • When was the exact date and time of unprotected sex?
  • What types of birth control have you have used in the past?

Is my daughter more likely to have unprotected sex if she has access to emergency contraception?

Multiple research studies have shown that easier access to emergency contraception does not increase unprotected intercourse or increase the risk of sexually transmitted infections (STIs).

Can my daughter use emergency contraception as a regular form of birth control?

No. Emergency contraception is not meant to be a regular method of birth control. It is meant to be a one-time emergency treatment. Your daughter should not use emergency contraception as her only protection against pregnancy, because this method is much less effective than other forms of birth control used on a regular basis. Also, emergency contraception does not protect against sexually transmitted infections (STIs).

What else should my daughter do to prevent pregnancy after she has taken emergency contraception?

Your daughter should talk to her health care provider about effective contraceptive methods. Her health care provider may suggest that she start birth control pills right away after emergency contraception. Find out more on birth control methods so you can talk with your daughter about her options.

How should I talk to my daughter about emergency contraception?

You can start by asking her if she has heard about emergency contraception (EC). You might want to mention that you recently read an article about it. If she has heard about EC, you may wish to ask her if she has an opinion about it, and then share your thoughts. It’s important that she understands your values, and it is equally important for you to hear her feelings about EC.

Your daughter’s reproductive health is an important aspect of her overall health and well-being. Encourage her to establish a trusting relationship with her health care provider. It is valuable for your daughter to learn about all of the options available to her so she can become proactive about her health.

Key Points to Remember about Emergency Contraception (EC):

  • Emergency contraception (EC) is a safe treatment to prevent pregnancy in adolescent girls and adult women who have had unprotected sex.
  • EC will NOT cause an abortionIt does not work after ovulation.
  • Emergency contraception does not guarantee that pregnancy is prevented. The best way to prevent pregnancy is for your daughter to use a regular birth control method, such as condoms or birth control pills, or not have sexual intercourse.
  • Plan B One-Step™ (EC) is available to women 15 and older at pharmacies in the United States without a prescription.
  • If your daughter is under 14, she will need a prescription for Plan B One-Step™ from her health care provider to have in the event of an emergency.
  • Encourage your daughter to talk to her health care provider about her reproductive health and whether her HCP thinks she should have a prescription to fill just in case she needs it.
On April 30, 2013, the Federal Drug Administration (FDA) approved the following: Girls who are 15 and older can buy Plan B One-Step™ emergency contraception without a prescription. According to the pharmaceutical company that makes Plan B One-Step™, a prescription will still be required for a few months or until the product (with new packaging instructions) is in stores.

Talk openly with your daughter. Listening to her, even when you disagree, will help to promote good communication. Let you daughter know that both her health and safety are your primary concerns.