Emergency Contraception (EC)

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Girl taking a pill

Emergency contraception (EC) is a backup method of birth control for preventing pregnancy after unprotected sex. Even though it’s commonly called the “morning-after pill,” there are both pills and an intrauterine device that can actually be used within 5 days (120 hours) of unprotected intercourse. However, the sooner you take the medication, the more likely they will work.

When should a woman use emergency contraception?

Emergency contraception (EC) should be used if:

  • You had unprotected sex, which means your partner did not use a condom and you are not using another method of birth control (pill, IUD, Nexplanon, etc).
  • You forget to take your birth control pills, hormonal ring or patch (and you’ve been having sex).
  • Your partner’s condom broke or slipped off while you were having sex.
  • You were forced to have unprotected intercourse (rape).

How does emergency contraception work?

The medications work by giving a strong short burst of hormones that changes the cycle and prevents ovulation. Ovulation is the time in your cycle you are most likely to become pregnant. The copper IUD works by preventing fertilization and if left in the uterus, it will continue to protect against pregnancy for 10 years or until removed by a health care provider.

It’s important to remember that EC doesn’t continue to protect against pregnancy during the rest of the menstrual cycle. You should not have intercourse. Talk to your provider about using a barrier method, such as condoms, a birth control method (pills, patch, ring, depo, implant, or IUD).

Does emergency contraception (EC) cause an abortion?

No. Emergency contraception (EC) does not work if a woman is already pregnant. EC will NOT cause an abortion.

Names of EC you should be familiar with:

  1. Levonorgestrel (1.5mg pills) Plan B One-Step®,Next Choice One Dose®, MyWay®, AfterPill™. These are available over-the-counter without a prescription. The directions say to use it within 3 days (72 hours) but it has been shown to be effective up to 5 days after unprotected intercourse. However, EC is most effective when taken as early as possible.
  2. Ulipristal acetate (30mg) includes Ella™ (urlipristal acetate or UPA). This is one pill (one dose) that can be taken up to 5 days or 120 hours after unprotected intercourse. A prescription is often needed for this pill, but in some states a pharmacist can dispense Ella without a prescription.  Ellacan also be purchased online after a telephone consultation; however, it is likely to be more expensive and you may need to factor in overnight shipping. Please be aware that online pharmacies cannot mail Ella™ to certain states including: Arkansas, Missouri, North Carolina, and Oregon. Your health care provider can write you an “advanced prescription” for Ella so it will be available for you if you have unprotected sex in the future. Talk to your health care provider about this option.
  3. Copper Intrauterine Device: Copper T IUD ParaGard®. This IUD is a small copper device that when placed in your uterus (through your vagina), not only prevents current pregnancy but future pregnancies up to 10 years as long as it remains in place. It is the most effective option of all EC options. The copper intrauterine device can be inserted in a woman’s uterus at most family planning clinics and if the woman has no signs of vaginal or uterine infection, it can be inserted right away.
  4. Other Oral Contraceptive Pills. Some oral contraceptive pills may be prescribed in two high doses (12 hours apart) by a health care provider. This type of EC must be taken within 72 hours of unprotected intercourse. However, this form of EC is the least effective, and can cause nausea and vomiting.

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. The risk of pregnancy depends on the type of EC used, when in your menstrual cycle you had sex, and what kind of birth control you use. You’re more likely to get pregnant around the time when the ovary releases an egg (ovulation). The pregnancy rate is less than 2% after ulipristal acetate use, 2-2.5% with levonorgestrel method (Plan B), and 0-2% after copper IUD insertion.

The best way to prevent pregnancy is to use a reliable regular birth control method such as condoms, birth control pills, vaginal ring, patch, depo, implant or IUD, or to not have sexual intercourse.

Is emergency contraception (EC) safe?

Yes. Millions of women have used emergency contraception (EC) without any problems. Any woman can take EC. Even women who can’t take hormonal birth control because of a medical condition (migraines, heart disease, liver disease, breastfeeding, and previous ectopic pregnancy) can take EC.

Does emergency contraception (EC) cause birth defects?

Emergency contraception does not cause birth defects or affect the health of future children that a woman may have.

Does emergency contraception (EC) have any side effects?

EC is tolerated well and side effects are usually absent or mild. The most common side effects include nausea and irregular bleeding. Other less common side effects may include: vomiting, breast tenderness, fatigue, dizziness, headache, and menstrual cramps but these side effects most often go away after 1-2 days. If you experience nausea after using EC, there  are over-the-counter medicines you can get such as Dramamine II or Bonine. If you vomit within 3 hours of taking EC, talk to your health care provider because you may need to take another dose of EC.

Where can I get emergency contraception?

In the United States any woman can get Plan B One-Step™ and other brands of LNG at most pharmacies without a prescription. You can also get Ella™  at a pharmacy, but you will need a prescription. For a copper IUD, you will need to be seen at a clinic, such as your primary care, GYN’s office, or Planned Parenthood, to have the IUD placed in your uterus. You may need to check many different pharmacies, because EC is not available in all pharmacies.

Use the EC website to find a health care provider or pharmacy if you have any questions about emergency contraception.

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?

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

Emergency contraception is not meant to be a regular method of birth control. It’s meant to be a one-time emergency treatment. Emergency contraception can be used when a condom breaks, when a diaphragm or cervical cap gets moved, or any time when there is unprotected sex. You should not use emergency contraception as your only protection against pregnancy, because this method doesn’t work as well as other types of birth control. Also, emergency contraception does not protect against sexually transmitted infections.

When can I expect my next menstrual period after I have taken emergency contraception?

Your period should start within 3 weeks after taking EC. Your next period may start a little early or a few days later than usual. If your next period is late, contact your health care provider and get a pregnancy test.

What if I have problems after I have taken emergency contraception (EC)?

If you have any problems after you take emergency contraception, you can contact your health care provider.

You should definitely call your health care provider if:

  • You do not get your period within 2 weeks after taking EC
  • You have very bad abdominal (belly) pain
  • You are spotting (small amount of blood on your underwear in between your menstrual periods)
  • Your next menstrual period is very light
  • You are dizzy

Do I need to do anything else to prevent pregnancy after I have taken emergency contraception?

Yes. You should talk to your health care provider about using a regular type of birth control method. Until you have your next menstrual period, it is best not to have sexual intercourse. If you decide to have intercourse, make sure to use a barrier method (condom), every time you have sex even if you are using hormonal birth control (pills, patch, or ring).After taking Plan B One-Step® you can start hormonal birth control (pills, patch, or ring) right away, but you should wait 5 days after taking Ellato use these methods because they may prevent the EC from working. Find out more about birth control methods so you can start thinking about what method will be best for you.

We hope that you have learned a lot about emergency contraception (EC) and that we have answered your questions. Below are the key points to remember about EC so you can be a resource to your family, friends, and others.

Key Points to Remember about Emergency Contraception (EC):

  • Emergency contraception (EC) is a safe treatment to help prevent pregnancy in adolescent girls and adult women who have had unprotected sex.
  • EC will NOT cause an abortion. Plan B One-Step®does not work after ovulation.
  • EC does NOT prevent sexually transmitted infections (STIs) or HIV
  • Emergency contraception does not guarantee that pregnancy is prevented. The best way to prevent pregnancy is to use a reliable birth control method or to not have sexual intercourse.
  • Many EC products are available to all women in the United States without a prescription including: Plan B One-Step®, Next Choice One Dose®, MyWay®, AfterPill,and other single dose 1.5mg Levonorgestrel products
  • Ella™ (Ulipristal acetate or UPA) is available with a prescription.
  • ParaGard® (IUD) is available at some health centers and clinics. It must be inserted by a health care provider.
  • You should have a pregnancy test if you do NOT get your period within 2 weeks after taking EC.
  • Abdominal pain and/or heavy or unusual menstrual bleeding after taking EC is not normal and should be reported to your health care provider right away.
  • After you take EC, a backup method of birth control (condoms) should be used for at least 7 days or you should not have sex during this time. Condoms should be used every time you have sexual intercourse to prevent STIs.
  • Talk with your health care provider about your options and decide if you want a prescription to fill just in case you need it.

Be sure to talk with your health care provider about how you can prevent pregnancy and stay healthy.