Emergency Contraception: A Guide for Parents

Emergency 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,” there is both a pill and an intrauterine device that 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) should be used if:

• A young woman has unprotected intercourse, meaning, she is not using condoms or another method of birth control (pill, IUD, Nexplanon, etc.)
• 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 to give a strong, short burst that breaks the hormonal cycle that is needed for ovulation to occur. The copper IUD prevents fertilization and, if left in the uterus, it protects against pregnancy for 10 years or until removed by a health care provider (HCP).

It’s important 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?

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

How is emergency contraception taken?

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 earlier as possible.
2. Ulipristal acetate (30mg) includes Ella™ (urlipristal acetate or UPA). Is one pill (one dose) that can be taken up to 5 days or 120 hours after unprotected intercourse. A prescription is needed. In many cases, a pregnancy test is also needed. In some states, a pharmacist can dispense Ella™ without a prescription. Ella™can 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 Caroline, and Oregon.
3. Copper Intrauterine Device: Copper T IUD ParaGard®This IUD is a small device that when placed in the uterus (through the vagina), not only prevents current pregnancy but future pregnancies for 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 least effective.

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. Oral hormones used for emergency contraception lowers the risk of pregnancy by 89%. The risk of getting pregnant depends on when 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).

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 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. 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. Some women may complain of moderate nausea and vomiting if regular birth control pills are used for EC,  but these side effects most often go away after 1-2 days. Over-the-counter medicine such as Dramamine II or Bonine help treat  nausea.

Where can my daughter get emergency contraception?

In the United States any woman can get Plan B One-Step™ at most pharmacies without a prescription. Women can get Next Choice® at age 17 and older without a prescription and under 17 with a prescription. Your daughter can also get Ella™ at a pharmacy, but she will need a prescription. For a copper IUD, she will need to be seen at a clinic, such as her primary care, GYN’s office, or Planned Parenthood, to have the IUD placed in her 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.

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 about 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 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 for your daughter to use a reliable birth control method, or 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™ is available with a prescription.
• Never purchase EC from a website as it could be fraudulent medication.
• ParaGard® (IUD) is available at some health centers and clinics. It must be inserted by a health care provider.
• Your daughter should have a pregnancy test if she does NOT get her 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 daughter’s health care provider right away.
• After your daughter takes EC, a backup method of birth control (condoms) should be used for at least 7 days or she should not have sex during this time. Condoms should be used every time to prevent STIs.
• Your daughter should talk with her health care provider about her options and decide if she wants a prescription to fill just in case, she needs it.

 

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.

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Our health guides are developed through a systematic, rigorous process to ensure accuracy, reliability, and trustworthiness. Written and reviewed by experienced healthcare clinicians from Boston Children's Hospital, a Harvard Medical School teaching hospital and consistently ranked as a top hospital by Newsweek and U.S. News & World Report, these guides combine clinical expertise, specialized knowledge, and evidence-based medicine. We also incorporate research and best practices from authoritative sources such as the CDC, NIH, PubMed, top medical journals, and UpToDate.com. Clinical specialists and subject matter experts review and edit each guide, reinforcing our commitment to high-quality, factual, scientifically accurate health information for young people.