Emergency contraception: Basic Info
Emergency contraception (EC) (sometimes called the "morning after pill") can stop a pregnancy before it starts by delaying ovulation. There are three different kinds of EC: an over-the-counter pill, a prescription-only pill (called ella), and certain IUDs.
Both the over-the-counter pill and the prescription-only pill work if you take them within five days (or 120 hours) after having unprotected penis-in-vagina sex. The sooner you take EC pills, the more effective they are, but prescription-only EC is more likely to be effective on the fifth day after unprotected sex than over-the-counter EC is. So it's a good idea to get EC in advance, so that if you need it in the future, you'll have it on hand and can start it as soon as possible.
Some people think that the emergency contraception pill is the same as the abortion pill, but they're actually completely different. Both types of emergency contraception pills work by preventing ovulation (the release of an egg from one of your ovaries) during your current menstrual cycle. If you don't ovulate, then there's no egg for your partner's sperm to fertilize. The abortion pill, on the other hand, stops a pregnancy that has already started (which means you've ovulated, the egg has been fertilized, and the fertilized egg has implanted in your uterus). Then it brings on your period, which flushes everything out of your uterus.
While EC pills are the most well-known kind of emergency contraception, the most effective kind of EC is actually having an IUD inserted within five days of having unprotected sex.
There are three IUDs that we know work as EC: Paragard, LILETTA, and Mirena. Not only can they prevent a pregnancy from starting after you've had unprotected sex, but they can also act as an extremely effective birth control method moving forward.
Quick Facts
Emergency contraception (EC) provides the possibility of pregnancy prevention after the fact.
- Effectiveness
The IUD as EC is super effective. The prescription-only EC pill is more effective than the over-the-counter EC pill but neither is as good at preventing pregnancy as lots of methods you can use before or during sex.
Perfect Use: If you use the IUD as EC, over 99% effective.
Typical Use: If you use the IUD as EC, over 99% effective.
- Hormones
There are hormonal and non-hormonal options.
- Side effects
With the IUD you might have bleeding changes and cramping. EC pills can cause temporary upset stomach, vomiting, changes to your period, and sore breasts.
- Cost
Anywhere from $0-$1300.
- STI protection
Emergency contraception doesn’t protect against STIs.
- Ongoing effort
With the IUD, it's inserted once and can stay in for years with no ongoing effort. With EC pills, once you’re done taking them, you’re done.
Different Types
Over-the-counter EC pill
Better known by the brand name Plan B or as "the morning-after pill," over-the-counter emergency contraception (EC) is an easy-to-get medication containing the hormone levonorgestrel. It works to prevent pregnancy by delaying ovulation when it's taken within five days (120 hours) after having unprotected sex, but it is more effective the sooner you take it.
You don't need a prescription to get it, and anyone, no matter how old you are or your gender, can get it at drugstores, at grocery stores, in vending machines, at health centers, online, and from many other places.
While this type of emergency contraception is the easiest kind to get your hands on, it's not the best option for everyone. Over-the-counter emergency contraception may not be as effective for people who weigh 165 pounds or more. (If that's you, don't worry—there are other options.)
Prescription EC pill (ella)
Ella is an emergency contraception (EC) pill that you can only get with a prescription. It works to prevent pregnancy by delaying ovulation when it's taken within five days (120 hours) after having unprotected sex. Ella is more likely than over-the-counter EC to be effective at preventing pregnancy on the fifth day after unprotected sex. You need a prescription to get ella, so you will have to see a health care provider in person or via telehealth. Ella may not work as well for people who weigh 195 pounds or more. (If that's you, don't worry—there are other options.)
IUD as EC
There are three different IUDs that can be used as emergency contraception (EC) if they're inserted within five days (120 hours) of having unprotected sex. They are the non-hormonal/copper IUD (Paragard) and the two hormonal IUDs that contain 52mg of levonorgestrel (LILETTA and Mirena).
IUDs are the most effective form of EC—they're 99.9% effective at preventing pregnancy after unprotected sex. Once you've had it inserted, you can keep the IUD in and use it as birth control for up to eight years (for Mirena and LILETTA) or up to 12 years (for Paragard). Or if you only want to use it as emergency contraception and not as birth control going forward, you can have it removed a few weeks after having it inserted.
