Emergency Contraception

Topic Overview

What is emergency contraception?

Emergency contraception is a way to prevent pregnancy if:

• You had sex without using birth control.
• Your birth control method failed. Maybe you forgot to take your pill or get your shot, the condom broke or came off, or your diaphragm slipped.
• You were raped. Even if you were using birth control, emergency contraception can help you make sure you don't get pregnant.

If you had sex without birth control, there is a chance that you could get pregnant. This is true even if you have not started having periods yet or you are getting close to menopause. You could also get pregnant if you used a birth control method that is not very reliable or if you didn't use it the right way.

Using emergency contraception right away can prevent an unwanted pregnancy and keep you from worrying while you wait for your next period to start.

What are the types of emergency contraception?

There are two types of emergency contraception: pills and the copper T intrauterine device (IUD). Most women choose pills because they work well, don't cost a lot, and are usually easy to get. The IUD works very well, but it costs a lot and has to be inserted by a doctor.

Pills: Pills used for emergency contraception are sometimes called “morning-after pills.” They can be used at any time up to 5 days after unprotected sex, but the sooner, the better. They contain hormones—either progestin only or a combination of estrogen and progestin.

• Plan B is a progestin-only pill that is packaged specially for use as emergency contraception. Plan B works better and has fewer side effects than combination birth control pills. It is considered the best type of pill. A single-use package (2 pills) costs from about $25 to $40.
• Some birth control pills are also used. If you already take birth control pills, you may be able to use the pills you have as emergency contraception. Talk to your doctor or check the Web sites listed below for the correct doses.

IUD: The copper T IUD is a small, T-shaped plastic device that is inserted into your uterus. The IUD is wrapped in copper, which helps kill sperm. It can be placed up to 5 to 7 days after unprotected sex to prevent pregnancy. (Note: The Mirena IUD is not used for emergency contraception.)

• Copper T IUDs work very well. They cost around $75.
• On the plus side, after a copper T IUD is in place, it keeps working for 2 1/2 years.

An IUD is not a good idea if you have a pelvic infection or sexually transmitted infection (STI). It could spread the infection and cause pelvic inflammatory disease, a serious health problem that can affect your ability to have children.

How does it work?

Morning-after pills act like birth control pills to prevent pregnancy. They are not the same as the “abortion pill,” RU-486. In most cases, they work by keeping the ovaries from releasing an egg or keeping an egg from being fertilized.

IUDs mostly work by killing sperm or keeping an egg from being fertilized.

Where can you get emergency contraception?

Plan B. You do not need to see a doctor to get Plan B. You can buy Plan B in most drugstores without a prescription. In Canada, Plan B is available behind the drugstore counter. Ask your pharmacist for it.

Birth control pills. If you already have birth control pills on hand, you may be able to use them for emergency birth control. Remember, though, that birth control pills may not work as well as Plan B. To find out which brands of pills work and how to take them, go to:

• The Canadian Federation for Sexual Health (formerly Planned Parenthood of Canada) Web site at www.cfsh.ca.
• The Web site www.sexualityandu.ca.

Some pharmacists will not sell Plan B or fill prescriptions for birth control pills. If this happens to you, ask for the location of a pharmacist who will, or:

• Go to the Planned Parenthood clinic nearest you, or call 1-888-270-7444 (this is the emergency contraception information line of the Canadian Federation for Sexual Health).

IUD. You can get an IUD from many doctors, from university and public health clinics, or in most hospital emergency rooms. An IUD has to be inserted by a doctor or other health professional.

How do you use it?

• With Plan B, you can take 1 pill right away and the second pill 12 hours later.
• With most birth control pills, you take one dose of 2 to 5 pills as soon as you can. Then you take a second dose 12 hours later. The dose depends on the type of pill.

You can take the first dose up to 5 days after unprotected sex, but it works best if you take it right away or within 48 hours.

If you use birth control pills for emergency contraception, keep the following in mind:

• Birth control pills can cause nausea. Take an antinausea medicine such as Gravol with the first dose and again 1 hour before the second dose.
• If you vomit within 2 hours of taking the pills, call your doctor for advice. You may need to repeat the dose.
• Be sure you take the active hormone pills. In a 28-day pack, the first 21 pills contain hormones. The last 7 pills (the ones you take during your period) do not contain any hormones. If you use 21-day packs, all of the pills contain hormones.

A doctor or other health professional has to insert an IUD.

How well does it work?

Emergency contraception works very well. The sooner you use it, the more likely it is to prevent pregnancy. Overall:¹

• Plan B is almost 99% effective. Only about 1 woman out of 100 who uses it will get pregnant, if taken within 48 hours.
• Birth control pills are around 97% to 98% effective. Only about 2 or 3 women out of 100 who use them as emergency contraception will get pregnant.
• The copper T IUD is more than 99% effective. Only about 1 woman out of 1,000 who use it will get pregnant.

If you haven't started your period within 3 weeks after using emergency contraception, get a pregnancy test.

Does it cause side effects?

Emergency contraception may cause some side effects.

• Plan B may cause spotting or mild symptoms like those of birth control pills. It usually doesn't cause nausea.
• Birth control pills can cause nausea or vomiting. In some women, they can also cause sore breasts, fatigue, headache, belly pain, or dizziness.
• An IUD may cause cramping and bleeding during the first few days after insertion.

Call your doctor if you have a headache, dizziness, or belly pain that is severe or that lasts longer than 1 week.

If you are already pregnant, pills won't harm the fetus. An IUD could cause problems with the pregnancy.

What else should you think about?

• Emergency contraception pills won't protect you for the rest of your cycle. Use your regular method of birth control, or use condoms.
• Unless you get an IUD, emergency contraception does not take the place of regular birth control. Find a good method of birth control you can use every time you have sex.
• Emergency contraception does not prevent sexually transmitted infections. If you are worried you might have been exposed to a disease, talk to your doctor.
• Accidents can happen. It is a good idea to keep a set of the pills on hand in case you ever need it.

	Go to top of page	Go to next section
Author:	Merrill Hayden Carrie Henley	Last Updated: August 16, 2006
Medical Review:	Adam Husney, MD - Family Medicine Joy Melnikow, MD, MPH - Family Medicine Kirtly Jones, MD - Obstetrics and Gynecology Femi Olatunbosun, MB, FRCSC - Obstetrics, Gynecology and Reproductive Medicine
© 1995-2008 Healthwise, Incorporated. Healthwise, Healthwise for every health decision, and the Healthwise logo are trademarks of Healthwise, Incorporated.This information does not replace the advice of a doctor. Healthwise disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the Terms of Use. How this information was developed to help you make better health decisions.