Emergency contraception (EC) has come a long way. You might know this as “the morning after pill” or “Plan B”. EC is a way to prevent pregnancy following intercourse when no birth control was used or, when the method of birth control you thought was reliable suddenly isn’t, such as a broken condom or a missed birth control pill. Lets face it…accidents happen and you want to be prepared when they do. Here is what you need to know:
1. Pills containing the progestin hormone Levonorgestrel, (Plan B One-Step, Next Choice) are available without a prescription to those of any age. It works best when taken within 24 hours after unprotected intercourse, but is still effective up to 5 days later. Side affects are minimal, possibly some nausea. This Levonorgestrel EC is not as effective in women weighing more than 154 (70 kg).
Even though EC pills are available without a prescription, which gives women privacy and convenience, it does not necessarily lower rates of undesired pregnancy. Unfortunately, multiple studies have shown that even though women may have EC pills available, few use them after every act of unprotected intercourse.
2. Pills containing another type of progestin is available only by prescription This pill contains ulipristal acetate (brand name, Ella). It works about twice as well as the levonorgestrel EC and is effective up to 5 days after unprotected intercourse. It is also more effective for obese women. Both of these EC pills are safe for all women and do not raise the risk of deep vein thrombosis (blood clots).
3. The copper-containing IUD is the most effective EC which needs to be placed within 5 days of unprotected intercourse. Having an IUD inserted will also give women long term effective birth control for up to 12 years! IUD’s can be expensive ($200-500) and needs to be inserted by a trained practitioner.
I do not recommend using the old “Yuzpe” regimen in which women would take 2 doses of 2-4 oral contraceptive pills that contain both estrogen and progestin. This method is less effective, less safe and has more side effects.
These oral methods of EC do not adversely effect an established pregnancy. It also has no long-term negative effects on fertility. They work by stopping or delaying ovulation (release of an egg from the ovary). The IUD works by thickening the cervical mucous so sperm get trapped and by changing the lining of the uterus so implantation cannot take place. These methods do not abort a growing embryo (abortifacient).
Talk to your doctor or practitioner about EC methods. These should be used as a back-up to your current on-going birth control method should something go wrong. Be aware that these EC methods do not protect against STI’s. There are many choices for women to prevent unwanted pregnancy.