Emergency Contraception

Emergency Contraception

Is this your symptom?

  • Emergency birth control after unprotected sex (morning after pill)
  • Female
  • Not pregnant

Some Basics...

  • Emergency birth control can help a woman from getting pregnant after sex. It works best if taken right away after sex. But it can be taken up to 5 days later.
  • There are 2 types of emergency birth control. There are emergency contraceptive pills (ECPs) which are also called morning after pills. There are also intrauterine devices (IUDs).
  • ECPs should only be used for emergency times. They do not work as well as regular birth control methods (pills, condoms, IUDs) in preventing pregnancy.
  • ECPs do not prevent STDs. Condoms are the only way to keep from getting STDs during sex.
  • ECPs do not work as well in women who are obese.
  • A person can buy ECPs at a drugstore. A person can also get ECPs or IUDs from a doctor, public health clinic, or Planned Parenthood office.

When Should a Woman Think about Using Emergency Birth Control?

  • Not using any birth control method (unprotected sex)
  • Condom broke or slipped off penis
  • Diaphragm or cervical cap was taken out too early
  • Failed coitus interruptus (semen was ejaculated into the vagina or on the outside of the vagina)
  • Spermicide was used alone during second or third week of menstrual cycle
  • Missed more than 2 birth control pills
  • Started birth control pill pack more than 2 days late
  • Delay in getting scheduled birth control shot
  • Sexual assault (not on birth control pill or do not have an IUD)

What are ECPs?

ECPs are hormone pills that prevent pregnancy after sex. They are also called "morning after pills," "morning after contraception," or "day after pills."

  • ECPs can be taken right away after sex. While they can be taken up to 5 days after sex, they work best if taken right away.
  • ECPs do not work as well as regular birth control methods in preventing pregnancy.
  • ECPs do not prevent STDs.
  • ECPs work 95% of the time at preventing pregnancy if taken within 24 hours of sex. They work 85% of the time if taken within 72 hours of sex. The sooner the ECPs are taken, the less chance of getting pregnant.
  • ECPs are used to prevent unwanted pregnancy after sexual assault, broken condom, or forgetting to use birth control.
  • ECPs work less well in obese women.
  • The normal cost of ECPs is $20-30.

Where Can a Person Get ECPs?

  • The doctor
  • Public health clinic
  • Planned Parenthood office
  • Drugstores

Is a Prescription Needed for ECPs?

One can get levonorgesterel (Plan B, Next Choice) over-the-counter.

  • United States: ECPs are sold OTC. Plan B One-Step is available without age limits in pharmacies in the United States. It is a single 1.5 mg tablet of levonorgestrel. Look for it in the family planning aisle next to condoms.
  • Canada: ECPs are sold OTC in the form of Plan B (levonorgestrel).
  • Australia: ECPs are sold over-the-counter (OTC).

One must have a prescription to get ulipristal acetate (Ella, EllaOne). Ulipristal may work better than over-the-counter ECP. Especially, when used between 72 to 120 hours after unprotected sex. It also appears that it works better than over-the-counter ECP in obese women.

What are Intrauterine Devices (IUDs)?

  • IUDs work very well to prevent pregnancy after sex. An IUD can reduce the pregnancy rate by 99%. The IUD must be inserted into the uterus within 5 days of sex. This must be done by a doctor.
  • Advantages: It can prevent pregnancy for up to 5-10 years. Low risk of side effects (see below).
  • Disadvantages: It does not protect against sexually transmitted diseases (STDs).
  • Side Effects: Some women have mild cramps or back pain after the IUD is put in. This may last a few hours. Some women may have mild cramping and bleeding for 1-2 weeks after the IUD is put in. Women may have heavier periods after getting an IUD. This often happens with copper IUDs.
  • Cost: The normal cost of getting an IUD is $600 (United States).

When to Call for Emergency Contraception

Call Doctor Within 24 Hours

  • You think you need to be seen

Call Doctor During Office Hours

  • You have other questions or concerns

Self Care at Home

  • Unprotected sex within past 72 hours (3 days)
  • Unprotected sex within past 72-120 hours (3-5 days; ECP is less effective)
  • Unprotected sex that happened more than 120 hours (5 days) ago
  • Questions about ECPs

Care Advice

Over-the-Counter Emergency Contraceptive Pills (ECPs)

  1. What You Should Know:
    • Emergency contraception (emergency birth control) works well to prevent pregnancy after sex. It works best if taken right away after sex, but can be taken up to 5 days after sex.
    • ECPs are just for emergency situations.
    • ECPs do not work as well as regular birth control methods in preventing pregnancy.
    • ECPs do not prevent STDs.
    • Here is some care advice that should help.
  2. How Effective are ECPs? Of women who have unprotected sex in week 2 or 3 of their menstrual cycle:
    • 8 out of 100 women will get pregnant without using an ECP.
    • 3-4 out of 100 women will get pregnant if they use an ECP 3-5 days after sex.
    • 1-2 out of 100 women will get pregnant if they use an ECP less than 3 days after sex.
  3. Side Effects of ECPs:
    • Nausea: 30-60% of women
    • Vomiting: 5-20% of women
    • Stomach pain: 10-20% of women
    • Fatigue and headache: 10-20% of women
    • Change in periods: 50% of women
  4. Do I Need a Prescription for ECPs?
    • Australia: ECPs are sold over-the-counter (OTC). Examples are Levonelle-1, NorLevo, and Postinor.
    • Canada: ECPs are sold OTC. Examples are NorLevo and Plan B.
    • United States: ECPs are sold OTC. Plan B One-Step is available without age limits in pharmacies in the United States. It is a single 1.5 mg tablet of levonorgestrel. Look for it in the family planning aisle next to condoms.
  5. Call Your Doctor If:
    • You have other questions or concerns

Prescription Emergency Contraceptive Pills - Ulipristal

  1. What You Should Know:
    • Emergency contraception (emergency birth control) works well to prevent pregnancy after sex. It works best if taken right away after sex, but can be taken up to 5 days after sex.
    • ECPs are just for emergency situations.
    • ECPs do not work as well as regular birth control methods in preventing pregnancy.
    • ECPs do not prevent STDs.
    • Here is some care advice that should help.
  2. Ulipristal (Ella, EllaOne):
    • One must have a prescription to get ulipristal.
    • It may work somewhat better than over-the-counter ECP. Especially, when used between 72 to 120 hours after unprotected sex.
    • It also appears that it works better than over-the-counter ECP in obese women.
  3. Side Effects of Ella:
    • Headache (18%)
    • Abdominal pain (12%)
    • Nausea (12%)
    • Menstrual cramps (9%)
    • Fatigue (6%)
    • Dizziness (5%).
  4. Call Your Doctor If:
    • You have other questions or concerns

Home Urine Pregnancy Tests

  1. What You Should Know:
    • Home pregnancy tests do not cost much and are easy to use. Most drugstores sell these tests over-the-counter (OTC).
    • Urine pregnancy tests are very accurate. They can often tell if you are pregnant during the first week after your missed period. This will be 2 weeks after you ovulate.
    • The test works best with urine from when you first wake up in the morning.
    • If you believe you are pregnant and the home test is negative, repeat it in 3-5 days. You should also talk to your doctor about other testing.
    • The pregnancy test may not work right if there is blood in your urine. A small amount of blood should not cause a problem.
    • You can find more information at: Pregnancy Tests.
  2. Pregnancy Test, When in Doubt:
    • If there is a chance that you might be pregnant, use a urine pregnancy test.
    • You can buy a pregnancy test at the drugstore.
    • It works best first thing in the morning.
    • Follow all package instructions.
  3. Call Your Doctor If:
    • Pregnancy test is positive or you have trouble with the at-home test
    • You have more questions
    • You get worse

Additional Resources

  1. Emergency Contraception Hotline - United States:
    • Run by the Association or Reproductive Health Professionals
    • Hotline has information and phone numbers of ECP providers.
    • Toll-free phone number: 800-584-9911
    • Their website is also helpful: http://ec.princeton.edu/providers/index.html
  2. Internet Resources:

And remember, contact your doctor if you develop any of the 'Call Your Doctor' symptoms.

Disclaimer: This information is not intended to be a substitute for professional medical advice. It is provided for educational purposes only. You assume full responsibility for how you choose to use this information.


Last Reviewed: 10/18/2017 1:25:57 AM
Last Updated: 5/7/2017 1:36:03 PM

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