Essential Guide to Emergency Contraception Options
If a condom breaks, if you missed a pill, if you are assaulted, and you are worried that it could lead to the birth of a baby, you may still have time to prevent this pregnancy. You have to act quickly (within a few days) and you have three options: an over-the-counter pill, a prescription pill, or a copper IUD. Any of them, if taken on time, has a good chance of preventing pregnancy.
(And if you’ve been attacked, you can get help here through the National Sexual Violence Hotline and other resources on the National Rape, Abuse and Incest Network .)
Pregnancy does not start the moment you have sex . The female reproductive system stores sperm for several days until the ovary is ready to release an egg. So, if you can prevent ovulation (the release of an egg), you can prevent pregnancy.
You only have a few days to do this, and none of the emergency contraception (EC) methods are 100% effective. So it is not reliable and should definitely not be your first line of defense against pregnancy. You have many birth control methods that you can use before intercourse. Compared to ECs, regular contraception is cheaper, less unpleasant (because ECs have minor but annoying side effects ), and more effective.
All EC methods we discuss here should be covered by most insurance plans under the Affordable Care Act . We look at the basic facts about each, but if you want more information, a great place to start is not -2-late.com , run by Princeton University’s Demographic Research Administration in conjunction with the Reproductive Health Association. Professionals . This website is not affiliated with pharmaceutical companies and has links to research papers so you can play around a bit, making sure you get all the facts.
These methods do not terminate an existing pregnancy. If you are in that boat, what you are looking for is called a medical (as in “cure”) abortion , and it basically involves taking a pill in the doctor’s office. With this National Abortion Federation tool, you can find a health care provider and explain state laws.
Intrauterine device
Name: Copper IUD ( Paragard brand) Cost: $ 500 to $ 900 according to Planned Parenthood , but insurance must cover it. The cost will vary from supplier to supplier. Availability: Office visit required. Efficiency: 99% or more. When to receive: within 5 days
You may not think of an IUD as an emergency contraception, but it is actually the most effective option on our list. Copper ions secreted by the IUD affect the ability of sperm to swim and fertilize an egg , and can also interfere with the implantation of a fertilized egg . It’s almost 100% effective if you can insert it within five days of unprotected sex.
Since the IUD is a long-acting birth control method, it can prevent the pregnancy you are currently worried about and then continue to work for another ten years. You can remove it at any time, so if after two years you decide that you are ready to have children, you just need to visit the office again and then you are ready to go.
The downside of the copper IUD is that it is most difficult to obtain on time because you have to visit the office to get it installed. Call and make sure your provider has one on the shelf and can get it to you quickly. (Some vendors do not stock them because they are very expensive.)
Many years ago, copper IUDs were only intended for women who already had children, so young women who asked for their doctor were often simply refused. This restriction was lifted in 2005 , so no one should deny you food based on your age or having a baby. If they do, hang up and find someone else. This guide to family planning clinics can come in handy.
Tablet “Recipe”
Name: Ulipristal Acetate (brand name Ella ) Cost: about $ 40 at the pharmacy Availability: Ella is a prescription only, but you have options Potency: about 70% , but less for women with a BMI over 35 When to take: Within five days
If you can get your gynecologist to call your local pharmacy, great, you get it for about $ 40 (or free with insurance). Otherwise, Ella’s manufacturer recommends an online pharmacy called Prjkt Ruby, where doctors can assess your situation and prescribe medication for you without a personal appointment . They don’t take insurance, but the doctor’s fee and next day delivery are included in the $ 67 price tag. Another online pharmacy, KwikMed, struck a similar deal for $ 59.
Ella blocks progesterone, a hormone needed to start pregnancy. Ella appears to be preventing pregnancy by preventing the ovary from releasing an egg . Usually, egg or ovulation occurs about two weeks before your period. Sex a few days before ovulation can (although not guaranteed) lead to pregnancy.
So if you can get Ella between sex and ovulation, it could prevent the egg and sperm from ever meeting. It’s okay if you don’t know when you should ovulate – you can just take Ella within five days of having sex. Better earlier, because if you ovulate on the third day and take the drug on the fourth, you may be late.
An important note about both pill options: they are less effective in women with a high BMI . If you are overweight, Ella may be more effective for you than levonorgestrel, which we discuss below. However, weight is not an issue for the copper IUD, so this is another argument in favor of the IUD.
Over-the-counter pills
Name: Levonorgestrel (many brands, including Plan B One Step ) Cost: About $ 25 Availability: Available over the counter for everyone (you can even have a friend pick it up for you ) Efficacy: 89% average, drops more time and less for women body mass index over 25 When to take: Within five days, but the sooner you take, the more effective.
This is the least efficient method, but the easiest to obtain. If you can take it within the first 24 hours after unprotected sex, it can be as effective as 95%. On the second and third day, the efficiency is 61% . You can still take it on the fourth and fifth day, but the effectiveness is even lower.
Since you can buy it so easily, you can even order it now and keep it in your medicine cabinet in case you or your friend ever needs it. But since the copper IUD is more effective, consider whether you can get it on time instead of collecting a supply of levonorgestrel. The choice between Ella and Plan B depends on the timing: levonorgestrel may be the best option if you can take it right away, but if you’ve waited a day, you’re better off with Ella.
Like Ella, levonorgestrel prevents ovulation, so sperm cannot meet the egg. But where Ella directly blocks progesterone, levonorgestrel works ahead of time to prevent the hormone surge that occurs before ovulation. This means that the amount of time the drug can take is shorter, and it becomes less and less effective as ovulation approaches. Therefore, even if it is sometimes called a “pill for the morning”, do not wait until the morning, if you have it at hand – take it right now.
Conventional birth control pills
Another option is that you can prevent ovulation in an emergency with a very large dose of regular birth control pills. They work similarly to Plan B and should also be adopted as soon as possible. Not-2-late has a chart showing dosages for different brands of pills . This option really only makes sense if you have birth control pills but haven’t taken them. If this is the case, you should still call your ISP and talk to them about finding a method (maybe an IUD?) That will work better for you in the future.