Everything You Need to Know About Emergency Contraception (Before You Need It)
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People have sex without adequate protection for a variety of reasons: your protection didn’t work, you didn’t have any protection, you thought another form of protection would cover you, your partner lied about protection, you didn’t think you could get pregnant because you’re breastfeeding are breastfeeding or not having a period, did not consent to sex, or changed your mind about getting pregnant after sex. Be that as it may, the result is the same. Penetrative sex, and in rare cases non-penetrative sex, between a person producing sperm and a person who has a uterus means that there is a possibility of pregnancy, and so you are now looking for some kind of emergency contraception.
What is emergency contraception?
Simply put, emergency contraception, or EC, is any procedure or medication that prevents pregnancy after sex. It does not reverse pregnancy and is not an abortion pill. Emergency contraception does not affect your future fertility or your ability to get pregnant in the future.
How to prevent pregnancy after sex? Well, imagine a stopwatch that starts the moment the sperm in question enters the world in any way where it can come into contact with your vagina. Spermatozoa are determined MFs that are known to live, no kidding, for five days inside the cervix and uterus . But until they meet an egg and that egg implants in your uterus, you are not pregnant. Remember the stopwatch: until it reaches 120 hours, you have time to take emergency contraception. (If you want to quickly review your options based on how long it’s been since you’ve had unprotected sex, check out this tool from Planned Parenthood .)
There’s a catch, however: depending on the method, your body, the prescriptions you’re taking, and where you’re in your menstrual cycle, emergency contraception may not always work. So it’s important to know that the earlier you take emergency contraception during those five days, the more likely you are to prevent pregnancy.
What are my options for emergency contraception?
There are three types of emergency contraception. First, you may have heard of pills that can be taken within five days of any sperm incident . The brand names you probably know them by are “Plan B” and “Ella”: “Plan B” is levonorgestrel, and “Ella” (who refers to herself as “ella” in lowercase) is ulipristal. Other brands of levonorgestrel exist, such as Take Action, My Way, Option 2, Preventeza, AfterPill, My Choice, Aftera, and EContra. These drugs work by preventing the ovaries from releasing an egg, and without an egg, the sperm go on a long and pointless journey to nowhere. Levonorgestrel tablets reduce the risk of pregnancy by 81-90% , and ulipristal by 97%. Sounds great, but there are a few major caveats that we’ll discuss below.
The second type of emergency contraception is the implantation of an IUD during this five-day period, in particular, the copper Paraguard IUD or the hormonal IUD Mirena or Liletta. The effectiveness of this method is exceptional – up to 99% – at any point in the ovulation cycle. An IUD is a safe and fantastically reliable birth control method that lasts for years and can be removed at any time if you decide to become pregnant.
But let’s be honest, inserting an IUD is still a procedure that can be expensive and needs to be done immediately (Planning Parenthood will work to prioritize calling you in if you need emergency contraception), and it’s known that this procedure hurt some people. In addition, copper-containing IUDs can sometimes make periods more painful or heavy. For this reason, the recent addition of Mirena and Liletta as an option is welcome as these hormonal IUDs often have the side effect of reducing bleeding and menstrual symptoms.
The last method is not usually recommended, but we will mention it for the sake of completeness: there is a protocol for using standard birth control pills as emergency contraception called the Yuzpe method. He uses combination pills (which use both progesterone and estrogen and are the more common type of birth control pill), of which there are hundreds of brands and types, and each is used slightly differently for emergency contraception. The Yuzpe method has a lower success rate than Plan B, Ella and the IUD – about 75% – and can have many side effects such as vomiting . So while it’s technically one of your options, it’s nowhere near as good as the others.
EC pills may not be suitable for everyone
Plan B and Ella are the most advertised forms of emergency contraception: they are non-invasive and inexpensive, but in some cases they are not the best option.
First, if you’re ovulating, neither Plan B nor Ella will work. Ella can act a little closer to ovulation, so this is often the best choice. It’s often difficult to determine when you ovulate, so using a calculator can help you estimate (usually two weeks after your last period started). Because of this problem over time, it is important to take the pills as soon as possible.
Medications can also interact with oral ECs. If you are taking certain antibiotics, such as rifampin, certain HIV medicines, anticonvulsants, St. John’s wort, or the antifungal drug griseofulvin, Plan B and Ella may not work. In such cases, you may want to consider getting an IUD, even though it may be more difficult to get one on time.
And there is another major problem that affects the performance of many people: weight and BMI.
Your weight may affect the effectiveness of EC tablets.
For Plan B and other levonorgestrel pills, Planned Parenthood and some other organizations’ recommended weight threshold is 165 pounds. For Ella, that’s 194 pounds or 30 BMI. (Both tablets are FDA approved for use by people of all weights, so these are not hard limits.) The effectiveness of these tablets may decrease when you exceed this weight threshold.
It is not clear how much the effectiveness is reduced , but at least one study suggests that it may be 50% less effective. (And before you ask: taking a double dose is not recommended.) Due to another downside of the industrial health complex regarding sexual health, people with wombs and obese people, the best advice for people with a weight threshold is to forget about pills. and get a Navy.
For advice, we turned to Kelly Cleland, Executive Director of the American Society for Emergency Contraception. “The best advice we can give right now if you’re over 194 pounds is to take an ella or get a copper IUD,” she says. Advocating for more research in this underfunded area, Cleland said: “If we look at a map of abortion restrictions across the country and a map of the proportion of people with a BMI over 30, we see a big correlation. In these settings, more effective emergency contraceptive options become even more important.”
To be absolutely clear: the pills are potentially less effective for a heavier person than for a lighter one, but they can still be effective in preventing pregnancy and are much more effective than doing nothing. If this is the only option available to you, you should take advantage.
What to consider when choosing an emergency contraceptive method
Here are three good options: an IUD, which will almost certainly prevent pregnancy, and two types of pills, which can prevent pregnancy. In terms of numbers, IUDs are more efficient, so in theory they would be a better option. However, pills are a much more convenient, less costly, and less expensive option, and IUDs are a long-term commitment, so it’s a tricky equation.
According to Cleland, if you choose the pill, “Ella is more effective for everyone because it works closer to ovulation than Plan B, so if you can get it, we recommend Ella as a first-line emergency option.” birth control pills.” She noted that while Plan B is available over-the-counter on drugstore shelves, ella is sometimes harder to get, but other things being equal, ella has a higher level of potency, a higher weight range, and works closer to ovulation.
It is also important to think about what you will do if the EU fails. This may mean that you need to consider local abortion restrictions when deciding how much risk you are willing to take, especially if your BMI, like the average person in America, is over 30 or 194 pounds. Cleland put it bluntly: “A lot depends on the context you’re in and how important prevention is for each person. If you live in Texas and pregnancy prevention is an immediate priority, the IUD is the most effective option, so it may be your best bet.”
How much does emergency contraception cost and where can I get it?
The Affordable Care Act requires ACA plans to pay for emergency contraception even if you don’t pay your deductible. Your B and Ella plans are insured if you got healthcare.gov or Medicaid and are likely to be covered by most insurance plans otherwise. To find out, call the number on the back of your insurance card. If you don’t have insurance, many states, counties, and even cities have funding programs that can help, and calling your local women’s clinic, such as Planned Parenthood, will help you find out about these options.
If all other options fail, levonorgestrel tablets (Plan B) cost between $25 and $55 and can be bought without a prescription at almost any pharmacy. You may have to ask the pharmacist for it and it may be locked, but you don’t need a prescription or show your ID. If a pharmacist gives you problems getting it because some laws allow them to use religious objections, they usually have to give you information about where you can get it or ask another pharmacist to intervene. No matter how upset you are (and you shouldn’t be!), this is a good time to call Calvary like a chatty friend and get your manager involved, because embarrassment shouldn’t lead to an unwanted pregnancy.
On the other hand, to get Ella, you’ll need a prescription and about $50. But there are ways to quickly get a prescription. First check if the Planned Parenthood app is available in your state and consider other online options like Nurx or PRJKT RUBY . It can be prescribed by your doctor or OB/GYN, as well as by your local family planning office—often without a visit. In some states, a pharmacist may prescribe it. It is covered by the Medicare and ACA insurance plans, and probably also by your private insurance.
Your insurance will likely also cover IUDs, which is good news as they are expensive and often cost $1,000 or more. As with the pill, your clinic will be aware of rebate programs and healthcare initiatives that can bring the cost down to zero, so don’t let cost be a factor in your referral. Remember that an unplanned pregnancy is much more expensive, and clinic staff are trained to help you figure it out.
Don’t forget to take a pregnancy test
If you have been taking Plan B, Ella, or any other EC pill, there is often no mention of the importance of subsequent pregnancy testing . These pills are not body armor. Take a pregnancy test two to three weeks after emergency contraception. In fact, when you take emergency contraception, set a reminder on your calendar or phone to get tested. Buy a test while you go to the pharmacy for Plan B or Ella.
Please don’t take this advice lightly, because if you do get pregnant you have options, but in half of the states in the US those options are very limited and have very tight deadlines. I got pregnant after taking Ella. Take the test.
How to prepare for your future sexual health
Fun fact: You don’t have to be pregnant to have Ella or Plan B on hand. You can buy it in advance and insurance should still cover it. They have a fantastic shelf life: four years for Plan B and three years for Ella. Since you want to take them as soon as possible after sex, keeping them at home is a good move.
Cleland issued a stronger warning: “Ella has been on the US market since 2010, but she is grossly underused. Many healthcare professionals are unaware of ella and only 10-12% of pharmacies keep it in stock for same-day prescriptions.” Pharmacies will order it for you, but time is precious. If you order it in advance, it will be in your bathroom when you need it.
You can order Ella right now by going to any of these online pharmacies:
You can order Plan B or follow-up pregnancy tests from Amazon.