Emergency Contraception: What You Need to Know

What is emergency contraception?

Emergency contraception (EC) can prevent pregnancy after unprotected sexual intercourse.¹ EC can be used if the primary form of contraception fails, if you have unplanned sex, or if you are forced to have sex. It is often known as “the morning after pill,” but this name is misleading because EC can prevent pregnancy up to 120 hours (five days) after unprotected sex. However, the sooner it is taken, the better. Used within 12 hours, EC reduces the risk of pregnancy by up to 99%.

How EC works

EC is simply regular birth control pills in higher doses. It can prevent pregnancy by delaying ovulation (when eggs are released from the ovary) or preventing fertilization (when an egg and sperm join). It has no proven effect on preventing implantation (when a fertilized egg attaches to the uterus). EC prevents a pregnancy—it does not end one. Although the directions on the Plan B packaging instruct you to take the two doses 12 hours apart, recent studies have shown that it is more effective to take both doses together, as soon as possible after sex.

EC cannot cause an abortion

EC is often confused with the “abortion pill” (mifepristone or RU-486). This pill is taken up to nine weeks into pregnancy. Mifepristone causes abortion; EC does not.

If you are already pregnant, EC will not harm the fetus.

Some people may take EC without realizing they are already pregnant. There is no evidence that EC will harm an established pregnancy. Babies born to women who continue taking birth control pills before finding out that they are pregnant do not have higher rates of birth defects.

EC is extremely safe

Even women who cannot take oral contraceptives for birth control can take them for emergency contraception because they are only used for a brief period of time. Some women experience temporary side effects when taking emergency contraceptive pills – mainly nausea or vomiting. Less common side effects include temporary headache, breast tenderness, dizziness, fluid retention, mood changes, menstrual irregularity or abdominal cramps. These side effects rarely last longer than a day or two.

If vomiting occurs it is not usually necessary to take an additional dose because the medicine has been absorbed into the bloodstream. However, some clinicians recommend an additional dose if vomiting occurs within one hour.

EC is helpful, but it should not replace regular birth control

Emergency contraception can prevent most pregnancies that would result from unprotected intercourse, but it is still not as effective as other contraceptive methods, and it does not prevent sexually transmitted infections. Taken within 72 hours of unprotected sex, EC reduces the risk of pregnancy by up to 89% (although it is effective if taken within 120 hours of unprotected sex). Regular oral birth control pills are 97-99.9% effective in preventing pregnancy. Male latex condoms are 97% effective if used correctly and consistently. A barrier method (such as a latex condom) is necessary to protect against sexually transmitted infections.

EC is not new—only newly available for general use

Women, including victims of rape, have been given post-coital (occurring after sex) birth control pills to prevent pregnancy for 30 years. The Food and Drug Administration (FDA) approved the first pills specifically packaged for this purpose, Preven, in 1998.² In 1999, the FDA approved Plan B, which causes fewer side effects. Plan B was approved for sales over-the-counter (OTC) to individuals 18 years and older in 2006.

How to get EC

Plan B is available over the counter (without a prescription) to individuals 18 years of age or older with a valid government issued I.D. Women under 18 need a prescription. Therefore, Plan B is kept behind the counter and only available when a pharmacist is on duty.

Minors do not need their parents’ permission to get emergency contraception (or any other kind of birth control).

Many family planning clinics, college health services, hospitals and providers who provide gynecological services offer EC as well. Some hospital emergency rooms will only provide EC to women that have been raped or forced to have unwanted sex. This is especially true of Catholic hospitals whose policies are based on Catholic teachings that prohibit the use of artifical contraception.

The American College of Obstetricians and Gynecologists (ACOG) recommends that women keep a dose of EC at home in case of an emergency. The American College of Obstetricians and Gynecologists (ACOG) recommends that women keep a dose of EC at home in case of an emergency.

WHAT IS THE COST OF EC?

The cost of Plan B can vary depending on where you purchase it. At commercial pharmacies, the price can range from $30-$60. Many family planning clinics and colleges offer emergency contraception to their patients at a reduced cost or even for free. Some states include Plan B in their Medicaid coverage.

Pharmacists and EC refusals

Four states (AR, GA, MS, SD) legally allow pharmacists to refuse to dispense medication (contraception including emergency contraception) based on their personal beliefs. More states are considering similar legislation. Seven states (CA, IL, ME, MA, NV, NJ, WA) have laws and policies that require pharmacists to fill valid prescriptions. Seven states (AL, DE, NY, NC, OR, PA, TX) have pharmacy board policies prohibiting pharmacists’ obstruction of patient access to medication or refusal to transfer or referral. For more on state policies and responses to refusals see the National Women’s Law Center’s Pharmacy Refusal Project.

Many Catholic hospitals will only provide EC to women if they have been raped or forced to have unwanted sex (if they provide it at all). For more information on Catholic hospitals visit Catholics for Choice.

Hotlines and Websites

A confidential hotline maintains a list of providers of emergency contraception across the country. A recorded message gives names addresses and phone numbers of five nearby providers based on the number you call from.

Toll-free hotline: 1-888-NOT-2-LATE

Website address: www.not-2-late.com

Planned Parenthood also provides emergency contraceptive services. To find the nearest Planned Parenthood, call toll-free: 1-800-230-PLAN

The website www.getthepill.com offers online prescriptions for both EC and birth control pills.

Pennsylvania Coalition Against Rape Information and Referral Line: 1-888-772-7227

If you have been raped, seek care at an emergency room immediately.

Hospital emergency rooms provide medications to prevent sexually transmitted infections, counseling services and forensic evidence collection. Many hospitals also offer EC or prescriptions for EC. However, you must seek treatment within three to five days of the assault for EC to be effective. The hospital staff should offer to connect you with accompaniment services from the local rape crisis center. Ask for this free, confidential service.

If you are not offered EC at the hospital, you or your rape crisis counselor should ask for it. If the hospital refuses to provide it, seek EC from your physician or clinic as soon as possible. Please contact the Duvall Project if the hospital did not provide you with EC.

If you choose not to go to the emergency department, it is advisable to seek EC and treatment for sexually transmitted infections through your private health care practitioner or a local clinic. The Pennsylvania Coalition Against Rape Information and Referral Line is 1-888-772-7227. This 24-hour, confidential number will connect you to a local rape crisis counselor. You may also visit the Pennsylvania Coalition Against Rape website, www.pcar.org, which provides useful information for victims, their families and friends.

¹ Another form of emergency contraception is the copper-T IUD, which must be inserted by a physician. The copper-T IUD can be used up to 8 days after unprotected sex and can remain in the uterus for up to 10 years afterwards for use as birth control. IUDs are not appropriate for sexual assault victims due to possible sexually transmitted infections.

² As of August 2004, Preven is being phased out of production.