Birth Control

What are Your Emergency Contraception Options?

Emergency Contraception

Emergency contraception (also known as EC for short) is a birth control option that you can use to reduce your risk of getting pregnant after having unprotected sex or contraceptive failure. Some people also refer to emergency contraception as "the morning after pill," but you will soon see that there are other forms of EC. Emergency contraception has been available for more than 30 years. It is a safe and effective method of birth control.

What Types of Emergency Contraception Are Available?

Over the past few years, your emergency contraception options have greatly expanded. Emergency contraception is available in all of the following ways:

  • Plan B One-Step - a progestin-only 1.5 mg levonorgestrel pill
  • Next Choice One Dose - the generic equivalent of Plan B One-Step
  • Fallback Solo - the generic equivalent of Plan B One-Step

**The list for generic alternatives to Plan B One-Step continues to grow.**

Who Should Use Emergency Contraception?

Generally speaking, most women who need emergency contraception can safely use it—this even applies to women who are not usually good candidates to use hormonal birth control as their main form of contraception. Emergency contraception can also be safely used by teenagers.

You may want to use emergency contraception if:

Keep in Mind: This list contains some of the reasons why you may choose to use emergency contraception.

There can be other reasons as well. If you believe that you could have experienced birth control failure in any way, you may want to consider using emergency contraception—just to be safe than sorry.

When Should You Start Emergency Contraception?

In order to reduce your risk of pregnancy, emergency contraception should be started up to five days (120 hours) after unprotected sex. The sooner it is used, the better the chances of preventing pregnancy.

With the morning-after pill Plan B One-Step (and its generic versions, Next Choice One Dose, Take Action, AfterPill, My Way, Fallback Solo, Opcicon One-Step, and EContraEZ), you only need to swallow ONE pill. Next Choice has TWO pills. You should use the morning after pill as soon as possible. The manufacturers suggest that it should be used within 72 hours of contraceptive failure or unprotected sex—but the sooner you take it, the more effective it will most likely be. That being said, the morning after pill may still be useful to take (hopefully to decrease your chances of pregnancy) for up to five days after unprotected sex.

Where Can You Get Emergency Contraception?

Plan B One-Step (and its generic alternatives) can now be purchased over-the-counter by people of any age—thanks to the court case Tummino v. Hamburg.

Next Choice (the two-pill Plan B generic option) is available at pharmacies without a prescription for men and women age 17 or older. You will need to present a valid ID. If you are under 17, a prescription is needed to purchase Next Choice.

Other forms of emergency contraception can only be obtained with a prescription (like Ella) or inserted by a medical professional (like ParaGard IUD), so these EC options require a doctor's appointment.

  • Of Note: Like Plan B One-Step, Take Action, Next Choice One Dose, AfterPill, My Way, Fallback Solo, Opcicon One-Step, and EContraEZ can also be bought with no point of sale or age requirements, meaning they can be purchased over-the-counter to people of any age. 
  • In order to protect the exclusivity clause granted to Plan B One-Step, the FDA has required that the labeling of Next Choice One Dose, AfterPill, Fallback Solo, Opcicon One-Step EContraEZ, and My Way state they are intended for use in women 17 years of age or older. Keep in mind, though, that the one levonorgestrel emergency contraception pill has been shown to be safe for women of all ages. This label requirement has to do with politics rather than safety.
  • Because the manufacturer of Take Action presented the FDA with research on emergency contraception use with the teenage population, this morning after pill does NOT need to follow this labeling requirement.
  • Even though Plan B One-Step, Take Action, Next Choice One Dose, My Way, Fallback Solo, Opcicon One-Step, and EContraEZ are all available over-the-counter, you may still need a prescription (regardless of your age) in order for your insurance to cover the cost of these medications, so be sure to check your health policy's rules.

Because levonorgestrel-based emergency contraception is more effective the sooner you use it, try to save time by calling your pharmacy/drug store ahead of time to make sure that they have these emergency contraceptives in stock.​ Also, keep in mind that some stores may keep these forms of EC at the pharmacy counter, so the pharmacy may be closed even if the store is still open. It may be a good idea to buy a pack of one of the morning after pills to already have at home—this way, if you need it, you can take it immediately (after all, nobody really plans that "accidents"will occur!).

How Does Emergency Contraception Work?

Emergency contraception typically contains the same hormone (a progestin) that is found in some birth control pills. The exact way that EC works, though, is not clear. It is believed that emergency contraception MAY help to reduce the risk of pregnancy by stopping ovulation or by preventing sperm from joining the egg. Research now suggests that hormonal emergency contraception does not prevent a fertilized egg from implanting into the uterine wall. The way emergency birth control works likely depends on where you are in your menstrual cycle.

What Emergency Contraception Is Not

Emergency contraception is not the same thing as an abortion. Plan B One-Step is often confused with the abortion pill (RU486). These two medications serve very different purposes and do not work in the same way.

Emergency contraception can​not end a pregnancy and does not hurt an existing pregnancy. Scientific and medical authorities are in agreement that emergency contraception reduces the risk of pregnancy and helps prevent the need for abortion. That being said, because it is still unknown if Ella causes any risks to a developing fetus, you should not take Ella if you suspect you are already pregnant—take a pregnancy test at your doctor's office before getting this prescription.

Side Effects of Emergency Contraception

Side effects may vary depending on the type of emergency contraception you are using. You should discuss any major side effects with your doctor. This is especially true if you end up vomiting after taking EC as your doctor can advise you if you should take another dose. If you are experiencing any signs of pregnancy after using emergency contraception, it is also important to contact your doctor. Some of the most common pregnancy signs include:

  • missed menstrual period
  • sore or enlarged breasts
  • nausea
  • frequent urination
  • unexplained fatigue
  • headaches

Is Emergency Contraception Effective?

In general, emergency contraception is meant to be a back-up birth control method. It is not as effective as the correct and consistent use of other reversible prescription birth control methods. Also, emergency contraception does not continue to prevent pregnancy during the rest of your menstrual cycle, so other birth control methods should be used after you use EC.

Two main factors influence the effectiveness of emergency contraception:

  • The amount of time that has gone by since the incident of unprotected sex/birth control failure.
  • The point in your cycle when you had sex.

The sooner you use emergency contraception after unprotected sex, the more effective it will be. But, it may also be helpful to know that the closer you are to ovulation (after having unprotected sex or experiencing birth control failure), the less effective emergency contraception will be. 

All methods of emergency contraception reduce the risk of pregnancy by 75 to 99 percent when they are initiated within 72 hours. This means that out of every 100 women who use any EC method, between one to 25 will become pregnant.

How Much Does Emergency Contraception Cost?

The cost for emergency contraception widely varies and depends upon the EC method. Total fees can range from about $25-$65 for Plan B One-Step and its generic alternatives—Next Choice, Next Choice One Dose, My Way, Fallback Solo, Opcicon One-Step, EContraEZ, AfterPill, and Take Action are typically priced around 10 to 20 percent lower than the branded Plan B One-Step. Ella can cost anywhere between $55 to $75, and it can cost up to around $500 to obtain the ParaGard IUD.

STD Protection

No emergency contraception method offers protection from STDs. Women who need emergency contraception may be at more risk for these infections. Women at the most risk are those who:

  • have had unprotected sex with infected partners
  • are victims of sexual assault
  • who use IV drugs or have a partner who does

The morning after pill may be a safer choice for those women at increased risk for STDs, instead of an IUD. This is because bacteria from a preexisting infection can be introduced into the uterus during IUD insertion. If this is left untreated, it can lead to pelvic inflammatory disease.

A Word From Verywell

Almost half (45 percent) of the 6.1 million pregnancies in the United States each year are unintended. Many of these pregnancies are due to not using birth control or contraception failure. Emergency contraception offers you a last chance option to prevent pregnancy. It is a safe and effective option in case that “oops” moment occurs to you. We understand that you may feel embarrassed about buying emergency contraception, but don’t let your emotions cloud your judgment. It is super easy to buy and use emergency contraception. If you are at all unsure as to whether or not to use EC, just remember this rule of thumb: If there is any chance that pregnancy could occur because you had contraception failure or unprotected sex, go get some emergency contraception and take it as soon as possible.

Sources:

Noé G, Croxatto HB, Salvatierra AM, et al. Contraceptive efficacy of emergency contraception with levonorgestrel given before or after ovulationContraception. 2011;84(5):486–492. doi:10.1016/j.contraception.2011.03.006.

Prine L. Emergency contraception, myths and facts. Obstetrics and Gynecology Clinics of North America. 2007;34(1):127–136. doi:10.1016/j.ogc.2007.01.004.

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