Emergency contraception

Emergency contraception

An image of an emergency contraception pill

Emergency contraception (EC) (sometimes called the “morning after pill”) can stop a pregnancy before it starts by delaying ovulation. There are three different kinds of EC: an over-the-counter pill, a prescription-only pill (called ella), and certain IUDs.

Both the over-the-counter pill and the prescription-only pill work if you take them within five days (or 120 hours) after having unprotected penis-in-vagina sex. The sooner you take EC pills, the more effective they are, but prescription-only EC is more likely to be effective on the fifth day after unprotected sex than over-the-counter EC is. So it’s a good idea to get EC in advance, so that if you need it in the future, you’ll have it on hand and can start it as soon as possible.

Some people think that the emergency contraception pill is the same as the abortion pill, but they’re actually completely different. Both types of emergency contraception pills work by preventing ovulation (the release of an egg from one of your ovaries) during your current menstrual cycle. If you don’t ovulate, then there’s no egg for your partner’s sperm to fertilize. The abortion pill, on the other hand, stops a pregnancy that has already started (which means you’ve ovulated, the egg has been fertilized, and the fertilized egg has implanted in your uterus). Then it brings on your period, which flushes everything out of your uterus.

While EC pills are the most well-known kind of emergency contraception, the most effective kind of EC is actually having an IUD inserted within five days of having unprotected sex.

There are three IUDs that we know work as EC: Paragard, LILETTA, and Mirena. Not only can they prevent a pregnancy from starting after you’ve had unprotected sex, but they can also act as an extremely effective birth control method moving forward.

Types of Emergency Contraceptions

Over-the-counter emergency contraception pill

Better known by the brand name Plan B or as “the morning-after pill,” over-the-counter emergency contraception (EC) is an easy-to-get medication containing the hormone levonorgestrel. It works to prevent pregnancy by delaying ovulation when it’s taken within five days (120 hours) after having unprotected sex, but it is more effective the sooner you take it.

You don’t need a prescription to get it, and anyone, no matter how old you are or your gender, can get it at drugstores, at grocery stores, in vending machines, at health centers, online, and from many other places.

While this type of emergency contraception is the easiest kind to get your hands on, it’s not the best option for everyone. Over-the-counter emergency contraception may not be as effective for people who weigh 165 pounds or more. (If that’s you, don’t worry—there are other options.)

Prescription-only emergency contraception pill (ella)

Ella is an emergency contraception (EC) pill that you can only get with a prescription. It works to prevent pregnancy by delaying ovulation when it’s taken within five days (120 hours) after having unprotected sex. Ella is more likely than over-the-counter EC to be effective at preventing pregnancy on the fifth day after unprotected sex. You need a prescription to get ella, so you will have to see a health care provider in person or via telehealth. Ella may not work as well for people who weigh 195 pounds or more. (If that’s you, don’t worry—there are other options.)

IUDs as emergency contraception

There are three different IUDs that can be used as emergency contraception (EC) if they’re inserted within five days (120 hours) of having unprotected sex. They are the non-hormonal/copper IUD (Paragard) and the two hormonal IUDs that contain 52mg of levonorgestrel (LILETTA and Mirena).

IUDs are the most effective form of EC—they’re 99.9% effective at preventing pregnancy after unprotected sex. Once you’ve had it inserted, you can keep the IUD in and use it as birth control for up to eight years (for Mirena and LILETTA) or up to 12 years (for Paragard). Or if you only want to use it as emergency contraception and not as birth control going forward, you can have it removed a few weeks after having it inserted.

Details
Emergency contraception (EC) (sometimes called the “morning after pill”) can stop a pregnancy before it starts by delaying ovulation. There are three different kinds of EC: an over-the-counter pill, a prescription-only pill (called ella), and certain IUDs. Both the over-the-counter pill and the prescription-only pill work if you take them within five days (or 120 hours) after having unprotected penis-in-vagina sex. The sooner you take EC pills, the more effective they are, but prescription-only EC is more likely to be effective on the fifth day after unprotected sex than over-the-counter EC is. So it’s a good idea to get EC in advance, so that if you need it in the future, you’ll have it on hand and can start it as soon as possible. Some people think that the emergency contraception pill is the same as the abortion pill, but they’re actually completely different. Both types of emergency contraception pills work by preventing ovulation (the release of an egg from one of your ovaries) during your current menstrual cycle. If you don’t ovulate, then there’s no egg for your partner’s sperm to fertilize. The abortion pill, on the other hand, stops a pregnancy that has already started (which means you’ve ovulated, the egg has been fertilized, and the fertilized egg has implanted in your uterus). Then it brings on your period, which flushes everything out of your uterus. While EC pills are the most well-known kind of emergency contraception, the most effective kind of EC is actually having an IUD inserted within five days of having unprotected sex. There are three IUDs that we know work as EC: Paragard, LILETTA, and Mirena. Not only can they prevent a pregnancy from starting after you’ve had unprotected sex, but they can also act as an extremely effective birth control method moving forward.
The price of EC can vary a lot depending on where you get it (pharmacy vs. health center) and which type you decide to use. Keep in mind that if you buy over-the-counter EC, it won't necessarily be covered by health insurance. ### Prices for Paragard* * **This method may be [free or low-cost for you](/free_birth_control)** * **With Medicaid:** Free * **With insurance:** [Free under most plans](/features/257) * **Without insurance:** Depending on your income, you may be able to go to [a low-cost clinic](/free_birth_control) to get Paragard at reduced cost. The full price of Paragard can range from $500 - $932. To see how this translates over a year, here’s what it would cost to pay for Paragard month-to-month at full price. * **Cost per month over one year:** $41 - $77 * **Cost per month over five years:** $8 - $15 * **Cost per month over 10 years:** $4 - $7 * **Payment assistance:** If you don't have insurance, the manufacturer offers payment plans where you can make 4 or 12 monthly payments. Contact the manufacturer at Paragard.com or 1-877-727-2427 to find out more. Also, check with your [local family planning clinics](/where_to_get_it) to find out if they offer free or low-cost IUDs (many do). ### Prices for ella:* * **With Medicaid:** Free * **With insurance:** [Free under most plans](/features/257), though if you order it online or get it at the pharmacy you may need to claim it with your insurance company to get it covered. * **Without insurance:** ella is available online through an [online health care prescription service, Kwikmed](http://www.ella-kwikmed.com/) and through [PRJKT RUBY](https://www.prjktruby.com/) for a flat rate of $67.00 including next-day delivery. * **Payment assistance:** Check with [your local family planning clinics](/where_to_get_it) to find out if they offer free or low cost EC (most do). ### Prices for Plan B One-Step and generic levonorgestrel-based EC pills:* * **With Medicaid:** Free * **With insurance:** [Free if you can get a prescription](/features/257) (otherwise see the "without insurance" section). * **Without insurance:** $35 - $49.99 in stores and pharmacies; $21.00 - $49.99 online. #### In-store vendors Levonorgestrel-based EC pills are sold without a prescription at CVS, Target, Walgreens, Walmart, and many other stores and pharmacies. Prices can range from $25 - $39.99. #### Online vendors Tip: If it's not an emergency and you just want to have some EC on hand, you can get EC from [AfterPill.com](https://afterpill.com) for $25 including standard shipping. We found Plan B One-Step and some of its generic forms including AfterPill, Take Action, Next Choice, My Way, and EContra EZ for sale through a bunch of different websites: #### Plan B One-Step * Amazon.com: $31.60 - $38.50 * CVS.com: $49.99 * Drugstore.com: $49.99 * RiteAid.com: $49.99 * Target.com: $49.99 * Walgreens.com: $49.99 * Walmart.com: $46.87 #### AfterPill * AfterPill.com: $25.00 * Amazon.com: $23.35 - $30.00 #### EContra EZ * PRJKTRUBY.com: $25.00 #### My Way * Amazon.com: $30.50 * RightAid.com: $39.99 #### Next Choice * Drugstore.com: $39.99 #### Take Action * Amazon.com: $24.70 * CVS.com: $39.99 * Drugstore.com: $39.99 * Target.com: $39.99 * Walgreens.com: $39.99 * Walmart.com: $34.78 _Note: These prices are averaged—including taxes and standard shipping costs—from a survey of select online vendors as of June 2016. Prices may change over time._ * **Payment assistance:** Check with [your local family planning clinics](/where_to_get_it) to find out if they offer free or low cost EC (most do). Also, manufacturers will sometimes offer money-saving coupons on their websites.

Emergency Contraception isn’t a method you should rely on all the time—there are much more effective methods out there. But if you have unprotected sex, it’s the quickest and easiest “after-the-fact” option out there. Here are the different types you can choose from.

####Copper-T IUD This is [the most effective](/features/110) EC there is. If you get the Paragard [IUD](/birth-control/iud#details_tab) inserted within 5 days after unprotected sex, it can lower the chance of pregnancy by 99.9%. You’ll need to make an appointment with a health care provider to have this procedure. ####ella You need a prescription to pick up [ella](/features/87) at a local pharmacy. In some states, you can order it from an [online pharmacy](https://www.prjktruby.com/products/ella/) without getting a prescription first (they handle that for you on their website). There’s no age limit to access ella. Take the one-pill formula within 5 days after unprotected sex. ####Levonorgestrel-based pills [Levonorgestrel-based EC pills are available off the shelf](/features/285) at pharmacies and grocery stores to anyone with no age restrictions. That means you should be able to buy Plan B One-Step or generic options like Next Choice One Dose, My Way, and Levonorgestrel without having a prescription or showing your ID. All levonorgestrel-based EC pills work like birth control pills, but at a much higher dose and taken temporarily. Best used as soon as possible, though they can be taken up to 5 days after unprotected sex.

Plan B One-Step, Next Choice One Dose, and My Way consist of just one pill that's to be taken as soon as possible after unprotected sex. (The original Plan B consisted of two pills and is no longer being sold.)

Next Choice and Levonorgestrel are both two-pill formulas. The instructions say to take one pill right away and the second 12 hours later, but research shows you can also take both pills at the same time.
Remember: Use EC as soon as possible after you’ve had unprotected sex. The sooner you take it, the better—within 24-hours to three days is ideal. But EC will still reduce your risk of pregnancy for up to 5 days. (The instructions for Plan B and Next Choice say to take it within 72 hours after sex, but studies show that Plan B One-Step, Next Choice, and Levonorgestrel can be taken up to 5 days after sex.)

There are positive and negative things to say about each and every method. And everyone's different—so what you experience may not be the same as what your friend experiences.

The Positive

Positive “side effects”? You bet. There are actually lots of things about birth control that are good for your body as well as your sex life.

The Negative

Everyone worries about negative side effects, but for many women, they’re not a problem. And if you do experience side effects with EC, they’ll probably go away after 24 hours.
Do you have questions about Emergency contraception? Visit Bedsider.org for answers to many of the most popular questions about this method of birth control.