It’s easy to get caught up in a moment of passion. Birth control may be the absolute last thing you’re thinking about. That is, until later.
Afterward is when you may think about how you haven’t been taking the pill regularly as directed. Or you took out your vaginal ring early this month. Or you remember that your patch hasn’t been staying in place very well.
Then, there’s the possibility that the condom your partner was wearing broke. Or perhaps you had sex without any protection whatsoever.
Any of these are good reasons to use emergency contraception. It might be the only way to keep you from getting pregnant after sex. That moment of passion should be a great memory, not a nightmare.
Fortunately, emergency contraception is readily available and effective. Step 1 is understanding how emergency contraception works.
Time Is of the Essence
In the event of any type of emergency, time is of the essence. The more quickly you act, the better your chances of achieving the outcome you want. In this case, that’s preventing pregnancy by taking a “morning after” pill.
There are two types of emergency contraception pills (ECPs) approved for use in the U.S. They must be taken within three to five days after unprotected sex to work. However, the sooner they’re taken, the better.
You might be wondering how quickly you can get ECPs. Some online providers may be able to prescribe and ship ella, or ulipristal acetate, straight to your door overnight. This type of emergency contraception is effective when used within five days of unprotected sex.
Plan B One-Step is available over the counter to women of any age, but it must be taken within three days. You’ll likely need to make a trip to the pharmacy, but it doesn’t require a prescription.
You also have the option of keeping either method as a medicine cabinet staple. That way, if the need arises, you can take it immediately and relax.
The Science Behind Emergency Contraception
Conception isn’t instantaneous. Sperm can survive for up to six days, and if you ovulate during that time, you could conceive. Ovulation can be variable, so don’t rely on knowing for sure when it will occur.
Ulipristal acetate works by prohibiting or slowing the ovaries from releasing eggs. It also makes the lining of the uterus hostile to implantation of a fertilized egg. Ulipristal is not a hormone, but it blocks the hormones necessary for conception.
Plan B and similar generic brands contain levonorgestrel, a progestin. It works like regular hormonal progestin-only birth control but uses a significantly higher dose. It’s designed to stop the release of eggs and prevent sperm from reaching any eggs already released.
There are levonorgestrel brands that require two doses. You take the first pill within three days of unprotected intercourse and the second 12 hours later. They are available without a prescription to women ages 17 and older.
Copper IUDs can provide both emergency contraception and effective birth control for up to 12 years. Copper causes an inflammatory uterine response that kills sperm. For use as emergency contraception, a healthcare professional must insert the IUD within five days of unprotected sex.
The Efficacy of Emergency Contraception
Taken within 72 hours of unprotected sex, ella and levonorgestrel are approximately 85% effective. However, the efficacy of levonorgestrel declines after 48 hours, whereas ella remains just as effective for up to 120 hours.
The copper IUD is 99% effective at preventing pregnancy if inserted within five days. Of course, you’re then committing to it as a birth control method, at least for a while.
You should not use any form of hormonal birth control for five days after taking ella. Doing so can significantly reduce its efficacy rate for pregnancy prevention. Use a condom, diaphragm, or other non hormonal method until you start your next period.
ECPs can be less effective for women with a body mass index (BMI) of 30 or higher. Studies have indicated that ella is more effective than levonorgestrel in women who weigh between 165 and 195 pounds. Women who weigh more than 195 pounds should talk to their doctor about the most effective option.
ECPs may be less effective if you are also taking certain medications, including barbiturates. Even an herbal like St. John’s Wort can reduce their efficacy.
Don’t confuse emergency contraception with the abortion pill. Emergency contraception is designed to prevent fertilization of an egg. It does not terminate an existing pregnancy.
What’s the Downside of Emergency Contraception?
Emergency contraception has few potential side effects that usually last only a few days for women who do experience them. It may spur or delay your normal period or result in lighter or heavier bleeding. Side effects may also include headache, fatigue, dizziness, nausea, vomiting, tender breasts, and abdominal pain and cramps.
Keep in mind that levonorgestrel is hormonal. It doesn’t contain the estrogen that presents certain increased risks for things like stroke and blood clots. But you should still talk to your doctor about taking progestin before you have an emergency.
Neither ella nor levonorgestrel should be used as regular methods of birth control. Routine birth control methods are more effective than ECPs. You should also note that no emergency contraception protects you for sexually transmitted infections (STIs).
In the event of an emergency, your choices for morning-after pregnancy prevention are highly effective. The rest of the time, you should be using a routine birth control method and even have a backup if you need it. Condoms, for example, provide extra protection against both pregnancy and STIs.
You don’t have to let the heat of the moment turn into motherhood. When you’re thinking clearly again, consider any issues you’ve had recently with your routine birth control method. In the event of a missed pill or a birth control method failure, it’s better to be safe than sorry.
When in doubt, reach for the ECP in your medicine cabinet. Text your online birth control provider for an overnight delivery. Or make the trip to the pharmacy for an over-the-counter dose of Plan B.
Just remember that you have effective options that might keep you from getting pregnant after unprotected sex. When in doubt, there’s every reason to use emergency contraception to provide extra protection and peace of mind.