Is it too late to take emergency contraception?

Originally Published: April 10, 2014
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Dear Alice,

My boyfriend and I had an "accident" Friday morning, around 3 am. We are not doing well economically, so we have been looking for a free clinic that is open on the weekend. We didn't have much luck finding anything yesterday or today. The only option I have is to wait until Monday morning, when the local free clinic opens where I can get a Plan B contraceptive free. My question is, will it be too late and will I get pregnant?

The 72 hr. time limit is over Monday at 3 am, but clinics don't open until about 8 am!

Dear Reader,

Accidents such as these certainly happen and can be quite distressing. Emergency contraception (EC), is a very effective method of pregnancy prevention, yet you are concerned you are stretching the time limit for its effectiveness. Well, you are in luck.

It’s true that  most EC is more likely to work if you take it very soon after sex that occurs when a birth control method failed or was not used. It’s best within the 72-hour window, about 89 percent effective. But it does not expire after 72 hours — it may still be effective for as long as five days (120 hours) after having sex. The exact effectiveness that many days after is not fully known, partially because there are many other factors besides when the EC was taken, such as age or regularity of periods, that may influence it's effectiveness. But you will be taking it just after the 72-hour window, so you may still fall within that 89 percent time period.

You were wanting to go to a clinic in order to get Plan B for free, but many are not aware that  Plan B One-Step® and other generic one-pill formulations of EC can be found on the shelves at your local drugstores and pharmacies. No prescriptions are needed and there are no age restrictions to purchase them. Depending on the pharmacy you use, Plan B One-Step®, Next Choice®, My Way®, and Ella®, generally cost anywhere from $35.00 to $60.00 in the United States (Note: Ella® is prescription only). You might also want to check the Plan B site as they frequently offer coupons. Your clinic may offer free services and free EC, in which case waiting for the clinic to open may make sense financially. But if the clinic will charge you even a small fee for the visit, it may be worth going directly to a pharmacy, not only because you could get EC more quickly, but also because you could bypass any fee you’d have to pay at the clinic to see a health care provider. If you live in one of the five boroughs of New York City, EC is available, 24 hours a day, at any public hospital for free. In the future, you might also consider picking up an extra dose to have on hand so that you can take it as soon as possible when needed after sex (it’s never a bad idea to back up your birth control!).

There are other “morning after” pregnancy prevention options out there. If you are in need of EC and are also considering an effective, long-term method of birth control, you might consider the intrauterine device (IUD). An IUD can be inserted up to 120 hours after sex to prevent pregnancy, but it requires a visit to your health care provider. Columbia students can make an appointment by contacting Medical Services (Morningside) or the Student Health Service (CUMC). For more information about EC and other long-term birth control methods, check out Alice!’s Contraception archives.

Alice