Emergency contraception basic information

Dear K, 

It sounds like you're searching for emergency contraception (EC), which can help to prevent a pregnancy if taken after sex that occurred when a birth control method failed or wasn’t used. You have a few options when it comes to EC. The kind you’re referring to is probably the EC (sometimes called the “morning after pill”) with levonorgestrel. This can be taken up to 72 hours after sex to prevent pregnancy, but there are a couple other types of EC that are effective up to 120 hours later. There are a few considerations to make when choosing which type of EC is best for you, but in any case, your best bet is to take it as soon as possible for greatest effectiveness. 

One of the most common types of EC is a one-dose pill containing levonorgestrel, which is a synthetic hormone also used in some forms of birth control. In the United States, it’s available over the counter. This means that you don't have to ask a pharmacist for it, and it can be sold to you without proof of age or a prescription. The cost is usually between 11 and 50 dollars depending on location and brand. Before you head out to the pharmacy or drugstore, it may be a good idea to call to see which types of EC are available. 

The other two methods with longer windows of effectiveness (up to 120 hours after sex) are ulipristal acetate (the brand available in the US is ella®) and a copper intrauterine device (IUD). Ulipristal acetate, like levonorgestrel, is a one-dose EC pill. It does require a prescription and can be a little pricier, typically in the 50 to 90 dollar range. One caveat to ulipristal acetate’s use is that it can interfere with hormonal birth control (BC) methods (such as the pill, patch, ring, or shot). So, it’s recommended to pause your hormonal birth control for five days after taking ulipristal acetate and use a barrier method (such as condoms) until your next menstrual period. On the other hand, the copper IUD is non-hormonal and might be an attractive option if you’ve been looking for a regular birth control method. It must be inserted into the uterus by a health care provider within 120 hours after sex to be effective as a form of EC, but it can remain in the uterus for up to twelve years as a long-acting, reversible birth control method. If you decide to go this route, it may be a good idea to call your provider as soon as possible to request an appointment for an IUD insertion within that 120-hour window. 

Another consideration as you decide on the type of EC you might like to use: a person’s weight can impact the effectiveness of some EC methods. Research has found that the levonorgestrel versions of EC pills may be less effective for people with a body mass index (BMI) of 26 or more, and ulipristal acetate may be less effective for those with a BMI of 35 or more. The effectiveness of the copper IUD isn’t affected by weight. That said, using any EC is going to be more effective than using none, so even for those with a higher BMI, it may have some benefits. 

Lastly, if EC is too expensive, there are a few potential options. Many family planning clinics, such as Planned Parenthood, are able to offer EC at a reduced rate. Additionally, sometimes public hospitals will offer free EC pills. Alternatively, if you have health insurance or Medicaid, your plan may cover these methods at a reduced or no out-of-pocket cost. One word of note — if you’re on someone else’s health insurance, they may be able to see your prescription EC on the insurance bill. While you’re at it, you might also consider getting another dose of EC to have on-hand so you have it when you need it and are able to take it as soon as possible in the future. 

Best of luck!