Emergency Contraception

Many people have heard of “the morning-after pill”, but few of them understand how it works or what it does. Read on to find out more about how to prevent pregnancy after intercourse has occurred.

Emergency Contraception is a way to prevent pregnancy after intercourse has already occurred and the primary method of birth control fails or was not used. There are a number of different brands of ECP, with two of the most common being Plan B® and Preven®. In general, is a high dose of some of the hormone(s) that are naturally produced in a woman’s body. When a woman takes ECP, these hormones work to prevent or slow down ovulation (the release of the egg) so that by the time the egg is released, all the sperm present in her body should have died. If a sperm has already fertilized the egg, ECP also changes the lining of the uterus, so that the fertilized egg may have difficulty implanting. If a woman is already pregnant when she takes ECP, she will NOT lose the pregnancy as a result of the medication.

ECP is not meant to be used as a woman’s primary method of birth control. It should be used for emergencies only.

ECP can be obtained from a health care provider (like a doctor or a clinic) and can also be purchased online in some states, including Ohio.  However, the brand Plan B® can be purchased over the counter, without a prescription or ID and has no age restriction.

If a woman wants to get ECP from a health care provider, she must first locate one that provides the service. If she needs help finding a provider, there are services that can help her. These services are available online at www.backupyourbirthcontrol.org or by calling 1-888-NOT-2-LATE. It is important for her to schedule an appointment as quickly as possible. Some clinics (like Family Planning) will only give ECP within 72 hours/3 days of unprotected intercourse and others (like Planned Parenthood) will only give it within 120 hours/5 days or unprotected intercourse.

Many health care providers will first administer a pregnancy test to make sure that a woman is not already pregnant when taking ECP. If the pregnancy test is negative (that is, if she’s not pregnant) and there are no other health concerns, she may start ECP. Typically, a woman takes ECP in two doses. She takes the first one in the office and the second one 12 hours later.

Generally, a woman who takes ECP can expect to menstruate one to three weeks after using the medication.

There are some potential side effects that may occur as a result of using ECP, most commonly:

o Nausea (upset stomach)
o Breakthrough bleeding or spotting

Most women find that these side effects, if they experience them, will pass within a few days.
When a woman goes to get ECP, her health care provider should explain other possible side effects to her. Whether or not side effects occur depends on the type of ECP that a woman takes, and many women find that taking ECP with food can help reduce upset stomach, if it occurs.

While ECP is perfectly safe for most women, there are some women who may have serious complications from the medication. Symptoms of serious side effects include:

o Sudden, sharp pain in the lower abdomen
o Shortness of breath
o Severe headaches that come on suddenly

If a woman has taken ECP and she experiences any of these things, she should seek medical attention immediately.

Properly taken, ECP is 75-90% effective, depending on where the woman is in her cycle. The sooner it’s taken after intercourse, the better it works. In order for ECP to be as effective as possible, it must be taken exactly as directed. ECP does not provide any protection against Sexually Transmitted Infections or HIV. ECP should be used for emergencies only. It should not be used as a woman’s primary method of birth control.

o Relatively inexpensive
o A great second chance for a woman to protect herself from pregnancy after she’s already had sex

o Potential side effects
o Relatively low effectiveness compared to other methods
o Offers no protection against STI/HIV

If a woman chooses to go to her health care provider for ECP, there may be a charge for the exam or pregnancy test to determine whether or not she can take ECP. How much she will have to pay depends on the provider and also on her insurance, if she has any. If cost is a concern, she should check with her health care provider or her insurance company. She can also visit a reproductive health clinic, many of which (like the Family Planning Association) operate on a sliding fee scale.

The cost of ECP varies depending on where a woman goes to get it. At the Family Planning Association, we ask for a contribution of $10 for ECP, if the patient is able to pay. Online providers of ECP charge $20-$25 for the assessment, which does not include the cost of the medication. If a woman purchases the ECP brand Plan B® over the counter, the cost may vary by location, but she should expect to pay $45-$50.

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