Everything You Need to Know About Plan B and Other Emergency Contraceptives
Due to the recent overturn of Roe v. Wade and the continued attacks on reproductive rights in states across the country, it’s especially critical that you know your options when it comes to preventing pregnancy. Emergency contraceptives — some of which are commonly referred to as the “morning-after pill” — are safe, effective methods of stopping a pregnancy before it starts, in the event that regular contraception isn’t used or fails during sex (i.e. the condom broke or you forgot to take your birth control pill).
Although the time frame varies among different emergency contraceptives, most must be taken within a few days of having sex, and some forms — such as Plan B — can be purchased right at your local drugstore.
Using emergency contraception is absolutely nothing to be ashamed of, and is a crucial option for pregnancy prevention after unprotected sex. But there’s a lot of important information to consider. So to help you understand all of your choices, we talked to Dr. Raegan McDonald-Mosley, Chief Medical Officer at Planned Parenthood Federation of America and CEO of Power to Decide, who breaks down everything you need to know about emergency contraception.
There are three types of emergency contraception.
Plan B, likely the most common type of emergency contraception, is a pill with levonorgestrel, a hormone that can prevent pregnancy. Plan B is an over-the-counter pill that you can purchase without a prescription at many drugstores with a pharmacy, including CVS, Walgreens, Target, and Rite Aid. You can also purchase Plan B from Amazon.
Julie, a new FDA-approved emergency contraceptive pill, also contains levonorgestrel. Julie is exclusively available at Walmart (both in-store and online) and like Plan B, it’s an over-the-counter pill that doesn’t require an ID or prescription for purchase.
Another option is Ella, a pill with ulipristal acetate, which also prevents pregnancy. However, Ella requires a prescription. According to Planned Parenthood, it’s more effective than other morning-after pills for people who weigh more than 165 pounds, but might be less effective for those who weigh more than 195 pounds.
A copper IUD (intrauterine device) can also act as an emergency contraceptive and doubles as a long-acting form of birth control. Unlike hormonal IUDs, which are only to be used as birth control (not emergency contraceptives), a copper IUD can work as both and is the most effective at preventing pregnancy. An IUD is a small, T-shaped device that a doctor inserts into the uterus for long-lasting pregnancy prevention. In order for it to also function as emergency contraception, it needs to be inserted within five days of unprotected sex.
Emergency contraception works by preventing your ovaries from releasing eggs.
It can take up to six days for the egg and sperm to meet, initiating conception. Emergency contraceptives like Plan B, Julie, and Ella work by preventing the egg from dropping out of your ovary, so it can’t meet the sperm. A copper IUD immobilizes sperm so it can’t swim to an egg.
Emergency contraception is NOT the same thing as an abortion or an abortion pill.
Emergency contraception prevents you from getting pregnant; an abortion or abortion pill terminates an existing pregnancy.
You need to take emergency contraception within a certain time frame after having sex.
Plan B is 75 to 89 percent effective if taken within three days (72 hours). Ella is 85 percent effective if taken within five days (120 hours). Julie needs to be taken with three days (72 hours) of unprotected sex. The copper IUD needs to be implanted within five days (120 hours) to work as an emergency contraceptive.
Emergency contraception isn’t 100 percent effective.
It’s possible to take emergency contraception and still get pregnant. Dr. McDonald-Mosley recommends taking a pregnancy test three weeks after you take an emergency contraceptive just in case (or sooner if you have any symptoms of pregnancy, which can include tender or swollen breasts, nausea, vomiting, increased urination, fatigue, and food aversions or cravings).
How much does emergency contraception cost?
Plan B typically costs between $40 and $50 at your local pharmacy. Ella costs between $50 and $60 and requires a prescription. (Most insurances cover the prescription for the pill itself, but may not cover the cost of the visit to the doctor.) Julie is priced at $42.44 and can be purchased at Walmart. The copper IUD can range between $0 and $1,000, depending on your insurance, and must be inserted by a doctor.
You may experience some side effects.
These can include nausea, vomiting, dizziness, headaches, breast tenderness, and an upset stomach. Because it affects ovulation, you might also experience irregular bleeding or find that your next period is slightly delayed or irregular. But remember, morning-after pills are safe and the side effects are only temporary, per Planned Parenthood.
If you vomit within two hours of taking a morning-after pill, call your doctor to find out if you should repeat a dose.
The pill might not have had enough time to be absorbed by your body, but you should ask your health care provider first, according to the Mayo Clinic.
If you’ve had multiple incidents of unprotected sex in the same 24 hours, you only need to take a morning-after pill once.
For example, if you have unprotected sex twice on Saturday, you only need to take an emergency contraceptive once. But if you have unprotected sex on Saturday and then again the next Friday, you should take it after each incident (and find a reliable form of birth control ASAP!).
Remember, some forms require talking to a doctor or healthcare provider.
You can get Plan B or Julie over the counter, but other forms aren’t quite as simple. In order to get Ella, you need to get a prescription from a doctor or a clinic. If you opt for a copper IUD, you need to have it inserted by a doctor. Because both methods need to be taken within five days of having unprotected sex, you need to make an appointment with your doctor or at a clinic as soon as possible. When making your appointment, let them know that it’s a time-sensitive matter.
If your BMI is over 25, Ella and the copper IUD are more effective choices than Plan B.
In 2013, a group of researchers discovered that levonorgestrel (the primary hormone used in Plan B, as mentioned above) may not effectively prevent pregnancy in people who weigh more than 165 pounds. A year later, the European Medicines Agency determined there wasn’t enough data available to say once and for all whether that 165-pound rule holds true. Dr. McDonald-Mosley recommends that if your BMI is over 25, you use Ella or the copper IUD instead of Plan B. (You can determine your BMI here if you’re 19 or younger and here if you’re 20 or older.)
The FDA-approved guidelines for Julie, a pill that also contains levonorgestrel, can be used regardless of a person’s weight or BMI, according to their website.
You should use a backup method of birth control for the next four days.
If you’re already using some form of birth control, such as the pill or an IUD, Dr. McDonald-Mosley recommends you use condoms as a form of backup birth control for four days, following your use of an emergency contraceptive.
Taking a whole bunch of birth control pills is not an effective form of emergency contraception.
Doubling up on birth control pills will not offer extra protection, and is not an effective form of emergency contraception. Plan B, Ella, Julie, or the copper IUD are the safest and most effective ways to prevent pregnancy after unprotected sex. Plus, popping tons of birth control pills can throw your cycle out of whack, make you super nauseous, and give you headaches and breast tenderness. It’s never a good idea to self-medicate or alter your doses of medication, and the pill counts as medication.
Emergency contraception won’t affect your future fertility.
You can take emergency contraceptives repeatedly without fear of it damaging your fertility or impacting your chances of getting pregnant in the future. If you're concerned about the cost and the side effects of emergency contraception, find a form of birth control that works for your lifestyle here.
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