Emergency Contraception: Nothing But the Facts

Things don’t always go according to plan. That's true in life, in love and, of course, in sex. Condoms break, pills are forgotten, folks get drunk and reckless (clearly not you, but other folks … ). When they do, emergency contraception (EC) can mean the difference between a brief panic and an unplanned pregnancy. However, before you can protect yourself with EC it’s important to know your options and how they work. Unfortunately, rumors, myths, misapprehensions and plain, old politics make this much more difficult than it should be. So let's take a look at the straight-up facts about last-minute pregnancy prevention.

How did we all get to be so confused?

A lot of the debate around emergency contraception comes out of confusion. First, this medication has a confusing nickname, and second, it's often confused with a drug that does something completely different. This confusion is often exacerbated by folks who oppose birth control and use the confusion to further their cause. So let's clear a few things up.

What’s in a name?

Emergency contraception is often referred to as "The Morning After Pill." Sounds kind of ominous, doesn't it? Dun dun duuun! That isn't the only problem. The other is that this name implies three things that aren’t true:

• That there’s only one kind of EC. Nope!
• That women must take it immediately (the morning after) or they are screwed. Not so!
• That it only comes in one form (a pill.) Incorrect!

Tada! We’ve just busted three major myths about emergency contraception. Right now you might be thinking, hold the phone, pills aren’t my only choice?! No, they aren’t. More on that in a minute.

A Case of Mistaken Identity

There are a lot of people out there who believe that emergency contraception and medication-induced abortion are the same thing. That's why EC is often called an "abortion pill." This is just plain wrong. Emergency contraception prevents pregnancy; it does not end it. Here’s how I like to think about it: Imagine you are a car and sex is driving (go with me here). In this world, EC acts like a set of brakes; it's there to prevent an accident. Medication abortion, on the other hand, fits in the same category as things like air bags; it's there in case said accident occurs. (Of course, the best option is to drive safely. Get some great tips in The Ultimate Guide to Safer Sex.)

To make things more clear, emergency contraception does its job before pregnancy begins by delaying or inhibiting ovulation, interfering with the movement of eggs or sperm, or preventing implantation of a fertilized egg. If an egg is fertilized, it'll implant itself in the lining of a woman's uterus five to seven days later. That, according to the National Institutes of Health and the American College of Obstetricians and Gynecologists, is called conception. If that's already happened, emergency contraceptive pills won't undo it.

Whew. Now that we’ve cleared that up ...

What are your options?

Get ready. Should you ever need emergency contraception, you may have more choices than you realize. Let’s take a look what’s out there, how it works and how to access it.

Plan B One Step

This is what we most often think of when we refer to emergency contraception. Plan B One Step (as well as Next Choice and Levonorgestrel) is basically a super-high dose of the same medication in regular birth control pills. You can take them up to five days after sex, but don’t dally: the rate of effectiveness drops every day.

Yuzpe Regimen

Now that we know that some forms of EC are so similar to birth control pills, it stands to reason that you can use some kinds of birth control pills as emergency contraception. This is called the Yuzpe Regimen (here’s more on that from Bedsider.org), and it's most effective within three days of having unprotected sex.

Ella

Ella is the new kid on the EC block and it's cool because you can take it up to five days after having unprotected sex. Plus, unlike other methods, it doesn’t become less effective during that time. That means that taking it on day five shouldn’t make it any less effective than taking it on day one.

Paraguard IUD

Are you surprised to see an IUD featured as EC? Well, this popular form of birth control is actually the most effective EC on this list. Getting a copper IUD inserted up to five days after having unprotected sex is more than 99.9 percent effective at preventing pregnancy. Plus, having that IUD will prevent future pregnancy as well. (You can learn more about all sorts of birth control in We Asked An Expert: Which Birth Control Is Best?)

How to Access Emergency Contraception

Plan B One-Step

On June 10, 2013, after years of legal wrangling, the U.S. government finally decided to stop fighting judges' orders and make this method of EC available over-the-counter without age restrictions. Expect full availability in the coming months. Previously, Plan B was obtained at the pharmacist’s counter (without a prescription) and restricted to women 17 and older. Even then, a 2011 study by JAMA found that many young women were still turned down.

Yuzpe Regimen

Because this method requires regular birth control pills and only works with certain types of pills, a prescription is necessary for anyone not currently taking one of the pills listed here.

Ella

Ella is available by prescription only.

Paraguard IUD

An IUD can only be implanted by a doctor.

So now you’ve got the facts. Go forth in safety, secure in the knowledge that if something goes wrong EC has your back.