Emergency Contraception
What Is Emergency Contraception (EC)?
Emergency contraception is a method of birth control you can use if you don't want to become pregnant after having unprotected vaginal sex (sex without a condom or birth control method) or if your birth control method did not work correctly. You should use emergency contraception as soon as possible, but no later than 5 days/120 hours after having unprotected sex to prevent pregnancy. The sooner emergency contraception is taken, the better it will work.
- Emergency contraception pills are different from the abortion pill. If you are already pregnant, emergency contraception pills do not stop or harm your pregnancy.
- Emergency contraception is also called the “morning-after pill," but you do not need to wait until the morning after unprotected sex to take it.
- Emergency contraception pills are safe but less effective than using a regular method of birth control to prevent pregnancy. Talk to your healthcare professional about different birth control methods that you can use before or during sex to help prevent pregnancy.
- Copper Intrauterine Device (IUD) is a small, T-shaped device that can be inserted into the uterus within five days of having unprotected sex. A healthcare professional must insert your copper IUD. You then can rely on the copper IUD for long-term birth control (for up to 10 years).
When Should I Think About Using Emergency Contraception?
Consider using emergency contraception if you had vaginal sex and:
- You didn't use a condom or other birth control method.
- You think your birth control didn't work (for example, you missed multiple days of birth control pills, it is more than 15 weeks since your last Depo shot, the condom broke/slipped off).
- You had non-consensual unprotected vaginal sex.
- *You should also seek immediate medical care to be evaluated for any health risks, including HIV. You may be eligible for post-exposure prophylaxis (PEP) which has to be started right away and is used to prevent HIV. Emergency room staff can request an advocate via the Helpline to support you during your visit. You may also want to consider completing a sexual assault evidence collection kit, whether or not you have plans to report the assault to law enforcement.
- If you need additional support, you can contact a support/crisis center—available 24 hours a day, 7 day a week. They have trained staff to help individuals who are being forced to have sex or are in abusive relationships.
Consider asking your healthcare professional for a prescription for emergency contraception pills, or having some type of emergency contraception pill available at home or with you in case you need it. You need an appointment with a healthcare professional to insert a Copper IUD for emergency contraception.
If your period is more than one week late, it’s possible you might be pregnant and should take a pregnancy test.
What Types of Emergency Contraception Are Available?
In the US, there are two types of FDA-approved emergency contraception available:
Emergency Contraception Pills
- ella® is a pill that has ulipristal acetate, an anti-progestin medication that can help prevent pregnancy (taken in one dose).
- Progestin-only pills
- Plan B One-Step® or Julie® are single pills with 1.5 mg levonorgestrel, a hormone that can help prevent pregnancy. Generic versions include AfterPill™, My Way®, Next Choice One Dose®, and Take Action (taken in one dose).
- Levonorgestrel tablets are taken as two pills that each have 0.75 mg levonorgestrel. They are available to people ages 17 and older without a prescription. Generic versions, including Next Choice® and LNG tablets 0.75 mg, are sold from behind the pharmacy counter (taken in two doses.)
- Combined Birth Control Pills as emergency contraception (EC) are combined hormonal birth control pills that have both estrogen and progestin, hormones that can prevent pregnancy. Taken in higher-than-usual amounts in two doses, they can be used for EC. The number of pills needed for EC is different for each brand of pill. An ob-gyn, other healthcare professional, or pharmacist can tell you how many pills you should take for the type of pill that you have.
Intrauterine Device (IUD)
- Copper IUD is a small, T-shaped device that is placed in the uterus. When used for emergency contraception, the copper IUD should be inserted within five days of having unprotected sex. A healthcare professional must insert your copper IUD. You then can rely on the copper IUD for long-term birth control (for up to 10 years). You can have the IUD removed by a healthcare professional at any time if you wish to become pregnant.
How Does Emergency Contraception Prevent Pregnancy?
Research shows that emergency contraception pills work mostly by preventing or delaying ovulation (the release of an egg from the ovary). Less commonly, emergency contraception may prevent fertilization of the egg by the sperm if ovulation has already happened. Emergency contraception will not harm or stop a pregnancy that has already started after an egg has been fertilized in the uterus.
Copper IUDs work by making it harder for sperm to reach or fertilize an egg.
Does Emergency Contraception Have Side Effects?
Yes, but the side effects are rarely serious. Side effects are usually mild and do not last long. Your next period may come early or late*, and you may have spotting/light bleeding between menstrual periods. Side effects differ for each person and may include the following:
- Headache
- Abdominal (belly) pain
- Tiredness (fatigue)
- Dizziness
- Nausea**
- Breast pain
Copper IUDs may cause an increase in menstrual pain and bleeding, which usually improves within a few months.
*If your period is more than one week late, it’s possible you might be pregnant and should take a pregnancy test.
**If you vomit within three hours of taking emergency contraception pill(s), talk to your healthcare professional to find out if you should take another dose.
How Do I Get Emergency Contraception?
It depends on the type of emergency contraception you need.
- Plan B One-Step® and similar generic versions are available in pharmacy stores without a prescription. You can buy Plan B without needing to show your identification (ID) to prove your age. If you do not see it on the shelf, ask the pharmacist for help. Generic versions of Plan B (My Way, Next Choice One Dose®, and Take Action®) are also available for purchase without age limits. The package may say it’s intended for use by women ages 17 and older, but anyone can buy it without ID.
- Julie® is also available at pharmacies over the counter or by prescription.
- Levonorgestrel tablets (two-pill generic Next Choice® and LNG tablets 0.75 mg) are available to people ages 17 and older without a prescription. These brands are sold from behind the pharmacy counter.
- ella® is available only by prescription from a healthcare professional.
- Copper IUD must be prescribed and inserted by a healthcare professional. Use the clinic locator to find a healthcare professional near you.
To find a health center that provides low-cost emergency contraception and other related reproductive health services, use the clinic locator.
Planned Parenthood offers a direct mailing service: plannedparenthooddirect.org/state/rhode-island (costs associated).
How Can I Get Free or Low-Cost Emergency Contraception?
Most insurance plans cover emergency contraception and birth control methods for free. Check with your health insurance plan to find out if Julie®, Plan B One-Step® or a generic version of emergency contraception will be covered without a prescription. You may need to get a prescription from your doctor or healthcare professional if you want your insurance plan to pay for it.
If you don't have insurance, a community health center may provide emergency contraception for low cost. To find one near you, use the clinic locator.
Do I Need Follow-up Care After Using Emergency Contraception?
No tests or procedures are needed after taking emergency contraception. You should have a pregnancy test if you have not had a period within a week of when you expect it. Emergency contraception pills do not cause long-term side effects and do not harm a pregnancy if you are already pregnant. Emergency contraception pills do not provide long-term protection (prevention of pregnancy). Follow-up care with a healthcare professional is recommended to start a regular birth control method (see below) or to advise on restarting regular birth control. If you have a Copper IUD placed as emergency contraception, this will become a long-term method of birth control.
Keep in mind that emergency contraception does not prevent sexually transmitted infections (STIs). If you have had unprotected sex and are at risk of getting an STI, call or visit a clinic/health center for testing and possible treatment.
Can I Use Emergency Contraception as my Regular Form of Birth Control?
Healthcare professionals do not recommend using emergency contraception pills as a form of regular birth control. While it is safe to use as many times as needed, it is not the most effective way to prevent pregnancy. If you use emergency contraception frequently, it can have side effects such as causing your period to be irregular.
Visit a healthcare professional to find a regular birth control method that best meets your needs.
Rhode Island Department of Health