Reproductive health experts advise that providers and patients should be aware of the available options when it comes emergency contraception. It’s often considered a last resort against unintended pregnancies.
Advocates recommend that women and anyone who is pregnant should have emergency contraception ready in case they need it. Cynthia Harper, a professor of obstetrics and reproductive sciences at the University of California in San Francisco, says that emergency contraception is crucial for those who live in states with low chances of getting pregnant.
Some emergency contraceptives work better than others, and not all options are available at the same time. Here are the facts.
This term refers only to contraceptive options used to prevent unintended pregnancies. It might be necessary if you had unprotected sexual activity, if your condom broke, or if you forgot to take some birth control pills.
It is not the same as a medication abortion, or abortion pills. However, that misconception is common, Dr. Suzan Goodman, director of the University of California Bixby Center’s Beyond the Pill program. This program promotes access and equity in contraception healthcare.
She explains that emergency contraception is used to prevent a pregnancy from ever happening, and medication abortion is used for ending a pregnancy that has already taken place.
Goodman states that emergency contraception is “not harmful to a developing baby.” She says that emergency contraception is often confused with abortion to limit access. “Abortion pills can disrupt and expel a pregnancy implanted, but they work in very different ways.”
People who have heard of emergency contraception most likely think of the morning after pill. There are actually four types of emergency contraception, two are pills and two intrauterine devices (or IUDs).
Plan B and other levonorgestrel pill: These are the most common form of emergency contraception. Although Plan B is the most well-known brand, it can also be sold under many other names such as Aftera, My Way or Take Action. It is a single-dose, non-prescription required and has no age restrictions. It is best to use it within 72 hours of unprotected sexual relations.
Ella: Ulipristal Acetate is the second type of emergency contraceptive pill. It’s sold in the U.S. under the brand Ella. This is a single-dose, prescription-only pill. Goodman says that Ella is effective for five days after intercourse. This is in contrast to levonorgestrel, which has a three-day drop in effectiveness. Patients who are over 165 lbs will also find it more effective.
Copper and hormonal IUDs are the best emergency contraception. They must be placed by a doctor within five days of having intercourse in order to prevent pregnancy. They are also the most effective method of primary contraception. You can use both hormonal and copper IUDs.
Harper from UCSF says that the copper IUD is almost 100% effective as an emergency contraceptive. Recent evidence has shown that hormonal IUDs aEUR sold under the names Mirena and Liletta aEUR’ are effective.
An IUD is a great option for emergency contraception, according to Dr. Alison Edelman, a professor of obstetrics and general gynecology from Oregon Health and Science University. You can have effective contraception for as long as you have it. Depending on the IUD you choose, they can be effective for 3-12 years.
Although levonorgestrel pills such as Plan B can be purchased over-the-counter and are supposed to be available in stores, research has shown that they are often kept behind the counter or in locked display boxes. You may need to ask your pharmacist. Online ordering is possible, but you will need to wait for delivery. This could be an option if you want to stock up and have it ready in case of emergency.
To get Ella you will need a prescription. According to studies, Ella is rarely available in pharmacies. Many experts in reproductive health recommend that doctors give their patients a script before they order Ella. For women who require a prescription for Ella, companies such as PRJKT ROUBY, SimpleHealth, and Nurx offer telemedicine services.
Kelly Cleland is the executive director of American Society for Emergency Contraception. She says, “We really want patients and health care providers to have that conversation all the time in order to ensure that people have emergency contraception available when they need it.”
Both the Pill options Plan B and Ella delay ovulation, so that an egg doesn’t get released until sperm become ineligible. IUDs prevent fertilization so that even if an egg is released it doesn’t combine with the sperm.
Edelman claims that copper IUDs can be used as an emergency contraception device. They release copper ions which are toxic to sperm. This creates a hostile environment, which prevents them from fertilizing eggs or reaching their reproductive organs. Although there isn’t much evidence to support hormonal IUDs’ exact mechanism, she believes they disrupt the way egg and sperm travel in the body.
Edelman points out that there’s still uncertainty over how hormonal IUDs function as emergency contraception. If you are in the middle or high risk of becoming pregnant, you might want to consider taking one of the pills forms of contraception while you wait for your hormonal IUD to be ready.
The sooner you take your pills, the better. “Most people don’t know where their cycle is at any given time. Cleland, of the American Society for Emergency Contraception, says that they don’t know when ovulation will occur tomorrow or tomorrow. This means that you might miss the window to prevent your ovulation by not taking the pills on time. You could also get pregnant if you do.
It is important that the IUD be placed within the five-day period after unprotected sexual sex.
Yes. There is evidence that Plan B and levonorgestrel pills don’t work well for patients who are more than 165 lbs. Ella is the better option aEUR” it works well for people up to 195 lbs. Ella does require a prescription. This can make it difficult to get access to the medication, as time is running out for these medications. IUDs are the best option for those who weigh over 195 pounds.
You might also consider double-dosing Plan B if you are unable to get Ella or an IUD fast enough. Edelman, who studies the relationship between emergency contraception and weight, said that although there isn’t any evidence that double dosing works well, it is not dangerous. She says that if it were her, she would choose to take one or two doses of emergency contraception over doing nothing.
Edelman also mentioned that there are places such as family planning clinics, Planned parenthoods or university medical centers where women can get IUD placements the same day.
Although there are exceptions to the rule, most insurance plans must cover contraceptives, including IUDs.
Because they are generics, Plan B and its variants are not usually covered by insurance. They typically retail for between $40 and $50. Planned Parenthood may be able offer it at a discount or free of charge. Online ordering can make it easy to find levonorgestrel tablets at a fraction of the cost if you order in advance. Another idea: Insurance will pay for Plan B prescriptions if your doctor gives you one.
Ella can be purchased at the pharmacy for $50 to $50. However, it may be covered by your health insurance or Medicaid. A prescription must be obtained from your doctor.
An IUD must be inserted by a qualified technician. Insurance should cover the cost of the procedure and the costs of the device. An IUD costing around $1000 will be required if you are unable to pay out-of-pocket.
Yes. However, reproductive health advocates worry that conservative states that ban abortion may target emergency contraception next. Because the label language suggests that levonorgestrel might interfere with the implantation of an egg already fertilized. Cleland says that this label was based upon old science. A body of evidence now supports the drug’s ability to stop ovulation and reproductive health experts call for the Food and Drug Administration (FDA) to remove the label. Cleland says, “We must ensure that these product labels conform to the scientific evidence.”
Yes. Yes. Although emergency contraception pills delay ovulation, if you have already begun to ovulate prior to taking them, it may not be possible to stop a pregnancy. Edelman warns that if you continue having unprotected sexual activity in the same month, the emergency contraceptive pill can fail. It is a good idea, Edelman says, to immediately get an IUD after unprotected sexual activity.
No. Cleland says that there were once age restrictions for the pills, but these have been lifted. There may be laws that require parental consent to IUDs for minors.
