About Emergency Contraception
Summary
Emergency contraception (EC), sometimes called the “morning-after pill,” is used to help prevent pregnancy after unprotected intercourse, contraceptive failure (such as a broken condom), or a missed birth control method. Emergency contraception works primarily by delaying or preventing ovulation before fertilization can occur. It is most effective when used as soon as possible after unprotected intercourse but can still be effective for several days afterward, depending on the method used. Emergency contraception does not terminate an existing pregnancy and is not the same as an abortion.
Why a Patient Might Choose This Method
A patient may choose emergency contraception if they have had unprotected intercourse, missed birth control pills, experienced contraceptive failure, or were concerned that their regular birth control method may not have worked properly. Emergency contraception provides a time-sensitive opportunity to reduce the risk of pregnancy after intercourse has already occurred and can offer reassurance while a patient establishes or resumes a regular contraceptive method.
How It Is Used
Emergency contraception should be used as soon as possible after unprotected intercourse. Depending on the method, it may be effective for up to 3–5 days afterward. Emergency contraceptive pills are taken as a single dose, while the copper IUD must be inserted by a healthcare provider. Emergency contraception is intended for occasional use and should not replace a regular birth control method. Patients should discuss ongoing contraceptive options with their healthcare provider if emergency contraception is needed repeatedly.
Options and Comparisons
Several emergency contraception options are available. They differ in how long they remain effective after unprotected intercourse, whether a prescription is required, and whether they also provide ongoing birth control.
| Product | Active Ingredient | Time Window | Advantages | Potential Disadvantages |
|---|---|---|---|---|
| Plan B One-Step | Levonorgestrel 1.5 mg | Up to 72 hours (best within 24 hours) | Available over the counter, widely accessible, single dose | Effectiveness decreases with time; may be less effective at higher body weights. |
| Take Action, My Way, Aftera, Option 2 | Levonorgestrel 1.5 mg | Up to 72 hours (best within 24 hours) | Lower-cost generic alternatives to Plan B | Same limitations as Plan B. |
| Ella | Ulipristal Acetate 30 mg | Up to 120 hours (5 days) | More effective later in the 5-day window; may be more effective in higher body-weight patients | Requires a prescription; cannot immediately restart hormonal contraception afterward. |
| Paragard (Copper IUD) | Copper | Up to 120 hours (5 days) | Most effective emergency contraception available; provides long-term contraception | Requires an office procedure and IUD insertion. |
Quick Decision Guide
This guide provides a general comparison of emergency contraception options. The best choice depends on how much time has passed since unprotected intercourse, your medical history, and whether you also want ongoing contraception.
| If You Want… | Consider |
|---|---|
| The easiest over-the-counter option | Plan B One-Step or a generic levonorgestrel emergency contraceptive |
| The most effective pill option | Ella |
| Emergency contraception up to 5 days after intercourse | Ella or a Copper IUD |
| The most effective emergency contraception overall | Copper IUD |
| Long-term birth control at the same time | Copper IUD |
| A lower-cost option | Generic levonorgestrel emergency contraception |
Clinical Pearl
Emergency contraception is most effective when taken as soon as possible after unprotected intercourse, but patients do not need to wait until the next morning. If unprotected intercourse occurs, emergency contraception can be used immediately. Having a dose available at home before it is needed can help avoid delays and maximize effectiveness.
Ready to discuss birth control options?
Choosing a birth control method can feel overwhelming, but you do not have to sort through the options alone. APNS can help you review your health history, preferences, and goals so you can make an informed decision with guidance from a healthcare provider.