Because knowledge is power.
Sometimes, especially in the heat of the moment, human beings make mistakes. But given the current fight over reproductive rights in America, the stakes are especially high if that mistake involves birth control. Still, if someone’s primary mode of pregnancy prevention fails, there are still plenty of options, thanks to emergency contraception.
In light of the expected reversal of federal abortion rights, Rebecca Brightman, MD, our resident women’s health expert, says there’s no better time than now for women to know their options if they accidentally have unprotected sex, because the consequences are certainly real — nearly half of all pregnancies in the U.S. are unplanned.
“What women really need to know is that, now more than ever, women need to make decisions in terms of their reproductive future,” she tells us. “And if they’re at risk of pregnancy, they should make decisions that suit their needs.”
Here’s what everyone needs to understand about the various forms of emergency contraception. And keep in mind that even if you’re not at childbearing age, this info can be invaluable for someone you love who is.
What are the different kinds of emergency contraception?
There are two main types: the intrauterine device (IUD) and emergency contraception pills.
IUDs
Though they’ve been around since the 1900s, IUDs have only gotten popular in the last few decades, and they’re now considered the most effective type of birth control (they’re up to 99.9% effective).
But it may surprise you to learn that they don’t have to be implanted before sex to be effective. “We have very good data showing that IUDs may be used as emergency contraception,” says Dr. B.
How are they typically used? A doctor inserts a T-shaped device the size of a quarter into the uterus up to 5 days after unprotected sex, which can prevent pregnancy. But despite what many have previously thought, Dr. B says new studies show that both hormonal and nonhormonal forms can be used as an effective form of emergency contraception. If you’re looking for one without hormones, then copper IUDs might be an option, since it’s wrapped with a coil of copper which acts to prevent pregnancy.
Dr. B recommends seriously considering an IUD for anyone who’s sexually active and doesn’t plan on getting pregnant anytime soon. Some offer effective protection for up to 7 to 12 years without the need for a replacement.
EC Pills
Morning-after pills, on the other hand, don’t necessarily require a trip to the doctor’s office and many are even available over-the-counter. That includes levonorgestrel pills like Plan B, which work best when they’re taken up to 72 hours (3 days) after unprotected sex.
There are also other options like ulipristal — also known by its brand name, Ella — that can be used up to 120 hours (5 days) after unprotected sex, but it requires a prescription and may not work as well for women who weigh 195 pounds or more.
Some doctors even combine emergency contraception pills. For instance, pills that contain estrogen and progestin can work together as emergency birth control, by delaying ovulation. But both of these pills require a doctor’s prescription and must be taken within five days of having unprotected sex.
How does emergency contraception generally work?
This depends on the type of contraception you’re using. IUDs prevent sperm from fertilizing the egg in the first place. Meanwhile, research shows that emergency pills typically work by preventing or delaying ovulation, according to the Office of Women’s Health, part of the U.S. Department of Health & Human Services.
But as the OWH notes, emergency contraception is not meant to be used in place of regular birth control. Timing is also everything — Dr. B says the sooner the better because “sperm can be viable for up to five days.”
What are the side effects of emergency contraception?
Even though Dr. B says IUDs are very effective and safe for most women, they still do come with risks. These can include pelvic infection or even damage to your uterus. Some IUDs have been known to fall out from the uterus into the vagina, but this is rare, only happening to approximately 2 to 10 percent of women, according to WebMD.
As for emergency contraception pills, Dr. B says side effects can range from nausea and fatigue to lower abdominal pain or bleeding between periods. Still, these symptoms are generally mild for most women and typically linger for just a few days. But Dr. B cautions that if there are any issues beyond those symptoms, they should be directed to a trusted doctor.
“If those using these forms of emergency contraceptives have any questions at all, they should talk to their physicians,” she says. “And if they don’t have a physician, reach out to Planned Parenthood.”
