Emergency Birth Control

What is emergency birth control?

Emergency birth control is used to prevent pregnancy soon after you have had sex without birth control or have been sexually assaulted (raped). It may also be used when another method of birth control has failed (for example, if a condom breaks). If you are already pregnant, emergency birth control will NOT work.

The 2 main forms of emergency birth control are emergency birth control pills and the copper IUD (intrauterine device).

The emergency birth control pill (ECP), also called the morning-after pill, is a birth control pill that can prevent pregnancy after you have had unprotected sex.

There are 2 types of ECP: one contains the female hormones estrogen and progestin, and the other contains progestin only. The pills may work in several ways to prevent pregnancy, such as:

• stop the release of an egg from the ovary
• stop fertilization (the uniting of the sperm and the egg)
• keep a fertilized egg from attaching to the womb
• thicken the mucus of the cervix, making it hard for sperm to reach the egg

A copper intrauterine device (IUD) may be inserted after unprotected sex. It may prevent pregnancy by stopping fertilization or keeping a fertilized egg from attaching to the womb.

Some women will try to use douches using plain water, vinegar, and a number of feminine hygiene products to try to remove sperm from the vagina after sex. The douche is supposed to flush the semen out of the vagina and kill the sperm. Since sperm can reach the uterus within 90 seconds after sex, douching is not effective or reliable as a method of birth control. Douching may force bacteria up into the uterus and cause an infection. If you are trying to prevent pregnancy, using douches is not effective and other methods should be used.

When is it used?

Emergency birth control pills may be used after you have had unprotected sex 1 or more times in the last 3 days (72 hours). The pills can be used as a backup method of birth control if, for example:

• Your regular birth control failed (your partner's condom broke or slipped).
• You made a mistake with your regular method (for example, you missed 2 or more birth control pills this month).
• You did not use any birth control method.

A copper intrauterine device (IUD) may be inserted up to 5 days after unprotected sex to prevent pregnancy.

How is it used?

Women 18 years old or older can purchase the progestin only emergency birth control pill without a prescription. Women 17 and younger need a prescription from their healthcare provider. All other types of emergency birth control pills are only available only by prescription.

Usually you will take the first dose as soon as possible and no later than 72 hours after unprotected sex. You will take another dose 12 hours later. Many different brands of birth control pills may be used for emergency birth control. The number of pills needed to prevent pregnancy may be different with different types of pills. Carefully follow the package instructions or your healthcare provider's directions for taking the pills.

Your healthcare provider is needed to insert an IUD into your uterus. This appointment needs to be within 5 days after unprotected sex.

With either method, most women will have their next menstrual period at the expected time or within a week of the expected time.

What are the benefits of emergency birth control?

The benefits of emergency birth control are:

• It can prevent unplanned pregnancies.
• It avoids a termination of pregnancy (also called TOP or abortion) for unwanted pregnancies.

The progestin only pills are safe if you are breast-feeding.

The copper IUD may be left in for up to 10 years as a regular method of birth control.

What are the disadvantages?

Emergency birth control pills are meant for infrequent emergency protection. They cannot be used as a regular birth control method. They do not work as well as most other forms of birth control when these other methods are used correctly. If you have unprotected sex again after taking the pills, the pills will not protect you from getting pregnant.

The emergency birth control pills may cause side effects such as:

• nausea and vomiting
• abdominal pain
• tiredness
• dizziness
• changes in your periods
• breast pain
• headaches

If you vomit within 1 hour of taking either dose of the medicine, call your healthcare provider to discuss whether you should repeat the dose.

Side effects of the IUD may include:

• vaginal bleeding
• menstrual pain
• escape of the IUD from the uterus
• tears in the uterus
• infection of the uterus or fallopian tubes

Emergency birth control does not protect you from AIDS or other sexually transmitted diseases (STD). Latex or polyurethane condoms are the only safe way to protect against AIDS and STDs. If you need to use emergency birth control often, you should ask your healthcare provider about the best methods of birth control and STD prevention for you.

Who should not use emergency birth control?

You should not use emergency birth control pills if:

• You are already pregnant (because they will not work).
• You are allergic to the hormone in the pills.
• You are a smoker over age 35 years old.
• You have had heart disease or blood clots.
• You have had cancer of the breast, uterus, or liver.

When should I call my healthcare provider?

If you have taken emergency birth control pills, call your healthcare provider right away if:

• You vomit within 1 hour of taking either dose of the pills (you may need to take another dose).
• You have severe lower stomach pain about 3 to 5 weeks after taking the pills, which could be caused by a tubal pregnancy. A tubal (ectopic) pregnancy needs immediate medical treatment.
• You have pain, redness, or swelling in your leg.
• Your arms, legs, hands, or feet are numb.
• You have vision problems, such as blurred vision or a partial or total loss of vision.

If you have had an IUD inserted in your uterus for emergency birth control, call your healthcare provider right away if:

• You have heavy vaginal bleeding, and need to change your pad or tampon more than once every hour.
• You have severe abdominal pain.
• You find that the IUD has come out.
• You have unusual vaginal discharge or odor.

If your menstrual period is more than a week late, you should take a pregnancy test. If you are pregnant, see your healthcare provider.

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