Emergency contraception, often called the “morning after pill” or “Plan B,” is a safe and effective way to prevent pregnancy after unprotected sex or birth control failure. It works by delaying ovulation—preventing your ovary from releasing an egg—or by stopping sperm from reaching the egg. Emergency contraception does not interrupt an existing pregnancy and is not the same as an abortion pill (find out more about abortion vs. the morning after pill in this post).
There are different types of emergency contraception, including pills you can take within a few days and certain IUDs that can be placed by a healthcare provider. Knowing how and when to use emergency contraception can give you peace of mind and help you stay in control of your reproductive health.
Emergency contraception should be taken after unprotected sex to lower the chance of pregnancy. This includes situations where no birth control was used or when a method didn’t work as expected—for example, if a condom slipped or broke, or if multiple birth control pills were missed.
Most forms of emergency contraception are effective for up to 72 hours (3 days) or 120 hours (5 days) after sex, depending on the type. However, it’s best to take it as soon as possible, since effectiveness decreases over time.
In the U.S., there are three main forms of emergency contraception (EC). The most common and accessible options are pills, but there are also other methods to be aware of.
*This method is not as effective and has more side effects than the other ones, but this is an option if you are not near a pharmacy or cannot get in touch with a physician for access to another EC option.
Both the levonorgestrel pill and the ulipristal pill (Ella) are available through Twentyeight Health, where you can also message a provider if you’d like guidance on which method may be best for you.
Typically, no but it depends on the type…
For regular combined birth control pills, you should consider using EC if you have missed 3 pills in a row and had intercourse or if you are 3 or more days late in restarting your patch or ring.
If taking the progestogen-only pill or “minipill,” you should consider taking EC if you take your pill even 3 hours late (or take it more than 27 hours from your last pill).
There is a special kind of combined pill that contains desogestrel, and if you are more than 12 hours late in taking this pill, you may also want to consider taking emergency contraception.
Lastly, if you are more than 4 weeks late for your depot-medroxyprogesterone acetate injection, you are no longer protected and should consider EC if having otherwise unprotected intercourse.
If taken as directed, these are the typical effectiveness rates:
Copper IUD: 99.9% effective
Levonorgestrel Pill (New Day, My Way, Plan B): 97.4% effective
Ullipristal (Ella): 99.2% effective
Yuzpe Method: Prevents about 75% of pregnancies
The most frequent side effects from the pills are headache and nausea. Most people get their periods within 1 week of when it is typically expected, but some patients may have some irregular bleeding or spotting the month after use. This should go away on its own. Other effects can be breast tenderness, dizziness and fatigue. IUD insertion comes with other possible side effects.
The only absolute contraindication in taking Emergency Contraception is if you know you are already pregnant, as the pills will no longer work. That said, there are a few things to note:
Women with a history of bariatric surgery should talk to a physician as they may be less able to absorb medication taken orally.
Repeated use appears safe and fairly effective, but there can be an increase of bleeding episodes.
See below - but for the oral options it is a minimum of 5 days.
If I am starting birth control, when do I start it after taking EC?
Ullipristal or Ella: Because Ella works opposite to birth control pills, we recommend waiting at least five days after you take Ella to start birth control. This includes pills, the patch, injection, any hormonal implant or IUD or the ring. As a reminder, you also need to use back-up like a condom for seven days after starting birth control. This means if you take Ella and then start birth control five days later, you should either abstain from sex or use a condom for a total of 12 days (5 days after taking Ella and another 7 days after starting birth control).
Levonorgestrel or Plan B: You can start birth control the same day you take the levonorgestrel and you should use a backup method such as condoms or avoid sex for one week (7 days).
Copper IUD: This serves as emergency birth control and also immediately starts to act as long-term birth control. No waiting period or backup is needed.
Yuzpe Method: You can start pills or any method of contraception after taking the second dose. You should wait one week to have sex or use a back-up method for seven days.
The levonorgestrel pill does not require a prescription. However, if you have insurance and get a prescription from a doctor, insurance will often cover it at $0 copay.
Ullipristal and the copper IUD require a prescription or trip to a physician.
Yes—you can absolutely keep emergency contraception pills at home so you have them ready if you ever need them. Like all medications, EC pills come with an expiration date, which is usually several years from the purchase date. After that date, the pill may become less effective.
It’s a good idea to check the expiration date on the package and replace your supply when needed, so you always have a reliable dose on hand in case of an emergency.
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Looking for more personalized info? Message a doctor through Twentyeight to get medical advice based on your needs and lifestyle.
