Emergency Contraception: Safe, Not Sorry

There has been a lot of speculation about the safety and efficacy of emergency contraception, also known as the morning after pill. Many people have questions as to how exactly it works, if it is safe for a woman to take, and what happens if a woman is already pregnant when she takes it. This post will try to dispel any rumors about this form of birth control, describe how to take it, and explain what happens when it is used.

Emergency contraception (EC) is made up of progesterone, a hormone found naturally occurring in a woman’s body. In fact, this is one of the hormones necessary to maintain pregnancy, and is frequently prescribed in the first trimester for pregnancy support. It is because of this, that progesterone is so effective as emergency contraception. When taken in a large dosage, which is what comes in EC pills, the body is made to believe that it is already pregnant so it will do what it can naturally to prevent another pregnancy from taking place. It does this by preventing ovulation, and thinning out the cervical mucus. However, if pregnancy has already occurred, meaning that the egg and sperm have united and implanted in the uterus, then the extra progesterone is a welcome addition to support the growing fetus.

You can take the morning after pill up to 72 hours after unprotected sex, though it works best if taken as soon as possible. Next Choice is composed of 2 pills, one taken as soon as possible after unprotected sex, the second one 12 hours later. Plan B only has one pill, taken as soon as possible.  These two types of contraception reduce the likelihood of pregnancy by 81-90% when taken properly.

The exception to this rule is a new EC pill called EllaOne. EllaOne is made of ulipristal acetate and can be used up to 5 days after unprotected sex.  It is available by prescription only, and pregnancy must be excluded prior to taking it. Please contact your physician if you are interested in using EllaOne.

It is important to distinguish emergency contraception pills from the pill used for abortive purposes called RU486. RU486 is composed of mifepristone, which competes with progesterone at the receptor sites, and essentially does the opposite of what progesterone does. RU486 combined with misoprostol, which induces uterine contractions, is used in abortion clinics to expel the fetus. RU486 is only available by prescription at these clinics, while progesterone-only EC pills are available over the counter. EC pills cost anywhere from $35-$60 and do not require a prescription for adults over 17. Those under 17 are required to have a prescription to access the pills.

Emergency contraception is a safe last resort to prevent pregnancy, but is not intended to be a first line form of birth control. There are many different regular forms of birth control available so please talk to your doctor about which would be best for you. Emergency contraception also does not protect against HIV, AIDS or other STDs and if you are having unprotected sex, you should get tested for these infections.


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