Emergency Contraception
by Wendy Davidson, RN, FNP

There are over 3 million unintended pregnancies per year in the United States. 1 out of every 2 women age 15-44 in the United States has experienced at least 1 unintended pregnancy. Making emergency contraception (EC) available in the U.S. can reduce the unacceptably high rate of unplanned pregnancies and decrease the number of abortions performed.

Emergency contraception is a way to prevent pregnancy after sex. There are several types of emergency contraception in this country, however, the emergency contraception pill is the most common form of EC used. EC is not the same as the abortion pill. 

What is the Emergency Contraceptive Pill?

The emergency contraceptive pill is sometimes known as the "morning after" pill, or "post coital" contraception. The term emergency contraception is preferred because the method is for limited emergency use and because it can be used a few days after unprotected intercourse, not just the morning after.

EC pills are basically just birth control pills taken a different way. The pills must be started within 72 hours (3 days) after unprotected intercourse. There are several kinds of birth control pills in the United States that are used for EC. There are two EC kits now on the market. Preven is a combined estrogen and progestin pill. Plan B, the new progestin only pill, has been found to be more effective with less nausea.

How effective is EC?

EC decreases the chance of a pregnancy occurring by 75% per act of intercourse. EC pills are the only oral treatment available to prevent pregnancy after sex. Vaginal insertion of an IUD up to 5 days after unprotected sex has also been shown to be effective.

When might you need EC?

  • You forgot to use birth control
  • The condom broke
  • You werenít planning to have sex
  • You were late for your birth control shot or pill
  • You were forced to have sex
  • He accidentally ejaculated inside your vagina

How do EC pills work?

By several mechanisms. Emergency contraception temporarily stops an egg from being released from a woman's ovaries. It may also stop the joining of the egg and sperm. EC also changes the way sperm and eggs are transported. Remember that EC should not be taken except under the direction of a health care provider.

Emergency contraceptive pills will not harm a fetus! Although they do not prevent a pregnancy if a woman is already pregnant, they will also not disrupt the pregnancy if a pregnancy is already established.

Is EC safe?

Yes. Almost any woman can safely use EC. On February 25, 1997 the FDA issued a statement in the Federal Register declaring EC "safe and effective" in preventing pregnancy after intercourse. EC has been safely used in rape treatment centers and emergency rooms for over 20 years. It is only recently that EC was made available to the public.

What are the side effects?

50% of women taking EC experience nausea after taking the pills. A non-prescription anti-nausea medication such as meclizine can be taken an hour before taking EC to help alleviate this. EC can also cause temporary irregular menstrual bleeding. If you do not get a period by 2-3 weeks after taking EC you should always see your health care provider and check a pregnancy test.

What ECPs are not

EC is NOT RU 486 - the french abortion pill

EC does NOT cause an abortion

EC WONíT interfere with an established pregnancy, nor will it harm the fetus if a pregnancy has already occurred.

Remember...

Do not use EC except under the direction of a health care provider. Because it is not as effective as regular birth control, (i.e. the pill, condoms, or the birth control shot), EC is for emergency use only and should never be considered your primary birth control method. EC does not protect you from sexually transmitted infections, or from AIDS. The best way to protect yourself from these infections is to wear a condom.

How do you get ECP's?

Call the EC hotline at 1 888 NOT 2 LATE (1 888 668 2528), for a list of providers in your area who supply EC. The hotline is available 24 hours/day in English and Spanish.

Go to http://ec.princeton.edu/providers/index.html to access the EC Provider Directory for your area. EC is available only by prescription. Call a health care provider such as a doctor, a nurse practitioner, a midwife, or a physicians assistant. Tell them you need EC. If the front desk does not know what EC is, or says the office does not provide it, ask to speak to a provider. You do not necessarily need to be seen the office to get EC the pills can be prescribed over the telephone.

In Washington State, it is possible to obtain EC directly from a pharmacy without having to see a provider. You can find an EC pharmacist in Washington by clicking here: http://ec.princeton.edu/providers/index.html.

Pre-need ECP

Itís a good idea to have EC available before you need it. Ask your health care provider for a prescription to keep in your medicine cabinet just in case it makes sense!

For current information from the author on this topic, please visit her web site.


Last updated:  March 28, 2001


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