What is emergency contraception (EC)?
Emergency contraception (EC) helps to prevent pregnancy after unprotected sex or failed birth control. A broken condom is an example of failed birth control. EC does not protect against sexually transmitted infections (STIs). EC does not cause an abortion or miscarriage if you are already pregnant. It only prevents a pregnancy from happening in the first place.
Emergency contraception should not be used as your regular birth control method, as it is less effective than regular contraceptive methods.
What types of emergency contraception are available?
There are 2 types of emergency contraception:
- Emergency contraceptive pills (ECPs)
- Copper IUD (intrauterine device)
Emergency contraceptive pills
Emergency contraceptive pills (ECPs), also known as the "morning after pill,” or Plan B (or generic brands) are most effective when taken within 72 hours (3 days) after having sex. ECPs can be used up to 5 days after having sex and not just the next morning.
ECPs contain hormones or a drug to prevent pregnancy after unprotected sex or failed birth control. In Canada, ECPs either contain a hormone called progestin or a drug called ulipristal (ella™).
ECPs that only contain the hormone progestin (Levonorgestrel) and ulipristal prevent pregnancy by stopping or delaying ovulation (an egg being released from the ovaries). Progestin only pills may also work to prevent fertilization of an egg by affecting the cervical mucus or the ability of sperm to bind to the egg. However, like any birth control method, these pills are not 100 per cent effective.
It is very important to take emergency contraceptive pills exactly as recommended.
A copper IUD is a small, T-shaped plastic device wrapped in copper. It is inserted into your uterus by your health care provider. When inserted within 7 days of unprotected sex, a copper-bearing IUD is the most effective form of emergency contraception available.
As emergency contraception, the copper-bearing IUD stops fertilization by causing a chemical change that damages sperm and egg before they can meet. Like any birth control method, the IUD is not 100 per cent effective.
A benefit of the copper IUD is that it can remain in your uterus for up to 5 years as an effective form of birth control if you wish.
When can I use emergency contraception (EC)?
All forms of EC should be used as soon as possible after unprotected sex or failed birth control. EC is more effective the sooner it is used.
You may wish to use EC in the following situations:
- You had unprotected sex, or your partner ejaculated on your genitals (withdrawal method).
- The condom broke, slipped off, or leaked.
- Your diaphragm or cervical cap slipped, tore, or came out less than 6 hours after intercourse.
- You missed taking your birth control pills more than 2 days in a row, or you took your progesterone-only pill 3 or more hours late.
- You missed taking 1 pill in the first week.
- It has been more than 13 weeks since your last Depo-Provera® injection.
- Your NuvaRing® has been out of your vagina for more than 3 hours and you had intercourse without a back-up method of birth control.
- Your contraceptive patch fell off, or you forgot to change the patch for more than 48 hours and no back-up birth control was used.
- You had nonconsensual sex (sexual assault).
Are there any side effects?
Side effects are uncommon and do not last long.
Emergency contraceptive pills
For ECPs, nausea and vomiting may occur and your period may not occur when you expect it. Taking a medication like Gravol® at least 30 minutes before you take the ECP may help to prevent stomach upset. If you vomit within 2 hours of taking the progestin only ECP, contact your health care provider because you may need to take another dose. If you vomit within 3 hours of taking the ulipristal ECP, another dose will need to be taken. Less common side effects of ECPs may include abdominal pain or cramps, headache, dizziness, fatigue, breast tenderness and spotting or bleeding in the week or month after treatment.
If you are already pregnant, ECPs will not interrupt the pregnancy or put the fetus at risk.
A copper IUD is a very effective EC and can provide long-term contraception at a low cost. Side effects of an IUD can include pain or cramping after putting it in, infection, a chance that it comes out or perforates the uterus, or more painful or heavier periods. If you choose to have an IUD inserted, your health care provider will discuss this with you.
Can anyone use emergency contraception?
Most women can safely use ECPs even if they cannot use birth control pills as their normal method of birth control. Your health care provider can tell you if you can use ECPs.
If you are unable to take ECPs or decide to use a copper IUD for emergency contraception, your health care provider will do a pregnancy test and confirm that you do not have a condition that may prevent you from using an IUD.
Where can I get emergency contraception?
You can get progestin only ECPs without a prescription from your doctor, pharmacy, walk-in clinic, youth clinic, sexual health clinic, women’s health or sexual assault centres, or hospital emergency rooms. The ulipristal ECP requires a prescription from your health care provider.
You can get ECPs in advance for use in case of an emergency. Emergency contraception should not be used for regular birth control.
An IUD is available from many doctors, and some clinics. An IUD must be inserted by a health care professional.
There may be a cost for emergency contraception. Discuss the options with your health care provider. For more information, call Options for Sexual Health toll-free at 1-800-739-7367 or visit www.optionsforsexualhealth.org.
Do teenagers need a parent’s consent?
No. If you are old enough to get pregnant you can use or ask your health care provider for contraceptives, including EC, without your parent’s or guardian's consent.
How can I tell if the pills worked or not?
The effectiveness of ECPs depends on how soon you take the pills, the type of pills, and where you are in your menstrual cycle. They may also depend on your weight. The Copper IUD is the most effective EC and does not depend on body weight.
Progestin only ECPs are less effective in women who weigh between 165 to 175 pounds (75 to 80 kg), and are not effective in women who weigh over 176 pounds (80 kg). If you weigh over 165 pounds, speak to your health care provider about alternative methods of emergency contraception, like the IUD.
Ulipristal ECP may be less effective in women with a body mass index greater than or equal to 35 kg/m2.
You should have a period within 3 weeks after taking ECPs. If you do not have a period within 3 weeks, a pregnancy test is needed. A pregnancy test can be done at home or by a health care provider. You can buy pregnancy tests at a pharmacy or grocery store.
For More Information
If you think you are pregnant already, see your health care provider to discuss your options.
For pregnancy counselling services throughout the province, including pregnancy options, visit BC Women’s Hospital & Health Centre Counselling Services www.bcwomens.ca/our-services/gynecology/abortion-contraception or call the Pregnancy Options Service at 1-888-875-3163.
If you have been forced to have sex without your consent, visit:
- VictimLinkBC: www.victimlinkbc.ca, or call tollfree 1-800-563-0808.
- Victimsinfo.ca: www.victimsinfo.ca
For information on STIs, see HealthLinkBC File #08o Preventing Sexaully Transmitted Infections.