Oops, the condom fell off or broke. Oops, you went away for the weekend and your birth control pills stayed home. In the past, women ran the risk of an unintended pregnancy when birth control was not used or failed.
Emergency birth control has been available for many years, starting with medicine approaches that were not approved by the Food and Drug Administration. In 1999, Plan B, levonorgestrel pills taken by mouth, was approved for use by prescription and in 2006 was approved without prescription for women 18 years old and over. It was approved for those 17 and older in 2009 without prescription. In late February, 2014, FDA approved over the counter sales of generic emergency contraceptives without proof of age.
Another option for emergency birth control is Ulipristal Acetate, marketed in the US as Ella. It is a prescription only product that is effective up to 5 days after unprotected sex unlike levonorgestrel which is effective up to 3 days after sex.
It has been discovered more recently that over the counter levonorgestrel is less effective when used by women who weigh over 155 pounds. In addition, Ella may not work as well in obese women, those with a BMI (body mass index) over 35.
A less well known but very effective approach to emergency birth control is to have a copper IUD placed within 5 days after unprotected sex. An advantage to the copper IUD is there are no weight restrictions and it provides ongoing convenient and effective contraception. Though effective and convenient, the progestin containing IUDs, Mirena and Skyla, are not to be used as emergency birth control.
Some people have feared that emergency contraception can cause an abortion. This is not true. The oral medications delay ovulation, a release of the egg from the ovary, so pregnancy does not occur. The copper IUD, brand name Paragard, makes sperm stop moving. Emergency contraception does not end a pregnancy and will not work if a woman is already pregnant.
How do you decide which to use? It depends on how much time has gone by since the unprotected sex and how much you weigh. Cost is another factor. Hopefully the price of over the counter emergency birth control will decrease with generic medication becoming available. Some have insurance coverage for birth control and may have a low copay for prescription medication or for a copper IUD placement. Some women choose to keep medication on hand for use as needed. You may check with your women's health provider to get a prescription if desired.
None of these emergency contraception methods work perfectly and none offer protection against sexually transmitted infections. Please be prepared with condoms if possible. Feel free to contact your women's health provider if you have questions.
Another resource is to call 1-888-NOT-2-LATE or go to www.not-2-late.com for more emergency birth control information.