Emergency Contraception: What You Need to Know

Emergency Contraception: What You Need to Know
Emergency contraception (EC) is a safe and effective way to prevent pregnancy after unprotected sex, contraceptive failure (such as a broken condom), or sexual assault. It is designed to be used in urgent situations and should not replace regular birth control methods.

Many women do not have access to accurate information about EC, leading to confusion and myths surrounding its use. This article explores different types of emergency contraception, how they work, effectiveness, and important considerations when using them.

What is Emergency Contraception?
Emergency contraception is a backup method to prevent pregnancy after sex. Unlike regular contraception, which is used before or during intercourse, EC is used after unprotected sex to reduce the chance of fertilization and pregnancy.

EC does not cause an abortion and will not work if a woman is already pregnant. Instead, it works by delaying ovulation, preventing sperm from fertilizing an egg, or making the uterus less receptive to implantation.

Types of Emergency Contraception
There are two main types of emergency contraception:

1. The Morning-After Pill (Emergency Contraceptive Pill - ECP)
The most common type of EC is the morning-after pill, which contains hormones that prevent or delay ovulation. There are different brands available, but they generally fall into two categories:

a) Levonorgestrel-Based Pills (Plan B One-Step, Take Action, etc.)
Available over-the-counter (no prescription needed in most places).
Best taken within 72 hours (3 days) after unprotected sex, but can work up to 5 days with reduced effectiveness.
Works by preventing ovulation or interfering with sperm movement.
Less effective for women with a BMI over 25.
b) Ulipristal Acetate-Based Pills (Ella)
Requires a prescription in some countries.
More effective than Plan B, especially between 3-5 days after sex.
Works by blocking the hormone progesterone, which delays ovulation.
Remains effective even if ovulation is about to happen.
Less effective for women with a BMI over 35.
2. The Copper IUD (Intrauterine Device)
The most effective form of emergency contraception.
Can be inserted by a healthcare provider up to 5 days after unprotected sex.
Works by preventing sperm from fertilising an egg and making the uterus less receptive to implantation.
Provides long-term contraception (up to 10 years) if left in place.
Not affected by weight or BMI.
How Effective is Emergency Contraception?
Morning-After Pills
Levonorgestrel (Plan B, etc.): 75-89% effective when taken within 72 hours.
Ulipristal Acetate (Ella): About 85% effective when taken within 5 days.
Copper IUD
More than 99% effective at preventing pregnancy when inserted within 5 days.
Note: The sooner you take EC after unprotected sex, the more effective it is.

How Does Emergency Contraception Work?
Morning-After Pill Mechanism
Prevents or delays ovulation, so sperm cannot fertilize an egg.
Thickens cervical mucus, making it harder for sperm to reach an egg.
Alters the uterine lining (in some cases), reducing the chance of implantation.
Copper IUD Mechanism
Releases copper ions, which are toxic to sperm.
Prevents fertilization and implantation.
EC does not work if implantation has already occurred, meaning it cannot terminate a pregnancy.

Common Side Effects of Emergency Contraception
Most side effects are mild and temporary. They may include:
✅ Nausea or vomiting – If vomiting occurs within 2 hours of taking the pill, another dose may be needed.
✅ Irregular bleeding or spotting – Your next period may be earlier, later, heavier, or lighter than usual.
✅ Breast tenderness – Temporary discomfort may occur.
✅ Headaches or dizziness – Usually mild and short-lived.
✅ Abdominal pain or cramping – More common with the copper IUD.

Who Can Use Emergency Contraception?
Most women can safely use EC, including teenagers and breastfeeding mothers.
The copper IUD is an excellent option for those who want ongoing contraception.
Obese or overweight women may find the copper IUD more effective than pills.
When to See a Doctor
Consult a healthcare provider if:
❗ Your period is delayed by more than a week (pregnancy test may be needed).
❗ You experience severe abdominal pain (possible ectopic pregnancy).
❗ You have persistent or unusual side effects.
❗ You are unsure about the best emergency contraception option for you.

Emergency Contraception vs. Abortion Pill
Many people confuse emergency contraception with the abortion pill, but they are very different:

Feature Emergency Contraception Abortion Pill (Medical Abortion)
Purpose Prevents pregnancy Terminates an existing pregnancy
Works By Delaying ovulation or preventing fertilization Inducing miscarriage using medication
Effectiveness Window Within 5 days after unprotected sex Used up to 10 weeks of pregnancy
Availability Over-the-counter (some types) Prescription required
EC does not cause an abortion and has no effect on an already established pregnancy.

Myths & Misconceptions About Emergency Contraception
❌ Myth: EC is 100% effective.
✅ Truth: No contraceptive method is 100% effective, but EC greatly reduces the risk of pregnancy.

Myth: EC can cause infertility.
Truth: EC does not affect future fertility. Women can conceive normally in future cycles.

Myth: You can only use EC once in your lifetime.
Truth: EC can be used multiple times but should not replace regular contraception.

Myth: The morning-after pill works even after implantation.
Truth: EC cannot terminate an existing pregnancy.