What is Emergency Contraception?
Emergency Contraception (EC), sometimes referred to as the “morning-after pill” or “Plan B”, is a dose of progestin (a hormone commonly used in birth control methods) that helps prevent pregnancy when taken up to 72 hours after unprotected intercourse or contraceptive failure. The sooner you take EC after unprotected sex, the more effective it will be at preventing pregnancy. Some example situations when you should take EC are: when you forget to take a birth control pill on time, when a condom tears, or when you’ve experienced a sexual assault**. EC works by delaying or preventing ovulation, which is the release of an egg from the ovary. EC will NOT impact an existing pregnancy and will not stop implantation or fertilization. EC is NOT the same as medication abortion (or “the abortion pill”).
There are actually three different forms of EC:
- Over the counter EC: can be purchased over the counter and requires no prescription; is the focus of the content in this section.
- Ella: requires a prescription but can be taken up to 5 days after unprotected sex
- ParaGard IUD: this copper IUD must be inserted by a physician but can last as a non-hormonal birth control method for up to 12 years. ParaGard must be inserted within 5 days of unprotected sex and is placed in the uterus by a healthcare provider. Tell your healthcare provider that you need ParaGard for EC so they will schedule you as soon as possible!
Since over the counter EC is the most accessible and well known, it is the focus of this section.
EC should not be used as a regular method of birth control and if you find yourself having to use it multiple times per year, you should speak with a health professional about picking a birth control method that is right for you.
How Will EC Affect My Body?
Side effects of EC are rarely serious. Side effects differ for each individual and may include headache, abdominal pain, fatigue, dizziness, nausea, and/or breast pain. These side effects do not last long.
EC may affect the start date and duration of your next period. It may also make your period lighter, heavier, spotty, or more/less painful than usual.
Studies show that EC may be less effective for individuals with high BMIs (1). The most effective EC choice for individuals with high BMIs is the copper IUD, called ParaGard. If your BMI is 26 or greater, take over-the-counter EC as soon as possible, but please contact your doctor to discuss whether you may need to consider alternative forms of EC.
EC does NOT protect against sexually transmitted infections (STIs). Please see your healthcare provider as soon as possible if you believe you may have been exposed to an STI.
Where Can I Buy EC?
EC is classified as an over the counter drug, which means it can be purchased without restriction or a prescription just like Tylenol or Advil. You do not need to speak with a pharmacist or go to a health professional for a prescription before purchasing EC. Over-the-counter EC ranges in price from $35- $60 at pharmacies, grocery stores, and chain stores like CVS, Walgreens, and Target and many college health centers offer it for a reduced price to students. Some common EC brands are Plan B One-Step, My Way, Next Choice One Dose, Take Action and Aftera.
Under the Maryland Contraceptive Equity Act, state-regulated insurance policies MUST cover the cost of over-the-counter EC with no copay. Call your insurance company to find out if your plan falls under state regulation.
In Maryland, there is no age restriction on purchasing EC and you do NOT need to show an ID or driver’s license to purchase it. Since EC is a higher cost item, many stores place it in locked boxes on shelves or store it behind the counter. If you don’t see EC out on the shelf or it’s in a locked box, ask a store employee to help you find and purchase EC. You should be able to purchase EC with the same ease as purchasing any other over the counter medication, however many stores institute unnecessary questioning or age restrictions. Don’t be discouraged if you try to purchase EC and it’s held behind the counter; overcome the barriers and take control of your reproductive health!
** If you have experienced a sexual assault, you have options. See our Sexual Assault Resources tab to find help through this difficult time.
(1) Glasier, A., Cameron, S. T., Blithe, D., Scherrer, B., Mathe, H., Levy, D., . . . Ulmann, A. (2011). Can we identify women at risk of pregnancy despite using emergency contraception? Data from randomized trials of ulipristal acetate and levonorgestrel. Contraception,84(4), 363-367. doi:10.1016/j.contraception.2011.02.009
(2) EC Fact Sheet: https://www.womenshealth.gov/files/fact-sheet-emergency-contraception.pdf