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Emergency Contraception Pills: What You Need to Know

Posted by Devanshi Somaiya, M.D., F.A.C.O.G. on Feb 6, 2019, 8:10:00 AM

There has been quite a bit of controversy surrounding emergency contraception, so I thought I could help clear things up about what emergency contraception pills (ECPs) can and can’t do. 

Emergency contraception, also called the “morning after pill,” is a birth control method that can be used if you had sexual intercourse and forgot to use your usual birth control, had unprotected sex, or if your usual birth control method failed. For example, a condom was used and it broke. After every coital act, the rate of pregnancy can be as high as 30 percent, depending on the time of the cycle it occurs in! 

Two FDA-Approved Options 

There are two types of FDA-approved ECPs in the United States: ella® and Plan B One-Step® (or a generic version of these). In most cases, a prescription is needed to obtain the pills, which should be taken within five days of unprotected sex, preferably as soon as possible after unprotected intercourse. 

  • After taking ella®, you can’t use a hormonal form of birth control for at least five days because it may cause the ECP to fail. Instead, a non-hormonal form of birth control, like a condom, should be used. It also requires a prescription.
  • After taking Plan B One-Step®, you can return to your usual form of birth control right away. This is available over the counter. 

ECPs are primarily used to prevent or delay ovulation, which is the release of an egg from the ovary. In some cases, they can prevent fertilization of the egg if ovulation has already occurred.

What ECPs Can’t Do 

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Now that we’ve discussed what emergency contraception is, let’s talk about what it’s not.

Emergency contraception pills are not abortion pills. If a fertilized egg has already implanted in the uterus, meaning you are pregnant, the pills will not stop, harm, or end your pregnancy.

Emergency contraception cannot be used as regular birth control. As the name implies, emergency contraception pills should only be used in an emergency, after unprotected sex. It is not effective – and has not been approved by the FDA – as a regular form of birth control for every instance of sexual intercourse. It also is usually much less effective and more costly than regular birth control methods. ECPs only prevent 50 to 65 percent of expected pregnancies, which is obviously better than doing nothing. But properly taken contraception can prevent 99-plus percent of pregnancies.

Remember what we said – it delays ovulation. So, further unprotected sex during that cycle still leaves you vulnerable for pregnancy.

You may experience some nausea after EC, which is common and not harmful. However, if you have vomiting within three hours of taking your EC, see your physician. You may need a repeat dose.

Also, your cycle may be delayed by one to two weeks. If you don’t have a cycle within three weeks of using EC, please check a pregnancy test and see your doctor.

Emergency contraception will not protect you from sexually transmitted infections (STIs) or sexually transmitted diseases (STDs). The only contraception that protects you from STIs and STDs is a condom. If you believe you may have been exposed to an STI or STD, contact your doctor right away.

It’s a good idea to ask your doctor for an ECP prescription in case you need it in the future. That way you can be sure to take it within five days of unprotected sex. At Kelsey-Seybold Clinic in Houston, my staff and I are happy to discuss birth control options with you and provide emergency contraception, if needed.


Dr. Somaiya is an OB/GYN specialist at Kelsey-Seybold’s Downtown at The Shops 4 Houston Center Clinic. Her clinical interests include laparoscopy, contraception, and teen counseling.



Topics: ob/gyn, emergency contraception, OBGYN, morning after pill

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