Emergency contraception (EC) is sometimes called the morning-after pill or Plan B. It is contraception used as soon as possible up to 5 days after unprotected sex if contraception isn’t used,
contraception fails, or when sex is coerced or forced.
There are two kinds of EC pills:
- Progestin-only EC (Plan B One-Step and generics like AfterPill) is available over-the-counter (OTC).
- Ulipristal acetate EC (sold as ella) is available with prescription only.
A copper IUD inserted within 5 days after unprotected sex can also be used as EC, and it has the added benefit of providing long-term pregnancy prevention. New research shows that a hormonal
IUD (like Mirena) may also be an effective option for EC.
EC is NOT the same as the abortion pill; EC prevents pregnancy before it happens.
Progestin-only EC (Plan B One-Step and generics such as Aftera) is approved for over-the-counter (OTC) sale, but access is not always easy:
- Not all campus health centers offer EC
- Health center and pharmacy hours may be limited, especially on nights and weekends, when people may need EC the most
- Students may have difficulty getting to a local pharmacy
- Pharmacy prices are high ($40-50)
- EC is not always stocked directly on the shelf - people buying EC may need to ask pharmacy staff for it, which can feel like a violation of privacy
- Some pharmacies still ask for proof of ID, based on outdated age restrictions
Exact effectiveness rates are hard to calculate for EC pills, because it’s difficult to know the risk of pregnancy for a particular act of intercourse. Here are some things to know about EC
- The copper IUD is by far the most effective option, followed by ulipristal acetate (ella - the prescription-only pill) and progestin-only EC (Plan B - the OTC pill).
- EC pills are an important option that should be available to everyone, but both types are less effective than regular contraceptives.
- Check out this chart from Bedsider comparing the effectiveness of different types of EC
Some research shows that EC pills may be less effective depending on your weight or body mass index (BMI).
- If you weigh 165 lbs or more (or have BMI of 26 or more), progestin-only EC may not work. In this case, ella (prescription-only EC) or a copper IUD may be a better choice.
- If you weigh 195 lbs or more (or have BMI of 35 or more) ella may not work. In this case, a copper IUD may be a better choice.
- Read more about the research behind EC effectiveness and weight here.
- Ella is a more effective option for nearly everyone because it works closer to the time of ovulation. If you want to use ella, see your healthcare provider or visit an online provider that
can prescribe and/or deliver EC, such as Pandia
Health,* Nurx, or Planned Parenthood Direct.
*Pandia Health is a financial supporter of EC4EC