Emergency Contraception 101

Your Guide to Morning After Options

Let's talk about emergency contraception pills (ECPs), which are often referred to by the brand name "Plan B."

It's important to note that "Plan B" is brand name levonorgestrel. Other generic versions of levonorgestrel are available, as well as the ulipristal acetate-based pill ella^®. Intrauterine devices (IUDs) can also serve as emergency contraception.

Today, I am going to discuss oral options.

What Are Emergency Contraception Pills?

• Active Ingredients: ECPs contain either levonorgestrel or ulipristal acetate.

• How They Work: The primary function is delaying ovulation, reducing the chance of sperm meeting an egg. Sperm can survive in the reproductive tract for up to five days, so postponing ovulation is the key to avoiding an unplanned pregnancy.

• Safety: ECPs are safe and have been used by millions worldwide. Levonorgestrel prevents ovulation by inhibiting the luteinizing hormone (LH) surge, while ulipristal acetate has an anti-progesterone effect, affecting the uterine lining.

• Effectiveness: When taken within 72 hours of unprotected sex, levonorgestrel-based pills are about 75–89% effective. Ulipristal acetate can be effective up to five days after unprotected intercourse. The sooner they're taken, the more effective they are.

What ECPs Are Not

• Abortifacients: ECPs do not terminate an existing pregnancy. If you've already ovulated or are pregnant, these pills won't be effective and won't cause harm.

• Not Regular Birth Control: While it's wise to have ECPs on hand, they shouldn't replace regular contraception. Explore long-term options if you're sexually active and want to prevent pregnancy.

What to Expect After Taking ECPs

• Side Effects: Some may experience mild side effects like headaches, nausea, or breast tenderness.

• Menstrual Changes: Your next period might be earlier, later, heavier, or lighter than usual. This is due to the hormone's effect on your cycle.

Important Reminders

• Vomiting: If you vomit within two hours of taking an ECP, you need to take another dose.

• Delayed Period: If your period is more than 7 days late, take a pregnancy test. The sooner you know what’s going on, the sooner you can make a plan.

• Weight Considerations: Plan B (and other forms of Levonorgestrel) are best for individuals who weigh 165 lbs or less. ella^® is the first choice for those who weigh between 165-195 lbs. Ella may be less effective in people who weigh 195 pounds or more. (Not ineffective, just less effective.) For those concerned about weight and effectiveness, a copper IUD is a highly effective emergency contraceptive option.

Where to Obtain Emergency Contraceptives

You can find levonorgestrel-based pills over-the-counter at most pharmacies, including major retailers like Amazon, Walmart, and Target.

ella^® requires a prescription. You can obtain a prescription online from reputable retailers like Nurx, PRJKT RUBY, or the Planned Parenthood Direct app.

As a public health professional specializing in reproductive health, I recommend considering generic levonorgestrel options like "My Choice Levonorgestrel 1.5 mg," which is affordable ($8.34 on Amazon), FSA and HSA eligible, does not require a prescription, and can be delivered discreetly. If you weigh over 165 lbs, consider obtaining a prescription online. Fill it and keep it on hand.

Mandatory disclaimer: Always consult with a healthcare provider for personalized advice.

Applying Harm Reduction Strategies to Reproductive Health

Reproductive health is under attack.

The recent removal of the federal website for reproductive rights and healthcare information, reproductiverights.gov, underscores the urgency of safeguarding access to essential reproductive health services.

Emergency contraception (EC) is a critical component of reproductive healthcare, serving as a vital tool in preventing unintended pregnancies. By providing accurate information and ensuring access to EC, we can empower individuals to make informed decisions about their reproductive health, thereby reducing potential harm.

Applying harm reduction principles to reproductive health involves offering comprehensive contraceptive counseling and education. This approach ensures that all forms of contraception, including emergency options, are accessible, allowing individuals to choose methods that best suit their needs and circumstances.

Harm reduction is an evidence-based approach to reducing public health risks. By integrating harm reduction strategies into reproductive healthcare, we can navigate the current challenges more effectively, promoting informed choices and better health outcomes for all.

References

Babs. (2023, August 31). Harm reduction: A novel approach to addressing unsafe abortion. Ipas. https://www.ipas.org/news/harm-reduction-a-novel-approach-to-addressing-unsafe-abortion/

Baca-Atlas, M. H., Nimalendran, R., & Baca-Atlas, S. N. (2023, January 15). Applying harm reduction principles to reproductive health. AAFP. https://www.aafp.org/pubs/afp/issues/2023/0100/letter-reproductive-health.html?utm_source=chatgpt.com

Emergency contraception | Types, cost, side effects & effectiveness. (n.d.). Bedsider. https://www.bedsider.org/birth-control/emergency_contraception

Plan B Morning-After Pill | How Plan B works & side effects. (n.d.). Planned Parenthood. https://www.plannedparenthood.org/learn/morning-after-pill-emergency-contraception/whats-plan-b-morning-after-pill#:~:text=You%20may%20be%20able%20to,when%20you're%20stressed%20out.

What is the ella Morning-After Pill? | Cost & Effectiveness. (n.d.). Planned Parenthood. https://www.plannedparenthood.org/learn/morning-after-pill-emergency-contraception/whats-ella-morning-after-pill