Emergency Contraception

What is "emergency contraception"?

The term emergency contraception covers several methods that can prevent pregnancy when used by women within a few hours or a few days following unprotected intercourse. These methods have been known to the medical community for many years and involve the use of standard contraceptive products.

The most common method, used in many countries for over 30 years, involves taking an elevated dose of birth control pills (either progestin-only pills or pills containing estrogen and progestin) within 72 hours of unprotected intercourse, followed by a second dose 12 hours later. These pills are called emergency contraceptive pills (ECPs). A copper-T IUD, inserted within five days of unprotected sex, also is occasionally used. Read more below, or visit the federal government source for women's health information.

EC In-depth

How do the pills work?

Depending on when ECPs are used during the monthly menstrual cycle, ECPs may:

stop or delay an egg from being released from the ovary;
prevent the sperm from getting to the egg;
(possibly) stop a fertilized egg from attaching to the uterus.

ECPs will not work once a pregnancy has started.

Does emergency contraception cause an early abortion?

ECPs cannot cause an abortion if the woman is already pregnant. Medical science considers that a pregnancy has begun once implantation of a fertilized egg in the lining of a woman's uterus is complete. The process of implantation begins about five days after fertilization and is completed about one week later, around the time of the expected menses. ECPs are ineffective once implantation has begun.

How safe are available ECPs?

ECPs carry few medical risks for most women. Although some women-those at risk of stroke, heart disease, blood clots, or other cardiovascular problems-should not use combined oral contraceptives on a regular basis, medical experts believe emergency use of birth control pills does not carry the same risks. There have been no reported deaths or serious complications involving ECPs in over three decades of use.

Side effects may include nausea and vomiting. These side effects may be reduced by taking anti-nausea medicine. Nausea and vomiting are significantly less common among women using progestin-only pills than among those using combined oral contraceptives.

How effective is emergency contraception?

ECPs reduce the chance of pregnancy by between 74 and 85 percent, depending on the formulation used. For example, if 100 women had unprotected intercourse, about 8 of them would be expected to become pregnant. If all 100 women used ECPs after intercourse, only 1 to 2 would become pregnant, a 74 to 85 percent reduction in risk. emergency insertion of an IUD is even more effective.

ECPs provide no protection against HIV or other sexually transmitted diseases.

Where can I obtain ECPs?

Here at Rice, Health Services provides emergency contraception for free. An appointment is required, but same-day appointments are typically available. Call 713-348-4966 to schedule an appointment. On weekends when Health Services is not open, Planned Parenthood is also available, however there will be a fee. Local pharmacies sell the pill for about $45, in Houston you can find EC at CVS, Walgreens and Kroger.

What will happen after taking ECPs?

Your next period may be earlier or later than usual and your menstrual flow may be heavier, lighter or more spotty than usual. If you see other healthcare providers before you get your period, remember to tell them that you have taken emergency contraception pills. Schedule a follow-up visit with your clinician if you do not have your period in three weeks after you take ECPs or if you have symptoms of pregnancy. You should use another method of contraception if you have vaginal intercourse before your period comes. After your period, begin using the birth control of your choice for as long as you want to avoid pregnancy.

What happens in cases of failure if a fetus is carried to term?

Over the years, many women have accidentally taken birth control pills (including older, high-dose pills) after they were already pregnant. Studies show no increased risk of birth defects or other problems when the pregnancies were carried to term. Thus there is no reason to suspect that emergency use of the pills would be associated with birth defects if the pills fail to prevent pregnancy or if they are taken after a woman already is pregnant.

What is the need for emergency contraception? Who uses the method now?

All current methods of contraception sometimes fail. Emergency contraception is an important back-up method when routine contraception fails to work properly, as when a condom breaks, pills are missed, or a diaphragm or IUD becomes dislodged.

For couples who did not use any contraceptive but wish they had, emergency contraception provides a critical second chance to prevent an unwanted pregnancy. Young people in particular may not be prepared for their first sexual experience.

Worldwide, one of the most critical uses for emergency contraception has been in cases of sexual assault. Rape crisis centers routinely provide emergency contraception, even in countries where the method is not generally in use.

Could emergency contraception reduce the number of abortions?

By preventing unintended pregnancies, emergency contraception can reduce the need for abortion. In the Netherlands, which has the lowest abortion rate of any industrialized country, contraceptive use is high among young people, and emergency contraception has been widely available as a backup for decades. In Finland, early evidence suggests that abortion rates among teenagers have dropped following the spread of information about emergency contraception.

In many developing countries, where abortion remains illegal, unsafe abortions are a leading cause of death among women of reproductive age. Abortions are also a major drain on scarce medical resources. In these settings, the availability of emergency contraception could prevent much needless death and suffering. It could also reduce the growing pressure on hospital beds, nursing staff, blood supplies, and medications needed to treat the life-threatening medical complications of abortions performed by untrained practitioners under unsanitary conditions.

Have many women used emergency contraception?

Yes. Rates of emergency contraceptive use appear to be highest in those developed countries where ECPs come specially packed in the proper dosages with instructions for both doctors and patients. These products make emergency contraception easier to prescribe and use.

Women in most developed countries have heard something about a "morning-after pill", but most do not know exactly what the treatment is or how long after unprotected sex they can use it. In the United States, for example, a 1994 survey by the Henry J. Kaiser Family Foundation showed that only about one percent of American women have ever used emergency contraception, and only about one-quarter of gynecologists regularly prescribe it. Baseline studies conducted by the Consortium for Emergency Contraception in Indonesia, Kenya, Mexico, and Sri Lanka, as well as studies by researchers in other developing countries, found that levels of knowledge and use were quite low.

Will access to emergency contraception encourage promiscuity among young people?

Will it also cause sexual irresponsibility?

There is no evidence to suggest that knowledge of emergency contraception increases sexual activity among young people. What is clear is that the need for emergency contraception often brings sexually active young people into family planning clinics, where they can receive other services and counseling, including help in learning how to say "no" when they choose to be abstinent. For adolescents who are already sexually active, emergency contraception provides a bridge to effective birth control and disease prevention.

Will women stop using other forms of contraception...

...if emergency contraception becomes too easily available?

Evidence to date suggests that most women will not stop using regular contraception if emergency contraceptives are available. The side effects associated with ECPs, although not serious from a medical standpoint, do discourage over-reliance on emergency contraception for routine birth control. ECPs are also less effective in preventing pregnancy and more expensive than most forms of regular contraception, which are two additional disincentives against routine use of the method.

Above emergency contraception information from Planned Parenthood and Advocates for Youth.