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Emergency Contraception

EC is birth control you can use to prevent pregnancy up to five days (120 hours) after sex. It may be needed if you weren’t using birth control when you had sex, you forgot to take your birth control, your partner’s condom slipped off or broke, your partner didn’t pull out in time, or  you were forced to have unprotected vaginal sex. It is also known as the “morning after pill.”

HOW MUCH DOES EC COST?

The cost depends on the method and place you buy it. Typical costs:

- Progestin pill ~$30-$70

- Ulipristal ~ $40-70

- IUD - contact your insurance company for copay info. If your insurance does not cover the IUD, it may be fairly expensive up front (~$700-$900), but more cost effective over time since it can provide ongoing birth control for up to 10 years.

WHERE CAN I GET EC?

At UNC, you can go directly to the Campus Health Pharmacy to get EC pills without an appointment or prescription. To be evaluated for an IUD as EC call CHS as soon as possible at 919.966.2281.

CAN I USE EC INSTEAD OF REGULAR BIRTH CONTROL?

EC pills should not be used as an ongoing regular birth control method. They are not nearly as effective and can also be very expensive. The copper IUD, however, can be inserted for EC purposes and left in for ongoing contraception.

WHAT IS THE DIFFERENCE BETWEEN EC METHODS AND THE ABORTION PILL?

EC methods do not cause abortions. All EC methods work to prevent ovulation, fertilization or implantation. If a woman is already pregnant, meaning that a fertilized egg has implanted in the uterus, EC will not work. EC is not the same as mifepristone (RU-486), a pill used for medical abortion.

Options for Emergency Contraception

Non-Hormonal Copper IUD (Paragard®)

+ Pros: Most effective form of emergency contraception available., when inserted up to 5 days (120 hours) after unprotected sex. Can prevent future pregnancies for up to 10 years or longer (can be removed anytime for quick return to fertility). This method is non-hormonal and some studies have shown that it may reduce risk of endometrial cancer. Insurance may cover all or some of the cost.

- Cons: Must be inserted into the uterus by a medical provider. If your insurance does not cover all of it, the IUD and insertion may be expensive. Possible heavier or longer periods and/or more cramping (in one study, 2 out of 3 women had more blood loss, 1 in 3 had more cramping). No protection against STIs. Rarely perforation of the uterus could occur at the time of placement.

How it works: The IUD’s precise mechanism is not known; likely several factors are involved. Pregnancy appears to be prevented by the changes in the uterine environment as a result of the introduction of a foreign body (the IUD) and copper that impairs sperm and ova function as well as prevents fertilization.

Progestin Pill (Plan B one-step®, Next choice one dose ®)

+ Pros: Can be used up to 5 days (120 hours) after unprotected sex but may be less effective as time passes. Easy to access - anyone can obtain without a prescription at pharmacies, including Campus Health Pharmacy. Can be obtained before you might need it in case of emergencies.

- Cons: May cause your next period to be earlier or later than you expect and be heavier or lighter. Frequent use may cause periods to become irregular. May cause nausea (take pills with food to reduce this effect. If you throw up within 2 hours of taking the pill, notify your provider.). There is evidence that progestin pills may be less effective for women with a BMI of >25 (Don’t know your BMI? Visit www.nhlbi.nih.gov/guidelines.obesity/BMI/bmicalc.htm to find out).

How it works: These pills contain progestin, which prevents pregnancy by delaying ovulation.

Ulipristal (ella®)

+ Pros: FDA approved for use up to 5 days  (120 hours) after unprotected sex. Insurance may cover all or some of the cost of ulipristal like it would any other prescription. Can be obtained with a prescription in case you need it in the future.

- Cons: Requires a prescription from a provider or CHS pharmacist. The most common side effects include nausea, abdominal pain, or headaches. Ulipristal may temporarily reduce the effectiveness of other hormonal contraceptive methods. You may continue using your usual hormonal contraceptive (pill, patch, ring), but it is recommended that you use a backup method of birth control (like condoms) for 14 days after taking ulipristal. There is evidence that ulipristal may be less effective for women with a BMI >35 (Don’t know your BMI? Visit www.nhlbi.nih.gov/guidelines.obesity/BMI/bmicalc.htm to find out).

How it works: Ulipristal suppresses progesterone, delaying ovulation for up to 5 days. It can also thin the lining of your uterus, making it more difficult for a fertilized egg to be implanted.

 

EC Pills are not as effective as regular birth control.

No form of EC protects against Sexually Transmitted Infections. Contact your provider for testing information.

For a printable version of this info, see the patient education brochure.