Which kind of emergency contraception should I use?

What kinds of emergency contraception are there?

There are 2 ways to prevent pregnancy after you have unprotected sex:

Option 1: 

You can get certain IUDs within 120 hours (five days) after having unprotected sex.

This is the most effective type of emergency contraception. These IUDs work as well on day 1 as on day 5.

Option 2:

Take an emergency contraception pill (AKA the morning-after pill) within 120 hours (5 days) after having unprotected sex.

The morning-after pill only works if you take it before you ovulate — so take it as soon as possible to be on the safe side.

There are 2 types of morning-after pills:

• A pill with ulipristal acetate. There’s only one brand, called ella.

  • ella is the most effective type of morning-after pill.

  • You need a prescription from a nurse or doctor to get ella emergency contraception, but you can get a fast medical consultation and prescription with next-day delivery online from Nurx, PRJKT RUBY, or the Planned Parenthood Direct app.

  • You can take ella up to 120 hours (5 days) after unprotected sex — but it’s best to take it as soon as you can.

  • If you weigh 195 pounds or more, ella won't work as well.

• A pill with levonorgestrel. Brand names include: Plan B One Step, Take Action, My Way, Option 2, Preventeza, AfterPill, My Choice, Aftera, EContra, and others.

  • You can buy levonorgestrel morning-after pills over the counter without a prescription in most drugstores, pharmacies, and superstores.

  • These types of morning-after pills work best when you take them within 72 hours (3 days) after unprotected sex, but you can take them up to 5 days after. The sooner you take them, the better they work.

  • If you weigh more than 165 pounds, levonorgestrel morning-after pills may not work.

You can use emergency contraception to prevent pregnancy if:

• you didn’t use a condom or other birth control method when you had vaginal sex

• you made a mistake with your regular birth control (forgot to take your birth control pills, change your patch or ring, or get your shot on time) and had vaginal sex

• your condom broke or slipped off after ejaculation (cumming)

• your partner didn't pull out in time

• you were forced to have unprotected vaginal sex

Using emergency contraception correctly after you have unprotected sex makes it much less likely that you’ll get pregnant. In other words, using emergency contraception ASAP gives you a better chance of delaying ovulation before it starts.

Emergency contraception pills are safe, don’t cause any long-term side effects, and won’t affect your ability to get pregnant in the future. But using them as your only regular birth control isn’t a great idea because they’re not as effective — or as affordable — as regular, non-emergency birth control methods (like the implant, pill, or condoms).

If you have sex (or think you might have it in the future),  explore different methods of birth control to find the best method for you.

What kind of emergency contraception is best for me?

The best emergency contraception (EC) for you depends on a few things:

• How long it’s been since you had unprotected sex — you have up to 5 days after unprotected sex to use emergency contraception.

  • Plan B works better the sooner you take it. Plan B doesn’t work nearly as well after 3 days (72 hours).

  • It’s better to take ella as soon as you can. But ella is more effective than Plan B, no matter when you take it.

  • The Paragard, Mirena, and Liletta IUDs are the best at preventing pregnancy, and they work as well on day 5 as they do on day 1.

• How much you weigh

  • Plan B may not work if you weigh more than 165 pounds.

  • ella works less well if you weigh 195 pounds or more.

  • IUDs work just as well no matter how much you weigh.

• Which kind of EC is easiest for you to get

  • Plan B is usually the easiest — anyone can buy it over-the-counter without a prescription at most drugstores, pharmacies, and superstores, no matter your age or gender.

  • ella can be harder to get than Plan B because you need a prescription. You can call your doctor or nurse for a prescription, go to your nearest Planned Parenthood health center, or buy it online from Nurx or PRJKT RUBY. Depending on where you live you may also be able to order ella online through the Planned Parenthood Direct app.

  • An IUD can be hard to get within 5 days because you need an appointment for a nurse or doctor to put it in.

• Whether you’re breastfeeding

  • Plan B and IUDs won’t affect your breast milk.

  • If you use ella, you’ll need to pump and throw away your breast milk for 24 hours after taking it.

This quiz can help you figure out the best EC for you.

If you can’t get the most effective types of emergency contraception, remember that using whichever method you can get is still better than not using anything at all. And timing is really important — you only have up to 5 days after unprotected sex to use emergency contraception, and sooner is better. In fact, many people get the morning-after pill ahead of time and keep it at home, so they can take it as soon as possible if they need it.

Don’t use 2 different kinds of morning-after pills (like Plan B and ella) at the same time or within 5 days of each other, because they may counteract each other and not work at all.

If you have questions about emergency contraception, you can talk with an educator on our Chat/Text line, or call your nearest Planned Parenthood health center.

How long do I have to get emergency contraception?

You can use emergency contraception up to 5 days (120 hours) after unprotected sex. So it’s important to act quickly so you have the best options possible. It can take time to get emergency contraception, so the sooner you start looking for it, the better.

IUDs and ella are just as effective throughout the 5 days. Plan B, My Way, Take Action, and other levonorgestrel morning-after pills work less well after three days (72 hours).

Is the morning-after pill safe?

Morning-after pills are safe — millions of people have used different kinds of emergency contraception for more than 30 years. There have been no reports of serious complications. Morning-after pills don’t cause any long-term side effects, and they won’t change your ability to get pregnant in the future.

How many times can I use the morning-after pill?

Taking the morning-after pill multiple times is safe and won’t hurt you. But it’s not a good idea to use the morning-after pill as your regular, go-to method of birth control. This is because:

• The morning-after pill doesn’t prevent pregnancy as well as other types of birth control like the IUD, implant, pill, shot, or ring.

• Taking the morning-after pill over and over again is usually more expensive and less convenient than being on a regular method of birth control.

• Morning-after pill side effects — like bleeding between periods or nausea — are temporary and harmless, but they can be annoying.

So it’s totally safe to take the morning-after pill as many times as you need to — it’s just not the best way to prevent unintended pregnancies long-term. Birth control that you use before or during sex (like the IUD, implant, pill, condoms, etc.) is way more effective, affordable and convenient.

Don’t use two different kinds of morning-after pills (like Plan B and ella) at the same time or within five days of each other, because they may counteract each other and not work at all. 

One of the most convenient things about getting an IUD as emergency contraception is that it keeps giving you super effective birth control for up to 8 to 12 years (depending on which one you get). So once you get an IUD, you won’t have to worry about pregnancy again (until you stop using the IUD).

How does emergency contraception work?

Pregnancy doesn't happen right after you have sex — that's why it's possible to prevent pregnancy a few days after you do it. It’s all about timing.

Sperm can live inside your body for up to 6 days after sex, waiting for an egg to show up. If you ovulate during that time, the sperm can meet up with your egg and cause pregnancy. Morning-after pills work by temporarily stopping your ovary from releasing an egg. It’s kind of like pulling the emergency brake on ovulation. Where you’re at in your menstrual cycle and how soon after unprotected sex you take the morning-after pill can affect how well it prevents pregnancy. Morning-after pills won’t work if your body has already started ovulating.

This is why timing is so important, especially if you’re using Plan B and other levonorgestrel morning-after pills. (ella works closer to the time of ovulation than levonorgestrel morning-after pills like Plan B.) Most people don’t know exactly when they ovulate, so it’s best to use emergency contraception as soon as possible — no matter where you are in your menstrual cycle or whether or not you think you’re about to ovulate.

The morning-after pill is NOT the same thing as the abortion pill (also called medication abortion). The morning-after pill doesn’t cause an abortion. It won’t work if you’re already pregnant, and it won’t harm an existing pregnancy. Emergency contraception (including the IUD) is birth control, not abortion. It doesn’t end a pregnancy — it prevents one.

How much does the morning-after pill or an IUD cost?

Plan B One-Step usually costs about $40–$50. Other brands of levonorgestrel morning-after pills like Take Action, My Way, Option 2, Preventeza, AfterPill, My Choice, Aftera, and EContra generally cost less — about $11–$45. You can sometimes get these pills for cheaper online, but they may not come in time if you need a morning-after pill right now. So you can buy it online ahead of time and put it in your medicine cabinet in case you need it in the future. Though there are many different brands of levonorgestrel morning-after pills, they all work the same way no matter how much they cost. 

If you have health insurance or Medicaid, there’s a good chance you can get morning-after pills for free — you just have to ask your nurse or doctor for a prescription so your health insurance will cover them (even though you don’t need a prescription to buy these types of morning-after pills over-the-counter). Read more about using health insurance to pay for emergency contraception.

ella usually costs about $50 or more at the pharmacy or drugstore — but it’s usually free if you have health insurance or Medicaid. ella costs $90 when you order it online (this price includes the medical consultation and overnight shipping). ella is the only brand of this type of morning-after pill. ella is more effective than Plan B and other levonorgestrel pills, especially if you weigh more than 165 pounds.

Getting an IUD costs anywhere between $0-$1,300. That’s a pretty wide range, but the good news is that IUDs are free or low cost with many health insurance plans, Medicaid, and some other government programs. And even if an IUD costs a lot up front, they usually end up saving you money in the long run because they give you really effective birth control for up to 12 years.

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