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The new rules for emergency contraception

Make sure you're up to speed on who, what, when, where, and how to get emergency contraception in the U.S.

By Sara Alcid of the Reproductive Health Technologies Project.

The condom broke, you forgot to take your pill (or change your patch, or put in your ring), or you got caught up in the moment and didn’t use a condom or birth control. Before you panic, remember, that’s what emergency contraception (EC) is for. It’s birth control you can use after sex—and it’s safe, effective, and more accessible than ever before! (Cue happy dance.)

Recently the rules and regulations for who can buy what EC options have changed, so check out this quick and easy guide to make sure you know exactly what to do if you find yourself in an emergency situation.

Who can get emergency contraception?

First of all, keep in mind that while body mass index (BMI) calculations are imperfect measurements of health, EC pills have been found to be less effective or sometimes not effective at all for those with a body mass index (BMI) of 25 or higher. The copper IUD, which is the most effective EC option regardless of weight, is probably the best option for those with a BMI of 25 or higher.

Another good reminder: EC can be purchased and used by people across the gender spectrum because people who don’t identify as female may still have the ability to become pregnant.

Some kinds of EC require you to talk to a health care provider first; others are available at pharmacies and stores without a prescription.

Easy to get, no prescription needed:

Anyone can buy Plan B One-Step and generic levonorgestrel-based EC pills like Next Choice One Dose, My Way, and Levonorgestrel without a prescription or having to present a form of identification. (There used to be age restrictions to get it without a prescription.) These EC options should now be available on the shelves of grocery stores and pharmacies next to the condoms and pregnancy tests. They may be in anti-theft plastic cases, which the cashier will remove at checkout.

You’ll need to visit or talk with a health care provider:

What is emergency contraception?

There’s lots of confusion about what exactly EC is and how exactly it works. There are four forms of it, but the one most people have heard of is the EC pill, commonly known as Plan B or the morning-after pill. There’s lots of misinformation about EC pills so check out Bedsider’s mythbuster article about it to make sure you have all the facts. A few quick details about all four forms:

  • No form of EC provides protection from HIV/AIDS or sexually transmitted infections (STIs).

  • All EC methods work before the beginning of pregnancy, so they won’t work if you’re already pregnant. (For an excellent 2-minute overview of how it works, watch ASAP Science’s “The Science of Plan B” video.)

  • EC can safely be used every time a woman has unprotected sex or experiences contraceptive failure, but it doesn’t protect against future acts of unprotected sex and it’s not as effective as other birth control methods. There’s one exception: The copper IUD. If you get one within five days of unprotected sex, it reduces your chance of getting pregnant by 99% and it will protect against pregnancy for up to 12 years after insertion!

When should I use emergency contraception?

  • Plan B One-Step, Next Choice One Dose, My Way, and Levonogestrel all work best the sooner you take them, so the ideal is to have a box on hand to take immediately in case of emergency. The makers of these EC options suggest taking them up to 72 hours (or three days) after unprotected sex or suspected contraceptive failure. Bedsider’s medical advisors say you can take them up to five days after, but remember that they get less effective each day.

  • ella works up to five days after unprotected sex or suspected contraceptive failure.

  • The copper IUD can also be used as EC for up to five days after unprotected sex or suspected contraceptive failure—but remember, you’ll have to visit a health care provider to get it inserted.

Where can I get emergency contraception?

Bedsider has a handy dandy “where to get it” EC locator that helps you find a pharmacy, grocery store, drugstore, or health clinic that stocks EC pills (or inserts IUDs) near you.

If pharmacy or store staff wrongly deny you EC or are stocking it in the wrong place, you can print out this pharmacy education tool about EC provider guidelines and show them you know what’s up.

How can I afford emergency contraception more easily?

With the average price of Plan B One-Step being about $48 and generic EC pills averaging $40, many people have a difficult time affording it. Here are a few ways to make it more affordable:

  • Some health centers or clinics offer free or reduced-price EC, including Planned Parenthood clinics.

  • You should be able to use your Medicaid coverage or private insurance coverage with a prescription. If your insurance company refuses to cover your EC even though you have a prescription, contact the National Women’s Law Center at 1-866-745-5487 or CoverHer@nwlc.org for help.

    Updated on July 22, 2014.


    Sara Alcid is a feminist writer, reproductive justice advocate, and cat mom. She works for the Reproductive Health Technologies Project as a Programs and Policy Associate.
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