What is emergency contraception (EC)?
Emergency contraception (EC) helps prevent pregnancy after barrier-free sex or a failed contraceptive. A broken condom is an example of a failed contraceptive. EC does not protect against sexually transmitted infections (STIs). EC does not cause an abortion or miscarriage if you are already pregnant. It only prevents a pregnancy from happening in the first place.
Note: Emergency contraception is different from abortion. Abortion ends a pregnancy. There are two types of abortion: medical abortion and surgical abortion. Medical abortion is a series of pills (Mifegymiso®) that you can take at home, if you are less than 8 weeks pregnant. Your physician or a nurse practitioner can prescribe the pills. Surgical abortion typically occurs after 9 weeks of pregnacny. It is also free in B.C.
For information, call 604 683-7151 (from the Lower Mainland) or 1 800 663-7100 (toll-free).
What types of emergency contraception are available?
There are 2 types of emergency contraception:
- Emergency contraceptive pills (ECPs)
- Copper IUD (intrauterine device)
Emergency contraceptive pills
Emergency contraceptive pills (ECPs) are also known as the "morning-after pill,” or Plan B. Generic brands are also available, such as Contingency One. ECPs are most effective when taken within 72 hours (3 days) after having barrier-free sex, but can be used up to 5 days after having sex. They do not have to be taken the next morning.
ECPs contain hormones or a drug to prevent pregnancy after barrier-free sex or a failed contraceptive. In Canada, ECPs either contain a hormone called progestin (levonorgestrel) or a drug called ulipristal (Ella™).
ECPs that contain progestin and ulipristal stop or delay ovulation (an egg being released from the ovaries). Progestin-only pills prevent fertilization of an egg by affecting the cervical mucus or the ability of sperm to bind to the egg. However, like any contraceptive method, these pills are not 100 per cent effective, and can be less effective for people who have a greater body mass index (see “How can I tell if the pills worked or not?”).
It is very important to take emergency contraceptive pills exactly as recommended.
A copper IUD is a small, T-shaped plastic device wrapped in copper. It is inserted into your uterus (via your vagina) by your health care provider. When inserted within 7 days of barrier-free sex, a copper IUD is the most effective form of emergency contraception available.
As emergency contraception, the copper IUD stops fertilization by causing a chemical change that damages sperm and egg before they can meet. Like any birth control method, the IUD is not 100 per cent effective.
A benefit of the copper IUD is that it can remain in your uterus for up to 5 years as an effective form of contraception if you wish.
When can I use emergency contraception (EC)?
All forms of EC should be used as soon as possible after barrier-free sex or a failed contraceptive. EC is more effective the sooner it is used.
You may wish to use EC in the following situations:
- You had barrier-free sex, or your partner ejaculated on your genitals (e.g., during withdrawal method)
- The condom broke, slipped off or leaked
- Your diaphragm or cervical cap slipped, tore or came out less than 6 hours after intercourse
- You missed taking 1 birth control pill in the first week
- You missed taking your birth control pills more than 2 days in a row, or you took your progesterone-only pill 3 or more hours late
- It has been more than 13 weeks since your last Depo-Provera® injection
- Your NuvaRing® has been out of your vagina for more than 3 hours
- Your contraceptive patch fell off
- You forgot to start, or you forgot to change, the patch for more than 48 hours
- You experienced a sexual assault
Are there any side effects?
Side effects are uncommon and do not last long.
Emergency contraceptive pills
After taking an ECP, you may experience nausea or vomiting, and your period may not occur when you expect it. Taking an anti-nausea medication like Gravol® at least 30 minutes before you take the ECP may help prevent stomach upset. If you vomit within 2 hours of taking the progestin-only ECP, contact your health care provider because you may need to take another dose. If you vomit within 3 hours of taking the ulipristal ECP, you will need to take another dose. Less common side effects of ECPs may include abdominal pain or cramps, headache, dizziness, fatigue, breast/chest tenderness and vaginal spotting or bleeding in the week or month after.
If you are already pregnant, ECPs will not interrupt the pregnancy or pose a risk to the fetus.
A copper IUD is a very effective EC and can provide long-term contraception. Side effects of an IUD can include pain or cramping during/after insertion, infection, a chance that it comes out or perforates the uterus, or more painful or heavier periods. If you choose to have an IUD inserted, your health care provider will discuss this with you.
Can anyone use emergency contraception?
Most people can safely use ECPs even if they cannot use birth control pills as their normal method of birth control. Your health care provider can tell you if you can use ECPs.
If you are unable to take ECPs or decide to use a copper IUD for emergency contraception, your health care provider will do a pregnancy test and confirm that you do not have a condition that may prevent you from using an IUD.
Where can I get emergency contraception?
You can get progestin-only ECPs without a prescription from a physician, public health nurse, pharmacy, walk-in clinic, youth clinic, sexual health clinic, women’s health or sexual assault centre, or hospital emergency room. The ulipristal ECP requires a prescription from your health care provider.
You can get ECPs in advance for use in case of an emergency.
An IUD is available from many doctors, and some clinics. An IUD must be inserted by a health care professional.
There may be a cost for emergency contraception. Discuss the options with your health care provider.
For more information, call Options for Sexual Health toll-free at 1 800 739-7367 or visit www.optionsforsexualhealth.org/.
Do teenagers need a parent’s consent?
No. You can use or get a prescription for contraceptives, including EC, without a parent’s or guardian's consent.
How can I tell if the pills worked or not?
The effectiveness of ECPs depends on how soon you take the pills, the type of pills, and where you are in your menstrual cycle. They may also depend on your weight. The copper IUD is the most effective EC and does not depend on body weight.
Progestin-only ECPs are less effective in people who weigh over 165 pounds (75kg). If you weigh over 165 pounds, speak to your health care provider about alternative methods of emergency contraception, like the IUD.
Ulipristal ECP may be less effective in people with a body mass index (BMI) greater than or equal to 30 kg/m2.
You should have a period within 3 weeks after taking ECPs. If you do not have a period within 3 weeks, you will need to take a pregnancy test. A pregnancy test can be done at home or by a health care provider. You can buy pregnancy tests at a pharmacy or grocery store.
For More Information
If you think you are pregnant already, see your health care provider to discuss your options.
For pregnancy counselling services throughout the province, including pregnancy options, visit BC Women’s Hospital & Health Centre Counselling Services at www.bcwomens.ca/our-services/gynecology/abortion-contraception or call Pregnancy Options Service at 1 888 875-3163.
If you have experienced a sexual assault, please see the resources listed below for confidential support, resources, and information about your options:
- VictimLinkBC: www2.gov.bc.ca/gov/content?id=18AD0E75BD1C4B0AB99F9C806C734190, or call toll-free 1 800 563-0808
- Victimsinfo.ca: www.victimsinfo.ca
For information on STIs, see HealthLinkBC File #08o Preventing Sexaully Transmitted Infections.