Contraception and Safer Sex
 

Abstinence
Birth Control Pills
Depo Provera
Diaphragm
Emergency Contraception Pill
Female Condom (Reality Condom)
Fertility Awareness Methods
Hormonal Contraceptive Patch (Evra Patch)
Hormonal Contraceptive Ring (Nuva Ring)
Intrauterine Device (IUD)
Intrauterine System (IUS)
Male Condom
Spermicides
Tubal Ligation
Vasectomy
Withdrawal

Emergency Contraception Pill

What are emergency contraceptive pills?
Emergency contraceptive pills (ECPs) are also commonly known as the “morning after pills.” ECPs are an emergency form of hormonal birth control that can be used after unprotected sexual contact or where other forms of contraception may have failed.  There are 2 types of ECP available: 2-pill emergency contraception or 4-pill emergency contraception. The 2-pill type is the most common and only contains progestin. It is now available over-the-counter at pharmacies without a doctor’s prescription. The 4-pill method contains both oestrogen and progestin and is not available over the counter. It requires a prescription. 

How do emergency contraceptive pills work? 
ECPs contain higher doses of hormones than everyday oral contraceptives. How the ECPs work depends on where you are in your menstrual cycle. If you have not already ovulated, ECPs will prevent ovulation (release of an egg/ovum). If you have already ovulated, ECPs will make it difficult for a fertilized egg to implant inside the uterine wall, by changing the lining of the uterus. If you are already pregnant ECPs will NOT affect your pregnancy. ECPs can only prevent pregnancy - it is not an abortion pill.

* ECPs do not protect against sexually transmitted infections *

When might I choose to use emergency contraceptive pills?
There are many reasons why a person may choose to use ECPs.  Here are some common reasons:
If your primary method of contraception fails in any way (e.g. if the condom breaks)
If you missed taking your birth control pills two or more days before having sex and did not use a backup method of contraception (e.g. a condom)
If you have unprotected sex
If you are sexually assaulted

How can I get emergency contraceptive pills?
You can get the 2-pill method without a prescription from most birth control clinics and pharmacies. Call them first to make sure they have it. The 4-pill method requires a prescription from a doctor.

How effective are emergency contraceptive pills?
ECPs are not intended as a regular method of birth control.  They are intended for emergencies. The sooner you take ECPs, the more effective they will be. You can purchase ECPs ahead of time so that if an emergency happens, you will have them readily available.

ECPs can be taken up to 5 days after unprotected sex. Depending on when the ECPs are taken, their effectiveness changes:
0-24 hours: 95% effective
24-48 hours: 85% effective
49-72 hours: 58% effective

*ECPs may cause spotting after being taken; this is not your period. ECPs can also make your period come earlier or later than usual. If your period is more than 3 weeks late, call your physician or clinic. You may need a pregnancy test. If you are pregnant you do have options available to you. 

How do I use emergency contraceptive pills?
There are two types of ECPs available in Canada:
 
2-Pill emergency contraception
Take the first pill as soon possible.
12 hours later take the second pill or both pills can be taken at same time (a pharmacist may recommend taking both at the same time, to prevent the possibility of forgetting to take the second pill 12 hours after taking the first one).
Because this method only contains progestin and has a lower dosage of hormones, you are less likely to become nauseous than with the 4-pill method; however you may still find it helpful to take anti-nausea medication.
If you do throw-up within 1 hour of taking the pills call the pharmacist/clinic/doctor as you may need to take additional pills

4-Pill emergency contraception (less common but available through prescription)
Take the first 2 pills as soon as possible.
To avoid getting nauseous, you can take anti-nausea medication thirty minutes before taking the second set of two pills. It may also be helpful to eat something with the medication.
Twelve hours after taking the first two pills, take the second two pills.
If you throw up within 1 hour of taking the pills, call the doctor/clinic as you will need to take additional pills.

What are the advantages of emergency contraceptive pills?
It can be purchased ahead of time so that you can have it readily available should an emergency arise.
The 2-pill type can be purchased over the counter at pharmacies
Can be used in emergency situations to prevent unintended pregnancy
It is safe to use.

What are the disadvantages of emergency contraceptive pills?
You might throw up or feel nauseous 
You might experience side effects from the hormones 
It may be difficult to access for people living in rural or remote areas
Does not prevent against STIs

How much do emergency contraceptive pills cost?
Sexual Health Centre: available at a significantly reduced cost. Call them at 613-234-4641.
Pharmacies: approximately $35-40 depending on the individual pharmacy’s dispensing fee and consultation fee.

If you decide to get ECPs from the pharmacy, the pharmacist may ask you a few questions, including (but not limited to):
When was your last period?
Are you certain that you are not currently pregnant (prior to your last unprotected intercourse)?
When was the incident of unprotected sex?
The pharmacist will also make sure that you understand what the ECPs can do, and what it will not do (for example, it will not protect you from STIs, it should not be used as your primary method of contraception and there may be some side effects similar to those from the oral contraceptive pills).

*NOTE* The IUD can also be used as an emergency method of birth control. If an IUD is inserted within 7 days after unprotected vaginal sex it may prevent a pregnancy. This is known as post-coital insertion of an IUD.  You may choose to keep the IUD in afterwards for use as a regular method of birth control.