- The condom broke or slipped.
- You forgot two or more pills.
- You’re worried your partner didn’t pull out in time.
- You didn’t use birth control.
- You were sexually assaulted.
- You were drunk or high and don’t remember if you had sex.
There are two types of birth control that can be used in the days following unprotected intercourse.
Neither of these methods help to protect against STIs. If you’re not sure of your partner’s STI status, get tested a couple of weeks later.
ECP: Emergency Contraceptive Pills (the “morning after pill”)
Sometimes known as the “morning-after pill”, ECP is actually a high dose of birth control pills that does two things:
- Stops the ovary from releasing an egg (so that it can’t be fertilized)
- Prevents a fertilized egg from implanting in the uterus (which would cause a pregnancy)
Important: if you’re already pregnant, ECP is not going to terminate the pregnancy. It is NOT an abortion pill.
How effective is ECP?
The earlier you take ECP, the more effective it is:
- 95% effective if you take them within the first 24 hours after unprotected intercourse,
- 85% effective within 48 hours,
- 58% effective within 72 hours.
Because it’s so time sensitive, some people may choose to purchase a dose of emergency contraception to keep on hand, just in case of an emergency situation, like the condom breaking.
Where can you get ECP and how much does it cost?
ECP is available from many pharmacies. They should be found on the shelf with the condoms, though many shops keep them behind the counter. It usually costs about $30-40.
You can get ECP from the Ottawa Sexual Health Centre for $10 or perhaps from campus sexual health centres for a reduced price.
If you have to request ECP from the pharmacist, they may ask you some questions in order to make sure you know what emergency contraception can and can’t do (it can protect against pregnancy, but can’t terminate a pregnancy, and shouldn’t be used as a primary method of birth control). They might also ask about your last period, or when you had unprotected intercourse to check if you’re in the time window when it can be used.
How do you take ECP?
You can take ECP up to 72 hours after unprotected intercourse.
- Take the first pill right away (as soon as you can after having unprotected sex), up to 72 hours
- Take the second pill 12 hours later.
- This medication can cause nausea – you may want to take an anti-nausea medication half an hour before you take each pill.
- If you throw up within an hour of taking the pill, make sure that you contact the doctor or pharmacist who provided the pill- it may be necessary to take a second dose.
What to expect
After taking ECP, you may have some spotting, which is not your regular period. These medications can make your period come earlier or later than usual. If your period is three weeks late, even though you’ve taken emergency contraceptive pills, you should take a pregnancy test. Remember, if you’re pregnant, there are options available to you.
A note about body weight and ECP
There are some concerns that ECP may not work as well in people who weigh over 165 pounds (75kg), and is not recommended for those over 176 pounds (80kg). That being said, there’s lot of controversy over this finding, and some researchers are saying it’s better than doing nothing. The bottom line is that it’s a good idea to talk to a doctor if you weigh over 165 pounds to see whether it’s the right choice for you.
Emergency Post-Coital IUD
Another lesser known option for emergency contraception is having a copper IUD inserted within 5-8 days after unprotected intercourse. It’s much more effective than ECP. It works by preventing a fertilized egg from implanting into the uterus.
You need to find a doctor who is willing to do an emergency insertion of an IUD. It is inserted the same way as any other IUD/IUS, and it can stay in for up to five years to help prevent against pregnancy. This is a great alternative for people who cannot take emergency contraceptive pills.
Only the copper IUD can be used as emergency contraception. Although an IUS (intrauterine system, which is an IUD that contains hormones) can be used very effectively for contraception, it doesn’t work after intercourse has occurred.
There may be some pain or cramping when the IUD is inserted, however this can be expected whenever you get an IUD. It’s possible that the copper IUD can cause heavier periods than before, or more cramping. However, it’s preferred by individuals who are unable or unwilling to take hormonal contraceptives.
IUDs may cost anywhere from $80-$160, and may or may not be covered by private insurance plans. The cost of the doctor’s visit to have it inserted should be covered by OHIP.