As much as we may try to be in control or prepared for any and every situation, it isn’t always possible—accidents do happen. Condoms break, or you forget to take your pill, and that can be a scary situation. Fortunately, emergency contraceptives have been made more readily available to women in recent years; in 2009, it was approved without prescription to women ages 17 and up and since 2013, women as young as 15 can get access to the morning after pill. But as one of the most easy-to-get forms of birth control, it might seem more convenient to rely on Plan B as your Plan A than to have to get a prescription for regular birth control (and not to mention, have to remember to take it each day)—so is it okay to take EC after every instance of intercourse and call it a day? We checked in with experts on how emergency contraception works, when to use it, and whether it's safe to use regularly as your primary form of birth control.
What is emergency contraception?
Emergency contraception goes by a lot of different names; the morning-after pill, the day-after pill, morning-after contraception and more. There are also various brands of EC that you can choose from, including Plan B One-Step, Next Choice One Dose, My Way and ella. All of these emergency contraceptives essentially serve the same purpose, and are used in the same way; they are pills you can take up to a certain amount of time following unprotected sex (usually five days) in order to lower the possibility of pregnancy.
Copper IUDs (rather than hormonal IUDs, the more popular form of IUDs) may also be used as emergency contraception, if you're looking for something that will give you more permanent results after the fact—up to five days after you've had unprotected sex, you can visit a doctor to insert an IUD, which is a small, T-shaped device made of copper that will be effective for multiple years.
How does an emergency contraceptive work?
There is a common misconception about what emergency contraceptives do. They do not stop pregnancies; however, they do reduce the risk of a pregnancy up to 95 percent, or 99 percent when using a copper IUD, if taken within the allotted time period.
A copper IUD releases copper ions that destroy sperm before it can fertilize an egg, while an emergency pill simply keeps you from releasing an egg. Therefore, emergency contraceptives do not terminate a pregnancy, but keep one from beginning in the first place.
When should emergency contraceptives be used?
For emergencies! They are designed to be a safety net for when unexpected situations arise. If you plan on having sex regularly or at all, taking birth control and using condoms are good precautions to take—especially since research shows that EC isn't as effective as standard forms of birth control can be. According to Princeton University, if you used only EC for a year, your annual pregnancy risk would be 20 percent. That means that if you have unprotected sex for a year and solely rely on emergency contraception each time, statistics show that your risk of pregnancy reaches one in five. In addition, obesity can lessen the effectiveness of emergency contraception; Plan B and Next Choice may not work well for women with a BMI over 25, and not at all for those with a BMI higher than 30. Ella, however, can be effective up to a 35 BMI, and copper IUDs are not affected by weight.
Emily*, a student at Indiana University, says she does not rely on EC regularly for that reason. “On the package, there is a warning about taking it regularly because it is not as strong as regular birth control,” she says. “So instead, I just rely on taking normal birth control daily.”
Not to mention, taking EC as a regular contraceptive can get incredibly expensive; it can cost anywhere from $35 to $60 a dose, depending on the brand. Birth control pills, on the other hand, can be anywhere from free up to $50 for a month's supply; many insurance plans cover it fully.
This doesn't mean that you shouldn't have EC on hand, though.
Dr. Shana Dowell, an obstetrician-gynecologist at the Vanderbilt Center for Women’s Health at NorthCrest Medical Center in Springfield, Tennessee, says, “I think ideally if you are going to have sex and you don't want to get pregnant, than starting some sort of birth control beforehand is best,” she says, adding that this is in no way to say that emergency contraception should be avoided. “There are so many barriers, however, to women getting appropriate contraception (cost, transportation, health insurance, privacy) and mistakes happen (prescriptions running out, condoms breaking). Or, having morning after pills as an option in the case of sexual assault is so important.”
How do the side effects of EC compare to the effects of the pill?
When it comes down to it, the effects of birth control and EC are relatively similar: nausea, breast tenderness, dizziness, fatigue and lower abdominal pain. “Most women tolerate them quite well,” says Dr. Dowell. “There are only a few contradictions, but this is a great option for most women who have a contraceptive mishap.” This means that like with any pill, some will experience intensified, varying side effects.
“I know friends who have taken it a few times and have experienced nausea, cramping, and irregular periods that lasted several weeks,” Emily says of her and her friends' personal experiences. “I really think it is different depending on the collegiette and her body.”
Although the symptoms associated with EC are relatively the same as those associated with taking birth control and a normal period, there are instances where girls have experienced painful or abnormal side effects. Even though most women do not experience unusual discomfort, there is the potential for some negative effects. This shouldn’t necessarily discourage you from taking it—but your body may tolerate long-term, consistent birth control better than it does EC.
According to Amanda*, a student at William Patterson University, “Every time I've taken it, it was followed by extremely painful cramps and back pain as well as very heavy vaginal bleeding. It usually lasts around 24 hours. It was so bad that after a while I just went on a hunt on finding the right birth control!”
If you plan on having sex, from a financial, health and mental standpoint, it is ultimately better to invest in regular birth control or condoms; after all, Plan B is just what the name suggests: a plan B. But this isn't to say that you shouldn't be able to count on emergency contraceptives when you need them—that's what they're there for, after all. If you're ever unsure about how well-protected you were during intercourse, it's always better to be safe than sorry. So know where to get them at a moment's notice if you need them, but don't rely on emergency contraceptives as your only form of birth control.
*Names have been changed.