BMIRH

The Morning-After Pill (Plan B) is now Easier to Get!

What is Plan B?

Plan B is a type of contraceptive (birth control) often called the morning-after pill. It is also know as emergency contraception.

Plan B is a safe way to prevent pregnancy after unprotected sex. For example, when a condom breaks, you miss a birth control pill or two, or you are forced to have sex. It can prevent pregnancy up to 3 days after unprotected sex, but it works best when it is taken as soon as possible. Some health centers offer it up to 5 days after unprotected sex.

Plan B is not the same as the abortion pill. If you are already pregnant, Plan B will NOT cause an abortion and will have NO effect on an existing pregnancy.

Plan B will not protect you against STDs or HIV. If you had unprotected sex, you may want to get tested for STDs. To protect yourself from STDs/HIV you must use a condom every time you have sex.

Plan B does not work as well as on-going birth control. Call 311 for a referral to a health care professional to talk about different types of birth control, or visit your local family planning clinic.

If you are 18 or older you can NOW buy Plan B at a pharmacy without a prescription.

If you are 17 or younger you can get a prescription for Plan B at a health center. Some health centers will give you Plan B for free.

All teens and women can get FREE Plan B from any NYC Department of Health and Mental Hygiene STD clinic. Plan B is also available at low cost from some health centers.

Call 311 for more information on how to get Plan B or to find a health center near you.

Emergency Contraception (EC)

• Click here to view the Emergency Contraception brand/dosage chart
• Click here to view an Emergency Contraception Toolkit for pharmacists.

What is emergency contraception?

Emergency contraception (EC) can safely prevent pregnancy after unprotected sex (vaginal intercourse). EC can be used when:

• No birth control method was used;
• A birth control method fails (for example a condom breaks, a diaphragm breaks or a woman forgets to take several birth control pills); or
• A woman is a victim of forced sex or rape.

How is emergency contraception usually provided?

Two methods are available in the United States: EC ("morning after") pills, the most common method, and the copper IUD (intrauterine device).

Emergency Contraception ("Morning After") Pills:
EC pills are most effective when taken as soon as possible after unprotected sex, ideally within 72 hours. When taken within 72 hours, EC pills are up to 89% effective in preventing pregnancy. Recent evidence indicates they are moderately effective when taken between 72 and 120 hours after unprotected sex. The sooner they are taken, the better!

EC pills work by providing a short, intense exposure to hormones that reduce the risk of pregnancy by:

• Preventing an egg from being released by the ovary (ovulation), or
• Preventing an egg and sperm from joining (fertilization), or
• Preventing a fertilized egg from attaching to the uterus.

A recent study found that most often, EC reduces the risk of pregnancy by preventing ovulation.

EC will NOT work if a woman is already pregnant. It reduces the risk of pregnancy, and helps prevent the need for an abortion if a woman does not want to be pregnant. It is NOT a form of abortion.

There are two types of EC pills:

1. Progestin-only pills. These contain only one hormone (progestin). Plan B is the only EC pill used exclusively for emergency contraception and is very effective in preventing pregnancy. Among EC pills, Plan B is the best choice - it is the most effective and has the fewest side effects.
2. Combined oral contraceptive pills. These regular birth control pills contain two hormones: estrogen and progestin. They can be prescribed for EC use and require special instructions from your health care provider on how to use them properly.

Copper IUD (intrauterine device):
Insertion of a copper IUD by a health care provider within 5 days after unprotected sex is very effective (99%) in reducing the risk of pregnancy. The IUD prevents pregnancy by stopping fertilization of the egg by sperm. A woman may choose to keep the IUD in place for up to 10 years for ongoing birth control protection, or she can have the IUD removed by her health care provider right after she has her next normal menstrual period.

How are emergency contraception pills taken?

EC pills are usually taken in 2 doses by mouth. Ideally, the first dose is taken within 72 hours (and not more than 120 hours) after unprotected sex, and the second dose 12 hours later. The number of pills in each dose depends on the brand of EC. Click here to view the brand/dosage chart.

Do emergency contraception pills have side effects?

Emergency contraception pills are considered safe: no serious or long-term complications have been linked to their use. The most common side effects are nausea (in up to 50% of women) and vomiting (in up to 20% of women). Progestin-only pills (Plan B and Ovrette) are less likely than estrogen-containing (combined) birth control pills to cause nausea and vomiting.

Other side effects can include headache, dizziness, fatigue, breast tenderness, moodiness, and changes in the next menstrual period (timing or amount of flow). If side effects occur, most last for 24 hours or less.

What should I do if I have side effects?

To reduce nausea and vomiting, ask your health care provider to prescribe Plan B. If you are using combined (estrogen-containing) birth control pills for emergency contraception, ask your provider for anti-nausea medication to take in advance, such as diphenhydramine (Benadryl).

If you vomit within 1 hour of taking the first EC dose, the general protocol is to take the second dose (to replace the first dose) and contact your health care provider as soon as possible to get another EC dose.

While serious side effects have not been associated with EC pills, call your health care provider if you have any concerns about potential side effects. If you have worrisome or unusual signs or symptoms and you cannot reach your health care provider, you should go to an emergency room.

Is there anyone who should not take emergency contraception pills?

Almost any woman who needs emergency contraception can safely use the pills. While women who are pregnant should not use EC, there is no evidence that EC pills cause any harm to the woman or her developing fetus. If you are already pregnant, emergency contraception won't end the pregnancy.

Where can I get emergency contraception pills?

To get EC pills, you can go to any of DOHMH's 10 STD clinics, talk to your health care provider, visit a family planning clinic, or call the Women's Healthline at 311. At all DOHMH STD clinics, emergency contraception is free and is available without an appointment and can be obtained without parental consent. You can also get information and referrals from the emergency contraception hotline by calling 1-888-NOT-2-LATE or by visiting www.NOT-2-LATE.com.

What will my health care provider need to know to prescribe EC for me?

Your health care provider will specifically want to know: 1) when you had unprotected sex (day and time); 2) when the first day of your last menstrual period was; and 3) whether you know yourself to be pregnant already. Also, it is always good to let the health care provider know if you are on any other medications and whether you have allergies to medications, although EC pills are safe in most situations.

Request from your health care provider an advance prescription (or pill-pack) for Plan B. This will ensure that you have ready access to emergency contraception, should it be needed in the future.

You also should talk with your health care provider about your risk for sexually transmitted diseases (STDs) and your choices for effective ongoing birth control and STD prevention.

Is emergency contraception the same as abortion?

No. Emergency contraception does not cause an abortion, it only prevents pregnancy. EC pills are not the same as "RU 486", the "French abortion pill" that provides medical abortion. EC pills don't work if you are already pregnant. Because EC reduces the risk of becoming pregnant, it helps to prevent the need for abortion.

If I have taken emergency contraception pills before, can I take them again?

It is safe to take EC pills more than one time, if necessary. However, emergency contraception is not as effective as other birth control methods and should not be used as a substitute for regular, ongoing birth control. The best way to prevent pregnancy is to visit your health care provider or a family planning clinic to choose the birth control method that's right for you. Many safe and effective methods are available - including the Pill, condoms, IUDs, the patch, diaphragm, and the shot.

What if I was exposed to HIV or other sexually transmitted diseases?

Anyone who has unprotected sex is at risk for getting or spreading HIV and other STDs. Emergency contraception does not protect against STDs. So if you've had unprotected sex, it is important to speak to your health care provider about testing and treatment for STDs.

Condoms are the only birth control method that can prevent HIV and other STDs. To protect yourself and others, use a latex condom or a female condom every time you have sex, no matter what kind of birth control you use.