I have taken emergency contraception (aka EC or the “morning after pill”) once, due to a condom that came off on the very day that I ovulated and was most fertile. This was in 1999, before Plan B, when morning after pills had two hormones in them and were about 75% effective at preventing pregnancy. These days, emergency contraception contains only progestin, is more effective (about 89%) and has fewer side effects.
Emergency contraception works best up to 72 hours after unprotected sex. It is for emergencies only, as it is not as effective as daily birth control pills or other methods of contraception (still much better than nothing!).
I had never taken any hormonal contraceptives before, so I was concerned about side-effects on me and on a potential fetus if I ended up pregnant. The public health doctor at the walk-in clinic I went to for a prescription described morning after pills as “safer than aspirin” for a single use. She also said that while there were no long-term studies on the effects of emergency contraception, the pills could not cause a miscarriage and were not expected to have serious effects on a fetus, since many women keep taking birth control pills before they realize they’re pregnant with no ill effects. That satisfied me. She also gave me one of those classic pamphlets with a sad pregnant woman on the front, which I found delightfully campy.
My morning after pills were in the form of two small pills, and then two more small pills exactly 12 hours later. These pills were all identical, contain a fake estrogen (estradiol for people like me who care) and progestin, and are essentially high dose birth control pills. In fact, mine came in pairs that had obviously been snipped from a birth control pill pack (they had days of the week written next to them). You can still use birth control pills as emergency contraception. The newer, progestin-only version involves only two pills.
The hormones in EC prevent ovulation if it has not already occured, and alter the lining of the uterus to prevent implantation of any fertilized eggs that are floating around. I think the hormones work on the same principle as other oral contraceptives, and "trick" the body into acting pregnant.
The combination-hormone EC pills commonly make people nauseous and are usually prescribed with Gravol (anti-puking drug). I did not get sick, but I got a little light-headed and had funny tummy cramps and minor diarrhea for about a week. My beloved boy has done this twice, and the previous time his girl got quite sick with it. It worked for both of us. I know several women who have taken it, and at least one for whom it didn’t work.
The pills cost us 10 dollars, and would have been deductible if I had been willing to send the receipt in and have it show up in my grandparents’ mail (I was on their medical plan). I forget who paid; we share these things. We got the pills at a walk-in clinic, but you can also get them in the emergency rooms of hospitals, from sexual health clinics and from your family doctor. In Canada you can also get them from a pharmacist, although this is more expensive than getting a prescription from a doctor.
Planned Parenthood has up to date information about emergency contraception.
I also enjoy this random headbanging video about emergency contraception.
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