Emergency contraception

Emergency contraception is birth control that you can use to reduce the risk of pregnancy after unprotected sex  –  if a condom broke, or you were more than 24 hours late taking a birth control pill, or you were later than 13 weeks in getting your next depo shot, or if nothing was used for protection. If you’re not sure whether emergency contraception would be a good idea in your situation, please call the Sex Sense Line at 604-731-7803 or 1-800-739-7367 or speak with a health care provider.

COPPER IUD

What is it? A copper IUD is a small device made out of plastic and copper that is inserted into the uterus by a doctor.

How do I use it? Within 7 days after unprotected sex, you can have a copper IUD put in as emergency birth control. There is even some evidence that it will work if inserted at any time during a menstrual cycle in which you had unprotected sex one or more times, as long as you still test negative for pregnancy at the time of insertion (do not wait to see if your period comes – if you miss your next period and are already pregnant it will be too late to have the emergency IUD).

How does it work? It interferes with sperm activity, prevents fertilization, and implantation of an egg.

How effective is it? A copper IUD is over 99% effective as emergency contraception, making it by far the most effective emergency method.

How long does it work for? If you want to leave the IUD in, it will continue to provide very effective (over 99%) protection against pregnancy for up to 5 or 10 years depending on which one you use. If you do not like it or want to get pregnant, you can have it taken out any time after your next period. Removal is a quick easy procedure and once removed, fertility returns immediately.

How do I get it? Call Everywoman’s Health Centre 604-322-6692 or Willow Women’s Clinic 604-709-5611. Make sure you say it is for an emergency IUD so that we can get you an appointment as soon as possible. For more information on IUDs go to ewhc.ca or willowclinic.ca. If you are not in the Vancouver area, call the Sex Sense Line at 1-800-739-7367 to find a local clinic that can do emergency IUDs or go to emergencyiud.com.

Is it safe? Yes. The risks are very small. There is a very small risk that the IUD could go through the wall of the uterus when inserted. This usually heals within weeks with no long term side effects, but sometimes requires a minor procedure to remove the IUD. There is a risk of about 5 percent over 5 years that the uterus will push the IUD out of place (expulsion). There is also a very slight increased risk of infection in the first few weeks.

What are the side effects?  Many people feel cramping pain when the IUD is inserted, but insertion is usually very quick. Some  may feel like they are having a period afterwards with light bleeding and cramping. Periods are usually heavier and longer afterwards, but often improve after the first 3 or 4 months.

How much does it cost? Everywoman’s Health Centre charges $75 for a copper IUD that is effective for up to 5years and $90 for one that is effective for up to 10 years. Prices may vary at other clinics or doctor’s offices.

Call 604-322-6692 to book an emergency IUD insertion appointment at Everywoman’s. If you leave a message please say that it is for an emergency IUD.

EMERGENCY PILLS

What are they? If you have unprotected sex (your method of birth control fails, such as when a condom breaks or you miss more than two birth control pills in a row), emergency pills can help reduce your chance of pregnancy. There are two kinds: progestin emergency pills (Plan B, Next Choice, Norlevo or Option2) and Ulipristal Acetate emergency pills (Ella).

How do they work? They postpone ovulation, the release of an egg. If you are already pregnant, taking these pills will not end or affect the pregnancy.

How effective are they? Ella (Ulipristal Acetate) pills are approximately 60 percent effective if taken within 120 hours after unprotected sex. Progestin emergency pills are approximately 50 percent effective. You can take them up to 120 hours after unprotected sex, but the sooner you take them the more likely they are to work. The effectiveness goes down over time.

Please note:

Emergency pills are not meant to replace a regular form of birth control. They are more far less effective and more expensive to use than the birth control pill, patch, ring, shot or IUDs.

If you are requiring emergency pills, then we recommend looking into methods of birth control that might be a better fit for you in the long term moving forward. You are welcome to come here to speak with someone about the different options that are available, to get a prescription or to have an IUD inserted. We also have birth control information on this website.

Also, emergency pills are meant to reduce the risk of pregnancy from one act of sex you have already had. Because they may delay your fertile time, you can get pregnant (perhaps even more easily), if you have unprotected sex in the days after taking them.

How do I get them? Ella (Ulipristal Acetate) emergency pills require a prescription. You can then purchase them at a pharmacy. Not all pharmacies carry it and you might have to have it special ordered, so consider calling in advance. Progestin emergency pills are available without a prescription. You can get them at most pharmacies and some clinics.  You can also purchase them in advance and have them at home so that they can be taken as soon as possible in an emergency.

How much do they cost?  With a prescription an emergency pill may be covered by an extended health drug plan (check with your plan for more information or bring your health plan card to the pharmacy).

Ella (Ulipristal Acetate) costs approximately $40 per dose. If you a youth, you may be able to get Plan B or another progestin emergency pill for free or at low cost from a youth clinic (Vancouver Coastal or Fraser Health). It is also available for a similar price at Costco (you may not require a membership if you have a prescription – please call in advance to make sure).

Are they safe? Yes. There is no harm to you if you take them, nor do they cause birth defects if they do not work or if you were already pregnant when you took them.

Can anyone use them?  Yes. However, progestin emergency pills may be less effective for people who have a Body Mass Index (BMI) of 25-29 or weigh 165 -176 lbs (75-80kg).  It may not be effective at all in people with a BMI of 30 or higher or who weigh more than 176 lbs (80kg). Ella (Ulipristal Acetate) may also be less effective for people who have a higher BMI, but seems to be more effective than progestin emergency pills.

What are the side effects? There is a small chance of headaches, lower abdominal (belly) pain, breast tenderness, fatigue, dizziness, nausea and vomiting for a day or two after you take emergency pills. You can use Tylenol, ibuprophen, or Gravol for these symptoms. Your period may be irregular in the month or two after you take an emergency pill – it may come earlier or later than expected. You may also experience some unexpected spotting or bleeding.

Is it OK to take often? There are no health risks in taking emergency pills often, but there may be a high risk of pregnancy.  Emergency pills are not as effective as other birth control – they are meant only as an emergency or “back-up” method. Talk to us, your family doctor or another clinic about contraception that provides more protection, such as the birth control pill, patch, ring, shot or IUD.

Please note: It is not recommended to take Plan B (or another progestin emergency pill) and Ella within a few days of each other. Please talk to your health care provider for more information.

How will I know if it’s worked? If you bleed like a period within three weeks of taking an emergency pill, it has likely worked to prevent pregnancy. If you do not have a period within three weeks, then you may want to take a pregnancy test. Pregnancy tests are available at a pharmacy, clinic or doctor’s office. They are most effective with the first urine of the morning.