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Q & A

Emergency Birth Control Pills:
Patient Questions & Answers: A Guide for Health Care Providers

Also available in [PDF] Format.

Many people know nothing about emergency birth control pills (also called emergency contraception, Plan B®, and the ‘morning after pill’). Others have misinformation and/or hold myths about them. It can be helpful to understand the type of questions that your patients and staff may ask and be ready with accurate, reassuring answers.

Question: Is there really something that I can do, after sex, to prevent pregnancy?
Answer:

Yes. Emergency birth control pills can prevent pregnancy after unprotected sex. They contain the same hormonal medication that is in regular birth control pills. They can be as much as 89 percent effective at preventing a pregnancy, depending on how soon you take them after the act of unprotected sex, the kind you take, and when the sex occurred during your menstrual cycle.

   
Question: How soon do I have to take them?
Answer: They are most effective when taken in the first 24 hours after sex; but they are very effective for up to 72 hours (three days) after sex and may still be effective, although somewhat less so, for up to 120 hours (five days) after sex.
   
Question: Won’t they make me sick?
Answer: They might for a short time. But, if you use progestin-only (mini) pills, the chance of side effects – like nausea, vomiting, headaches, spotting, and dizziness – is a lot less with these pills. If you are concerned about nausea, I can prescribe anti-nausea medication for you to take before you take the emergency birth control pills.
   
Question: How do I get emergency birth control pills?
Answer: In August 2006, the Food and Drug Administration (FDA) ruled that young women (and men) ages 18 and older can obtain Plan B®, the only prepackaged, dedicated emergency birth control pill product, without a prescription. Women of this age can simply go to a pharmacy that carries emergency birth control pills and show proof of age to the pharmacist to obtain the medication. For young women under age 18, you will continue to need a prescription which I can write for you now.
   
Question: I heard that women who use emergency birth control pills are irresponsible. Do you think that’s true?
Answer: No. I disagree completely. It’s very responsible to take a medication to prevent a pregnancy that you don’t want. Researchers have found that women who use emergency birth control pills almost always rely on a regular method of birth control. They are very responsible. But, they can’t always control all facets of their lives. They forget a pill or can’t get an appointment to get their depo-provera injection on time. Maybe they were forced to have sex or didn’t use a condom correctly. It happens. That’s why emergency birth control pills are so useful.
   
Question: How do emergency birth control pills work?
Answer: Emergency birth control pills work like regular birth control pills. They delay ovulation – that’s when your body releases an egg. And, they may inhibit fertilization. That means that emergency birth control pills make it much harder for a sperm to fertilize an egg that has already been released from the ovary.
   
Question: Are emergency birth control pills safe?
Answer: Yes, they are very safe. We have had more than 40 years of experience now with birth control pills – the same medication that is in emergency birth control. Birth control pills are among the best- and most-studied as well as safest drugs available today. In fact, the World Health Organization says that emergency birth control pills are safe even for women for whom regular birth control pills are not safe – like those with liver or heart problems. That’s because a woman takes only a few emergency birth control pills in a short period of time.
   
Question: Will these emergency birth control pills protect me until my next period?
Answer: No. The emergency birth control pills that I will prescribe for you only protect you from pregnancy from the sex that you already had. They don’t protect at all against pregnancy from future acts of sex. So you will need to use a condom and to get on a regular method of birth control as soon as possible.
   
Question: What if I’m already pregnant?
Answer: If you are already pregnant when you take emergency birth control pills, they will not work. You’ll still be pregnant after you take them. They won’t harm the developing embryo or fetus, and they won’t harm you. That’s why many medical organizations today suggest that there is no need to wait for the results of a pregnancy test before taking emergency birth control pills.
   
Question: When can I expect my next period?
Answer: It should begin within a week (before or after) you would normally have expected it. If your period is more than a week late, then please take a pregnancy test. You may be pregnant, and you will need to know to ensure follow-up care.
   
Question: Will emergency birth control pills affect my ability to get pregnant in the future?
Answer: No, not at all. In fact, you will need to use a regular method of contraception after using emergency birth control pills because unprotected sex would put you again at risk of pregnancy.
   
Question: So, is this a one-time thing or could I use emergency birth control pills in the future?
Answer: It is safe to use emergency birth control pills as often as they are needed. However, it is better for you to be on a regular method of contraception. Emergency birth control pills – just as the name says – are for use in an emergency, in case you missed some pills or were late for your depo-provera shot, or the condom tore, or someone forced you to have sex. Emergency birth control pills aren’t really for use as a regular method. For one thing, other methods – like regular birth control pills, depo, the patch, or the ring – are much more effective at preventing pregnancy. Regular methods also have fewer side effects than emergency birth control pills.
   
Question: Will emergency birth control pills also protect me against HIV or other sexually transmitted infections?
Answer: No. None of the most effective methods of pregnancy prevention – birth control pills, the patch, the ring, or depo – protects you against STDs. For that, you need to use condoms at every act of sex unless you know, for sure, that both you and your partner are completely free of STDs. Since it may be hard to know for sure, we recommend that sexually active young women use both condoms and another method of protection.
   
Question: Isn’t taking emergency birth control pills the same thing as having an abortion?
Answer: There is a difference between emergency birth control pills and the “abortion pill” (RU486). Most medical authorities agree that a pregnancy begins when a fertilized egg has implanted in the uterus (womb). But emergency birth control pills will not harm an egg once it has implanted, so they can’t cause an abortion.
   
Question: But, what if I think that a pregnancy begins with conception (fertilization)?
Answer: That’s your personal value, and it just means that you will have to decide for yourself whether you want to use emergency birth control pills to avoid a pregnancy that you don’t want. Emergency birth control pills may or may not prevent a fertilized egg from implanting in the uterus – we just don’t know.
   
Question: So, what is next?
Answer: If you are over 18, you can get Plan B® without a prescription at _____________pharmacy. If you are under 18, you will continue to need a prescription. I can write you a prescription now. You can get the prescription filled at ______________pharmacy.

Written by Sue Alford, MLS
New Morning Foundation and Advocates for Youth © 2006.

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