Morning After Pill – An Overview of Emergency Contraception

Morning After Pill – An Overview of Emergency Contraception

What is the Morning After Pill?

The “Morning After Pill” is a common name for the most popular type of emergency contraceptive. Emergency contraception or emergency birth control (EC) is used to reduce the chance of a woman getting pregnant after she has had sex without using birth control, during the fertile days while using natural family planning, or if the birth control method failed. While some EC methods may be taken as much as 3-5 days after unprotected sex, EC is most effective when taken as soon as possible (i.e. within a few hours).

Emergency Contraceptive Pills

Emergency Contraceptive Pills

There are two types of emergency contraception: emergency contraceptive pills (ECP), also known as the “Morning After Pill,” and the Copper-T intrauterine device (IUD). The IUD is a small, T-shaped device placed into the uterus by a doctor within five days after having unprotected sex. Emergency contraception pills (ECP) may prevent or delay ovulation by blocking fertilization while the IUD works mostly by making the sperm less able to fertilize the egg. Emergency contraceptives will not protect against sexually transmitted diseases (STDs).

The latest scientific research shows that FDA approved ECPs containing levonorgestrel or ulipristal acetate do not inhibit the implantation of a fertilized egg. Emergency contraception pills (ECPs) stop pregnancy by keeping the egg from leaving the ovary or keeping the sperm from joining the egg. The Morning After Pill will not stop or harm an embryo that has already implanted. If you are already pregnant, ECPs will not work. It is not the abortion pill. Emergency contraceptive pills do not protect against HIV or other sexually transmitted diseases.

ECP are available with or without a prescription. The Ella brand pill requires a visit to a doctor to obtain a prescription. Plan B One Step and other generic brands are ECPs that can be purchased at the pharmacy without a prescription.

While some emergency contraception pills can be used more than once during the month, they should not be used as a regular birth control method to prevent pregnancy. ECPs do not provide lasting protection. ECPs work before ovulation occurs so if you have unprotected sex after ovulation, taking ECPs may not stop a pregnancy. If you have unprotected sex in the days or weeks after the use of ECPs, there is a risk of becoming pregnant.

Important: If you become pregnant or experience severe abdominal pain and/or bleeding 3-5 weeks after taking the emergency contraceptive pill, you may have an ectopic pregnancy (the egg has implanted outside the uterus). Since ectopic pregnancies may be life threatening, you should seek immediate medical attention.

How do I know if I should be concerned?

You should be concerned about an unintended pregnancy if you had sex and your birth control failed (i.e. condom broke, diaphragm not inserted correctly, during the fertile days while using natural family planning, etc.), if you did not use contraception, or if you missed/forgot to take your birth control pill(s). If you had sex and think that you may be at risk of pregnancy, chat with our nurse online or schedule an appointment at one of our three Bay Area Support Circle clinics in Oakland, Redwood City, and San Francisco. Support Circle offers free pregnancy tests and same day appointments.

Support Circle provides information about but is not a provider of the morning after pill.


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Ectopic Pregnancy or Tubal Pregnancy

Ectopic Pregnancy or Tubal Pregnancy

Ectopic Pregnancy or Tubal Pregnancy

Ectopic Pregnancy or Tubal Pregnancy

An “ectopic pregnancy” occurs when the fertilized embryo implants outside of the uterus; most commonly in fallopian tube. When attached to the fallopian tube, this is referred to as a “tubal pregnancy.” Approximately 16%1 of women seeking emergency medical attention due to cramping and/or vaginal bleeding in the first trimester are diagnosed as having an ectopic pregnancy. Overall, ectopic pregnancies are rare, occurring in 1%-2%2 of all pregnancies. As the embryo grows, it can cause the tube to rupture (burst), which can cause major internal bleeding. This can be life threatening3 and/or cause future fertility issues if not discovered early.

Bleeding and cramping are the most common symptoms of an ectopic or tubal pregnancy. Women who are pregnant or may be pregnant should seek immediate medical attention for a possible ectopic pregnancy if they experience any or all of the following symptoms:

  • Cramping pain in the lower abdomen that may worsen with coughing, moving, or bowel strain
  • Sharp, steady pelvic pain
  • Vaginal bleeding
  • Nausea and vomiting
  • Dizziness or weakness
  • Shoulder pain
  • Feeling of pressure in the rectum

Risk factors leading to a greater risk for an ectopic pregnancy include: previous tubal surgery, sterilization, previous ectopic pregnancy, current use of an intrauterine device (IUD), history of pelvic inflammatory disease (PID), infertility for two years or longer, women over the age of 35 years, and smoking.

When a pregnant patient presents with first-trimester bleeding or abdominal pain, physicians should consider ectopic pregnancy as a possible cause. The patient history, physical examination and imaging with transvaginal ultrasound can usually confirm the diagnosis. In some cases, a blood test may also be used to determine diagnosis.2 The ultrasound is performed to check where the embryo implanted, if not found in the uterus. An ultrasound is one of the best methods to determine where the embryo may have implanted and alert if there are other health concerns to be aware of.

Since ectopic pregnancies may be life threatening, they must be treated as an emergency situation and the doctor will determine how best to end the pregnancy, as the embryo cannot be transplanted into the uterus. Many cases of ectopic pregnancy, if caught early enough, can be treated with medicine and not surgery. Early detection may help preserve the fallopian tube for future pregnancy attempts.

In all cases of suspected tubal pregnancies, the Support Circle technician or nurse will immediately refer the woman to the emergency room. If you have questions, Support Circle staff at our three Bay Area clinics are available.


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