What is the Morning After Pill?
The Bottom Line
“Morning after” pills such as Plan B One-Step® can be used to prevent pregnancy after unprotected sex or after other contraception methods have failed. These pills are generally safe and effective, but it is important to know how to use them correctly and when to seek medical care. The use of emergency contraceptive medications like Plan B One-Step® is not abortion.
What is the morning after pill?
“Morning after” pills refer to medications used to prevent pregnancy after unprotected sexual intercourse or after contraception has failed, such as a condom breaking. They are also referred to as emergency contraception. Other forms of contraception, such as birth control pills and condoms, are generally used before or during intercourse. There are a few different types of morning after pills on the market. Common brands of morning after pills include Plan B One-Step®, My Way®, Take Action®, After Pill®, and Ella®.
What do Plan B One-Step® and other morning after pills do?
Morning after pills contain hormones that work by preventing fertilization of an egg by a sperm. Morning after pills also prevent implantation of fertilized eggs into the uterus (womb). Morning after pills like Plan B One-Step® do not work once implantation occurs, and do not cause an abortion.What is the difference between Plan B One-Step® and Ella®?
Plan B One-Step® and many other morning after pills contain the progesterone hormone levonorgestrel and are available over-the-counter. Plan B One Step® can be taken up to 3 days after unprotected sex. Ella® contains a different kind of medication, ulipristal, and as of August 2022, only available by prescription. Ella® has the advantage of being consistently effective at preventing pregnancy for up to 5 days after unprotected sex. Additionally, Ella® may be more effective than Plan B One-Step® and other levonorgestrel-containing pills (including My Way®, Take Action®, and After Pill®) in preventing pregnancy in women who are overweight.Are morning after pills effective?
Morning after pills, including Ella® and Plan B One-Step®, are effective when used as emergency contraception. Ella® is more effective than Plan B One-Step® in preventing pregnancy when the medication is taken more than 3 days after sexual intercourse and in women that are overweight or obese.Do morning after pills have side effects?
Morning after pills are generally well tolerated with only minor adverse effects. The most common side effects of morning after pills are nausea, stomach aches, abdominal cramping, and vaginal spotting. Menstrual cycles may also be delayed by a couple of days after taking emergency contraceptive pills.How do copper IUDs work as emergency contraception?
An alternative form of emergency contraception is the insertion of an intrauterine device (IUD). Although copper IUDs are not approved by the United States Food and Drug Administration (FDA) for emergency contraception, they are highly effective when used for this purpose and can be inserted up to 5 days after unprotected sexual intercourse. The copper IUD also offers the advantage of providing long-term contraception, but does require insertion by a medical professional. Hormonal IUD’s (including Mirena®) have also been studied for use as emergency contraceptive agents but are currently only approved by the FDA for use as routine contraceptives and for the treatment of heavy menstrual bleeding.What is the difference between the morning after pill and an abortion pill?
Morning after pills are used to prevent pregnancy after unprotected sexual intercourse. Morning after pills do not work once pregnancy has occurred and do not cause an abortion.What should you do if you take too many morning after pills or have unexpected symptoms?
If you experience adverse or unexpected symptoms from morning after pills or take too many, get guidance from Poison Control immediately. Poison Control help is available online at webPOISONCONTROL and by phone at 1-800-222-1222. Both options are free, confidential, and available 24 hours a day.Maryann Amirshahi, PharmD, MD, MPH, PhD
Medical Toxicologist
Poisoned?
Call 1-800-222-1222 or
Prevention Tips
- To avoid getting pregnant use a reliable form of birth control.
- Take the morning after pill as soon as possible after unprotected sexual intercourse.
- Consider taking a pregnancy test prior to taking the morning after pill if you are concerned you may already be pregnant.
- Seek medical care if you have a positive pregnancy test after taking the morning after pill.
- Seek immediate medical care if you have severe pain or bleeding, cannot keep down fluids, or are having significant pain after using the morning after pill.
- The morning after pill should only be used for emergency contraception, not for routine pregnancy prevention. Other forms of contraceptive are safer and more effective for routine pregnancy prevention.
- Morning after pills do not protect against sexually transmitted infections.
This Really Happened
Case #1: A 28-year-old woman had unprotected sexual intercourse and purchased Plan B One-Step® at a pharmacy three days later. One month later, she missed her menstrual period and had a positive pregnancy test at home. She then decided to get a medication abortion.
Case #2: A 36-year-old woman was sexually assaulted in a parking lot when she was walking to her car after an evening shift at work. She went to the emergency department, where she was offered emergency contraception with Ella® because she weighed 210 pounds. She took the medication and did not become pregnant.
Case #3: A 19-year-old woman went to a gynecology clinic after having unprotected sex 2 days prior. She wanted emergency contraception but also was concerned about getting pregnant in the future because she wanted to finish college. She underwent insertion of a copper IUD in the clinic that day for both emergency and long-term contraception.
For More Information
American College of Obstetricians and Gynecologists. Emergency contraception FAQs.
References
American College of Obstetricians and Gynecologist Practice Bulletin. Emergency contraception.
Ella® Prescribing Information. Watson Pharma, Inc. Morristown, New Jersey. Revised August 2010.
Poisoned?
Call 1-800-222-1222 or
Prevention Tips
- To avoid getting pregnant use a reliable form of birth control.
- Take the morning after pill as soon as possible after unprotected sexual intercourse.
- Consider taking a pregnancy test prior to taking the morning after pill if you are concerned you may already be pregnant.
- Seek medical care if you have a positive pregnancy test after taking the morning after pill.
- Seek immediate medical care if you have severe pain or bleeding, cannot keep down fluids, or are having significant pain after using the morning after pill.
- The morning after pill should only be used for emergency contraception, not for routine pregnancy prevention. Other forms of contraceptive are safer and more effective for routine pregnancy prevention.
- Morning after pills do not protect against sexually transmitted infections.
This Really Happened
Case #1: A 28-year-old woman had unprotected sexual intercourse and purchased Plan B One-Step® at a pharmacy three days later. One month later, she missed her menstrual period and had a positive pregnancy test at home. She then decided to get a medication abortion.
Case #2: A 36-year-old woman was sexually assaulted in a parking lot when she was walking to her car after an evening shift at work. She went to the emergency department, where she was offered emergency contraception with Ella® because she weighed 210 pounds. She took the medication and did not become pregnant.
Case #3: A 19-year-old woman went to a gynecology clinic after having unprotected sex 2 days prior. She wanted emergency contraception but also was concerned about getting pregnant in the future because she wanted to finish college. She underwent insertion of a copper IUD in the clinic that day for both emergency and long-term contraception.