The Morning-After Pill: Everything You Need To Know About Emergency Contraceptive Pills

You wake up after a drunken hook-up with a frat boy and remember that you forgot to use protection the night before; you forgot to take your birth control pill — again, and realize you left them in your other purse back at the dorm, hours after checking into the hotel for a weekend trip; you notice that the condom broke, but it’s too late — if you’ve ever experienced one of these dreaded realizations, you know the panic that ensues. 

Accidents happen, but thankfully modern medical technology has provided us with a back-up plan, otherwise known as the morning-after pill. Many of us might still have fears and doubts about emergency contraception, so we asked those tricky questions and got the help of birth control experts to give us the answers.

So what is the morning-after pill, exactly?

The biggest misconception about the morning-after pill is that it is equivalent to an abortion. In reality, the morning-after pill prevents pregnancies from happening but does not cause harm to the woman or fetus if she is already pregnant.

Elizabeth Dawes, senior associate of programs and policy for Reproductive Health Technologies Project, a nonprofit organization that advocates for women’s reproductive freedom, explains: “Emergency contraception is often confused with a pill used to induce an abortion. EC [emergency contraception] should not be confused with Mifeprex®, also known as RU-486. EC and Mifeprex® are different drugs. Although ulipristal acetate [the drug found in the morning-after pill called ella] and mifepristone are both antiprogestins, they work differently. Ulipristal acetate, like other EC pills, helps to prevent pregnancy, while Mifeprex® terminates an early pregnancy.”

There are two types of U.S. Food and Drug Administration-approved emergency contraceptive pills: progestin-only pills (like Plan B One-Step and its generic counterparts Next Choice and Levonorgestrel tablets) and an antiprogestin pill with ulipristal acetate, called ella. They both work by preventing the ovary from releasing an egg.

“[Emergency contraception] is more effective in the first half of your cycle, so in the first couple of weeks after your period,” says Dr. Wendy Norman, a researcher at the Women’s Health Research Institute at B.C. Women’s Hospital and Health Centre.

When should you take it?

Despite its name, these pills aren’t strictly limited to next-morning use. Levonorgestrel products like Next Choice and Plan B One-Step can be used up to 72 hours after, and ella can be used up to 120 hours (five days) after unprotected sex. That being said, it is a good idea to take it as soon as possible because the quicker you use it the more effective it is. “There is no reason to delay treatment,” says Dawes.