Birth Control and Emergency Contraception
I don't believe that seeking birth control and emergency contraception carry the same legal risks as seeking abortion pills or traveling for an in-clinic abortion, but who even knows what is going to happen. I know there are a few states that might soon classify emergency contraception as an abortifacient (it is not) so use your discretion when it comes to protecting your digital security around this topic. I'll refer you, again, to Chapter 2.
Most of the information in this chapter comes from this YouTube video, from the ever-amazing Mama Doctor Jones: https://www.youtube.com/watch?v=nj4N92c6Uxo
Emergency contraception (EC) is a form of birth control that can be used after unprotected sex with someone who can get you pregnant. It isn't necessarily bad for you to take emergency contraception pills repeatedly, but it is less effective than other forms of birth control, so this shouldn't be your primary mode of protecting yourself from becoming pregnant.
First, we should establish that while usually when we talk about emergency contraception we're thinking of pills like Plan B, IUDs (both hormonal and copper-based) can also be used as emergency contraception. When inserted within the first five days after unprotected intercourse, both copper IUDs (Paragard) and hormonal IUDs (Mirena or Liletta) are more than 99% effective at preventing pregnancy. This is awesome, and is especially cool because you then have a very effective 'Plan A' for birth control going forward (copper IUDs can remain inserted for up to 10 years, while hormonal IUDs are rated for 3-7 years, depending on which one you have.) The obvious drawback is you have to find an appointment for within the first five days after unprotected intercourse, and this can be really hard to do in many places (especially now.)
So, if that is not really feasible for you, let's get back to the more common form of emergency contraception: pills.
Oral EC works by preventing ovulation, and is not effective at ending an existing pregnancy, or at preventing one if ovulation has already occured. There are two types: levonorgestral (brand name Plan B) and ulipristal acetate (brand name Ella). I'm going to refer to them as these brand names from here on out but know that they are sold by other companies as well. Both of these types of EC work better the sooner you take them. Ella is up to 75% effective at preventing pregnancy if taken within 72 hours, and drops to 60% effective if taken within 5 days. Plan B can be between 56-89% effective if taken within 72 hours (probably with some benefit up to 5 days.)
Does Plan B work for people over a certain weight?
There is data that suggests Plan B is less effective for people with a BMI over 30. However, it is still better at preventing pregnancy than if you were to take nothing after unprotected intercourse. There is a less clear causal link between weight and the effectiveness of Ella, so this may be a better option if you are over this BMI. In other countries, a double dose of Plan B (so two 1.5 mg tablets of levonorgestral) is often recommended for patients over this weight, though this is an off-label use in the United States. If you can manage to find an appointment to have an IUD inserted within five days, this may be the best option for you.
There is a third form of oral EC called the Yuzpe method, which is where you take your already-prescribed birth control pills at a higher dose for two doses 12 hours apart. This is also an off-label use, is much less effective than either Plan B or Ella, and has more side effects (including extreme nausea). However, since it is possible that access to regular emergency contraception could be limited by your living situation or by laws being passed in your area, I think it is worth mentioning. Depending on which birth control you are taking there are different dosage requirements; you can find the correct dosage with this chart: https://www.uptodate.com/contents/image?imageKey=PI%2F74604
You can buy birth control and emergency contraception online. It might be worth buying emergency contraception in advance (even if you didn't have unprotected sex) to have on hand in case you or a friend end up needing it. This is a great website that has multiple links for places to buy birth control pills and oral emergency contraception pills, as well as more information about how they work (https://www.threeforfreedom.com/). Please be aware that it also has a link to Aid Access (where you can purchase abortion pills) and be cautious of your digital footprint when visiting the site.
Websites where you can buy birth control and emergency contraception online:
- https://www.nurx.com/
- https://heyfavor.com/
- https://www.prjktruby.com/
I might add some more stuff about regular birth control in the future, but am going to post this for now. Here is a link if you would like to know more about different birth control methods: https://www.plannedparenthood.org/learn/birth-control
And here is a link to find free condoms by state: https://www.goodrx.com/health-topic/sexual-health/free-condoms
Natural Family Planning
It's come to my attention that there's a big TikTok movement around pushing Natural Family Planning/The Rhythm Method/Fertility Awareness Methods as alternative birth control methods to hormonal and barrier methods. Please be aware that these methods are far from fool-proof and often require you to have a consistent menstrual cycle and perfect adherence in order to work. There are many fertility tracking apps on the market, including one named Daysy (which claimed their method was 99.4% effective at preventing pregnancy.) The scientific "evidence" that they tout is actually based on a study that has since been retracted for selectively using data. The rhythm method (and related methods) are NOT as reliable as hormonal and barrier methods. If you are not prepared to become a parent (or have to seek an abortion) I would highly recommend against using a rhythm or related method for your birth control. Read more here: https://www.buzzfeednews.com/article/stephaniemlee/daysy-fertility-tracker-science-retraction.
Thank you for reading!
Last edited July 20th, 2022.