It’s tiny yet powerful, and now, it’s more accessible than ever. Back in June, the Obama administration dropped its appeal of a judge’s order that required Plan B, also known as the morning-after pill, to be available to all women without a prescription. Now, it can be found on pharmacy shelves—no prescription required.
Prior to the ruling, Plan B had been available without a prescription to women 17 years and older, but formal doctors’ orders were required in order for women younger than 17 to obtain the emergency contraception. Because of the ruling, however, women of all ages are now able to buy Plan B over the counter without a prescription, meaning that girls younger than 17 can obtain Plan B without consent from a parent or doctor.
This pivotal policy change has sparked widespread debate about the use of Plan B by women of all ages. In light of the issue, we here at HC are bringing you all the facts about Plan B, so that you can make an informed decision about purchasing and using the emergency contraceptive.
What is the morning-after pill?
Charlotte*, a junior at the University of North Carolina, had a wild weekend with her boyfriend that left both of them concerned about the risk of potential pregnancy. She wasn’t on birth control at the time, and the couple worried that their only method of contraception – condoms – had failed. She hadn’t missed her period yet, but they worried nonetheless. So within a couple of days, her boyfriend suggested Plan B.
Rachel*, also a junior at UNC, had missed a couple of pills in her birth control cycle when she had sex with her boyfriend. Worried and confused, she told her boyfriend about the issue and decided to take Plan B that very night.
Charlotte and Rachel both found themselves in common situations for modern collegiettes. Whether your partner’s condom broke, you missed a birth control pill, or you were just too drunk to think about using protection (a big no-no, collegiettes!), unprotected sex can – and does – occur for a number of reasons. But you do have options, such as Plan B.
Plan B and Plan B One-Step are the most common form of emergency contraception. Although Plan B and Plan B One-Step are often used interchangeably to refer to the popular method of back-up birth control, there is one fundamental difference between them: Plan B consists of two pills, each containing 0.75 milligrams of levonorgestrel and taken 12 hours apart, whereas Plan B One-Step consists of one pill (as the name so cleverly suggests), which contains the entire dose of 1.5 milligrams of levonorgestrel. Plan B One-Step is the newer method; it was approved by the FDA in 2009 to replace the two-dose regimen, and is now the brand of emergency contraception most recommended by OB/GYNs in the United States.
Taking emergency contraception is a serious decision, yet it is often made quickly and without much consideration. Charlotte herself admits doing little research prior to taking the pill.
“I didn’t read about any of the risks before taking it,” she says. “At the time, pregnancy seemed to be a bigger issue than any of the potential risks.”
To keep you informed about Plan B, we consulted Erin Zabel, vice president of external affairs at Planned Parenthood of Southeastern Virginia.
How does it work?
Plan B is essentially a highly concentrated form of hormonal birth control. “Basically, it gives your body a big dose of what’s called progestin, which is what your body produces during pregnancy,” Zabel explains. “That’s basically how normal birth control typically works, too—by tricking your body into thinking you’re already pregnant so that you don’t ovulate.”
By preventing ovulation, Plan B prevents the fertilization or implantation of an egg in a woman’s uterus. Depending on where a woman is in her cycle when she takes Plan B, however, the pill can also use other methods to prevent pregnancy.
“What it will also do is thin the lining of your uterus or thicken the cervical mucous,” Zabel says. “So there are a number of ways to make it more difficult for you to become pregnant even if for some reason you do ovulate.”
It’s important to understand that as a highly concentrated form of hormonal birth control, Plan B will only prevent pregnancy. It is not the abortion pill, and it will not terminate an existing pregnancy.
“Because it’s progestin and that’s what your body is already creating in pregnancy, if you are already pregnant at that point, it’s not going to affect the pregnancy,” Zabel says.
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What side effects can Plan B cause?
Because it works like normal birth control, Plan B can cause side effects similar to those caused by starting or following a normal birth control regimen. The most common side effects include an abnormal period, nausea, lower abdominal pain (a.k.a. our oh-so-beloved cramps), headache, and breast pain.
“I experienced an abnormal period after taking Plan B,” Charlotte says. “I usually only get my period every two months, but I got it right away after I took Plan B and had it heavily for about a month.”
Rachel also experienced some of the common side effects. “I had pretty severe cramps the day after I took Plan B,” she says. “It kind of worried me at first, but they went away quickly and I got my period like normal.”
As Zabel explains, these side effects can vary significantly from woman to woman. “The side effects really depend on where you are in your cycle,” she says. “Typically we hear about some nausea, some headaches, but it really just depends.”
When should Plan B be taken?
When trying to prevent pregnancy after an incident of unprotected sex, time is of the essence. “It can take five to seven days after unprotected sex to become pregnant,” Zabel says. “At any time in your cycle other than ovulation, your body will kill the sperm off, but if you’re within that five to seven day range of ovulation, your body will keep the sperm alive. So preventing that ovulation and taking Plan B as quickly as possible after the incident is key.”
Although it is more effective the sooner it is taken, Plan B can be taken up to 72 hours after unprotected sex and still effectively prevent pregnancy. After 72 hours, however, the success rate drops dramatically.
“We were freaking out because it had almost been 72 hours when I finally took Plan B,” Charlotte says. Despite the multiple-day delay, the pill worked just fine for her.
“Within 72 hours, you have about an 89 percent chance of preventing pregnancy, but every day after 72 hours cuts that percentage in half,” Zabel explains. “Plan B can be taken up to five days [after the incident], but after the first three days, your chances of preventing pregnancy are cut in half each day.”
If you are considering taking Plan B, but you are unsure about the timeframe in which you have to take it, the makers of Plan B One-Step offer a countdown clock on their website.
If you are in need of emergency contraception but you’ve exceeded the 72-hour window of opportunity, you can take an alternative pill, called ella. “With ella, you have a higher chance of preventing pregnancy for five full days,” says Zabel. “But ella is not available over the counter, so you have to meet with a health practitioner and get a prescription.”
Who should (and shouldn’t) take it?
Because Plan B contains naturally occurring hormones, it is safe for just about any woman to use. At Planned Parenthood, Zabel recommends that any woman of childbearing age (like us collegiettes!) have Plan B at her disposal in case something unexpected happens.
“It usually has a two- to four-year shelf life,” she says. “Mistakes happen, sexual assault happens, so it could be a good idea to just have it in case, for you or a friend.”
Most women can take Plan B without any problems or complications – other than maybe some pesky cramps the next day. In fact, Zabel says that she’s never heard of anyone having a serious or life-threatening reaction the Plan B. However, there are some reasons why you shouldn’t take it.
“It is a hormonal form of birth control, and there are women that have contraindications [symptoms that make a particular treatment inadvisable] for hormonal birth control,” Zabel says. “A family history of blood clots and migraine problems or other hormonal issues are contraindications.”
In these situations, Zabel and the staff at Planned Parenthood would not advise taking Plan B. But because Plan B is available over the counter, pharmacists and practitioners do not typically ask for a woman’s medical history before she purchases the pill. This means that it is usually the responsibility of the woman herself to do research and read the warning labels before taking Plan B, Zabel says.
Plan B should also not be taken on a regular basis. If you are not on a normal birth control regimen, or you regularly miss taking your pills, you shouldn’t resort to Plan B as a replacement for a regular birth control method. Plan B is an emergency contraceptive, and is only intended for use as a back-up birth control method when your primary method of contraception fails. Ignoring the “emergency” warning and taking Plan B regularly is an unhealthy habit because of Plan B’s ability to disrupt your cycle and cause unpredictable side effects.
“Some people use Plan B regularly instead of going on birth control, and that’s something that we really try to discourage, because if you do that, you don’t really get to know your cycle,” Zabel says. “It should be a red flag for you as a person if you have to take it several times in a row – that your method of birth control isn’t working and you need to find one that will.”
In addition to the medical issues caused by repeated use of Plan B, you should not rely on the pill as your only form of contraception for another big reason: Plan B, like normal birth control pills, does not prevent against the spread of STDs. To effectively prevent yourself from getting an STD, you should always use a condom and talk to your partner about getting tested for such diseases prior to having sex.
Where can I get Plan B?
Another reason not to take Plan B regularly – it can be bad for your budget. Collegiettes can find Plan B at most drugstores and pharmacies across the country, as well as Planned Parenthood, but it can be one costly little pill.
“At Planned Parenthood we are able to sell it for $30, but most places, like Walgreens and CVS, sell it for $50 or $60,” Zabel says.
With the newly reduced regulations of Plan B, emergency contraception is more accessible than ever. Even though the removed age restrictions don’t change things for most of us collegiettes, it’s important to do your research and stay informed about emergency contraception so you can make sure you’re making good decisions relating to your sexual health.
*Names have been changed.