How Are Birth Control and Emergency Contraception Different?

People often get confused about the difference between birth control and emergency contraception. We get it – they are both hormones taken in pill form to help prevent an unplanned pregnancy.

Birth control is any method of contraception used to help prevent pregnancy – emergency contraception is not a form of regular birth control.

Birth control pills are more effective at preventing an unplanned pregnancy than emergency contraception. Birth control pills are 91 to 99 percent effective compared to ECP’s 75-89% efficacy rate. This means that when 100 people have unprotected sex, only one to nine will get pregnant if they take birth control pills, whereas 11-25 people could get pregnant if they just used ECP.

Birth Control Pills and Emergency Contraceptive Pills Have Different Hormones

Also known as “the morning after pill,” emergency contraception comes in two different FDA-approved forms in the United States:
  • ella® (ulipristal acetate)

  • Plan B One-Step® (levonorgestrel) — Some common generic names are One-Step® AfterPill™, My Way®, Next Choice One Dose™, and Take Action™.

  • ella® (ulipristal acetate)

  • Plan B One-Step® (levonorgestrel) — Some common generic names are One-Step® AfterPill™, My Way®, Next Choice One Dose™, and Take Action™.

Ulipristal acetate and levonorgestrel are synthetic versions of your natural hormone, progesterone. Progestin is the general name for all synthetic versions of progesterone.

Birth control pills come in many different formulations. Some birth control pills have some of the same progestins as emergency contraception, In some birth control pills those progestins are combined with another hormone, estrogen. And, you need a prescription for birth control pills. If you’re not sure which birth control pill would work best for you, Choix can help you figure it out.

Emergency Contraceptive Pills Work Differently Than Birth Control Pills to Prevent Pregnancy (Sort of)

Both ECP and birth control pills prevent ovulation – the process of your ovaries releasing an egg. Depending on where you are in your cycle, ECP may only be able to delay ovulation – that is why it is less effective than the birth control pill.

Birth control pills also prevent pregnancy by:

  • Making it harder for sperm to get to the egg, by thickening the mucus from your cervix (opening of your uterus or womb)

  • Changing the lining of your uterus so it is harder for a fertilized egg to implant

Emergency contraceptive pills prevent pregnancy by:

  • Delaying or stopping ovulation

  • Preventing sperm from fertilizing your egg if you have already ovulated

Unlike the pills taken for medication abortions, ECP will not disrupt a pregnancy if you are already pregnant when you take it.

You Take Birth Control Pills Differently than Emergency Contraceptive Pills

To work best, birth control pills must be taken every day. In contrast, you take ECP when you have a contraceptive emergency on your hands.

ECP works up to five days after unprotected intercourse, but the sooner you take it, the more effective it is. You can lower your chance of getting pregnant by 75-89% if you take ECP within three days after unprotected sex.

And what is a contraceptive emergency calling for ECP? Here are a few possible scenarios:

  1. A condom or other method of birth control were not used with penis in vagina sex in the last five days

  2. You made a mistake with your regular birth control (forgot pills, were late for your shot, didn’t change your ring or patch on time)

  3. Your partner ejaculated inside of your vagina before pulling out completely

  4. Your partner’s condom broke or fell off inside of you after ejaculation (cumming)

You Need A Prescription For Birth Control, But Not Always For ECP

Unlike birth control pills, patches, rings, shots, and IUDs, you can buy some types of emergency contraception “over the counter” without having to see a healthcare provider or talk with a telehealth provider like Choix.

You can buy:

  1. Plan B One-Step® and generic versions in stores without a prescription, regardless of your age

  2. Levonorgestrel tablets (two-pill generic Next Choice® and generic versions) with a prescription, if you are 17 years or older. You will need to ask the pharmacist for the ECP because it is kept behind the counter.

  3. Ella® (ulipristal acetate) only from a doctor, family planning clinic, or Choix with a prescription.

If you have health insurance, you will need a prescription from a doctor in order for insurance to pay for ECP. Medicaid coverage of emergency contraception varies from state to state.

Some Types of ECP Work Better For Certain People And Situations

Here are a few details to keep in mind as you figure out which type of emergency contraception is best for you:

  • Plan B works best for those people weighing less than 155 pounds.

  • Ella is the most effective form of emergency contraception but does not work as well for people weighing more than 195 pounds.

  • Ella is more effective than Plan B, no matter when you take it

  • Don’t use Ella and another type of ECP within 5 days of each other– they can counteract each other and not work

  • If you take Ella, don’t use another hormonal birth control method (pills, ring, or IUD) for at least five days. These could also keep ella from working. Instead, use a condom, contraceptive sponge, or Phexxi gel until your next period, and then restart your hormonal birth control.

  • You can restart hormonal birth control at any time after taking Plan B

  • The Paragard (Copper) intrauterine device (IUD) works as emergency contraception if you are able to have it inserted within five days after unprotected intercourse. With the IUD, you get emergency contraception plus a highly-effective (99 percent) birth control that works for up to 12 years.

Choix telehealth providers are always here to help you figure out which emergency contraception will work best for you.

Keep Emergency Contraception On Hand For Life’s Emergencies

We understand accidents happen. More than half of US pregnancies are unplanned, so you are not alone if you suddenly find yourself stressing about the possibility of an unplanned pregnancy. That’s why its helpful for every sexually-active person to keep backup EC on hand.

Choix is all about getting you the right method to get the job done. We want you to be prepared for the unexpected, especially when it comes to birth control. Learn more about finding the form of contraception that best fits your needs and sex life. We are committed to offering a range of safe, affordable, and accessible birth control and emergency contraceptive options for all.