What is Emergency Contraception

Emergency Contraceptive Pills are often called the “morning-after-pill;” however they may be taken up to 5 days (120 hours) after unprotected sex to prevent pregnancy – not just the next morning. The sooner you take ECP - the more effective it will be in preventing pregnancy. The most common type of ECP contains progestin, which is one of the hormones found in combined birth control pills. ECP does not protect you from sexually transmitted infections, including HIV/AIDS.

To purchase ECP in Canada, you no longer need a doctor’s prescription. You can now get the pills Over the Counter (OTC) at your local pharmacy.  

ECP is not an abortion pill. There is a pill known as RU-486 that is used to terminate pregnancy in the first trimester; however it is not currently available in Canada. ECP can only prevent a pregnancy from happening up to 5 days after unprotected sex. If you are already pregnant ECP will not cause an abortion or miscarriage.

How effective is ECP in preventing pregnancy?

The effectiveness of ECP depends on: 

• how soon after unprotected sex you take it, 
• where you are in your menstrual cycle, and 
• what type of ECP you take.

Effectiveness decreases the longer you wait – so don’t delay.

For example, if you follow proper instructions for the most common type of ECP, it will be approximately 95% effective within 24 hours, 85% effective within 25 to 48 hours and 58% effective between 49 and 72 hours.

Where can I get ECP?

Most pharmacies should have ECP in stock, however it is best to call ahead and ask to make sure. Because ECP is now available OTC, you will have the option of having a consultation with the pharmacist before it is dispensed to you. The pharmacist will ask you about your monthly cycle and when you had unprotected sex – this information will be kept confidential.

ECP can also be obtained at a cheaper cost (or sometimes free) from some members of the Canadian Federation for Sexual Health. ECP is also available at many birth control clinics, women’s clinics/health centres, university health centres and emergency hospital rooms. Make sure you call ahead to see if ECP is available. For more information on where you can obtain ECP in your area.

You can also get an extra package of ECP to have at home in case of another accident or emergency.

There is no age of consent for obtaining ECP

You have a right to obtain emergency contraception regardless of your age. You don’t need parental consent to get emergency contraception.

What is the average cost of ECP?

The cost of ECP differs across Canada from around $25 to $50, depending on where you live and where you choose to get ECP. ECP may be more expensive if purchased directly from a pharmacist and may be available at a lower cost from your doctor or local health care centre. Your insurance may cover ECP; talk to your insurance provider.

How to take ECP

If you are taking the most common type of ECP there are two white pills in the package. As indicated on the package, take one pill as soon as possible and the other pill exactly 12 hours later.

There is a less common type of ECP that contains 4 pills. This type of ECP is not available over the counter. Ask your health care provider if you would like more information on your options.

Possible side effects

Almost all women can safely use ECP; in fact, emergency contraception has been used worldwide for decades. There are no known long-term or serious side effects from using ECP. Some women experience some nausea and vomiting when taking ECP. You may want to eat and take an anti-nausea tablet an hour before you take a dose of ECP. If you vomit after one or more hours after taking ECP, it will have already passed through your stomach and will still be effective. If you vomit within the first hour of taking ECP you’ll have to take another dose.

You may also experience the following side effects: fatigue, headache, dizziness, breast tenderness and/or bleeding.

How ECP works

ECP work much the same way as birth control pills (“the pill”) work except they contain a larger dose of hormones. The most common type of ECP contains only one hormone, progestin, while the less common method contains progestin and oestrogen.

ECP can work in 3 different ways depending on where you are in your menstrual cycle:

• If your ovaries have not released your monthly egg (ovulation), ECP will delay ovulation. If no egg is released there is no chance of the egg and sperm meeting and therefore no chance of pregnancy.
• ECP may prevent fertilization (when the egg and sperm come together)
• ECP may also prevent a fertilized egg from becoming implanted in your uterus by altering the lining of the uterus (endometrium), thereby preventing a pregnancy from happening.

Sex after ECP

ECP does not continue to protect you from pregnancy with any other acts of unprotected sex that you have after taking the pills. Use a form of birth control to prevent pregnancy, there are many choices. Using a condom (male or female) is the only way to prevent sexually transmitted infections, including HIV. 

Menstruation after taking ECP

Your next period may come a little early or a little late and may be heavier or lighter than usual. If you have not started your period within three to four weeks you should get a pregnancy test and talk to your health care provider.

Can ECP be used instead of a regular form of birth control?

ECP is not as effective as other contraceptive methods and should therefore be used only as a back up method of birth control. While frequent use of ECP is not recommended, repeated use over time poses no known health risks. Taking ECP won’t have any effect on your future ability to get pregnant.