Since the Dobbs decision to overturn Roe v Wade, there has been a great deal of uncertainty surrounding the legality of pregnancy prevention and birth control. Because of lacking comprehensive, medically accurate sexual health education in our state, Alabama’s young people are confused on what they can legally do to prevent pregnancy, maintain agency and autonomy, and keep themselves safe. We hope to set the record straight and correct any misinformation or myths that are circulating in our communities.
Emergency contraception (EC) can stop a pregnancy before it begins by delaying ovulation so that the sperm and the egg never meet. Emergency contraceptive pills are NOT the same as the abortion pill. Emergency contraception is legal in Alabama and across the country because it does not terminate an existing pregnancy, it only prevents a pregnancy from occurring.
While the best methods of family planning happen before or during sexual intercourse, like using a condom and/or another birth control method, accidents still happen. Sometimes, a condom breaks. Sometimes, people forget to take their birth control pill on time. Rape is a horrible thing, but it does happen. In any or all of these cases, emergency contraception may be an option to consider in order to prevent an unplanned pregnancy.
If you or a loved one finds themselves in any of these situations, there are a few types of emergency contraception (EC) with varying degrees of effectiveness. The most effective EC is having a medical provider insert the Copper-T (non-hormonal) intrauterine device (IUD) within 5 days (120 hours) of unprotected sex. This method is free if you are covered through Medicaid and through most insurance plans. For those who do not have health insurance, the full cost of inserting the non-hormonal Copper-T IUD, also known as Paragard, can range from $500-932. Once inserted, the Copper-T IUD continues to prevent pregnancy for up to 12 years or until it is removed by a medical provider. While this method is 99.9% effective if used within 120 hours of unprotected sex, sometimes it is difficult to get an appointment with your doctor in time.
If Copper-T IUD insertion is not possible within the five day window, ella is another effective form of emergency contraception. ella is a single pill that can be taken orally within five days (120 hours) after unprotected sex. Unlike other EC pills, ella does not decrease in effectiveness within that five day window. This is a somewhat effective method of pregnancy prevention. The costs vary, but ella typically costs $55 dollars. A prescription is still required to access ella, but you may be able to get a prescription filled online with next-day delivery ($48 shipping cost) by filling out an online questionnaire consultation on Kwik Med or Prjkt Ruby, which is reviewed by a U.S.-based physician the same day it is submitted. ella should not be used when breastfeeding or if you suspect you are already pregnant. Some studies show that ella is less effective in people who weigh over 195 pounds.
Finally, if you are unable to get a prescription to cover the costs of ella, Plan B and other Levonorgestrel-based pills are another option. These are over the counter pills that do not require a prescription. Plan B loses effectiveness each day, so it is best to take this single pill orally as soon as possible after unprotected sex. Research suggests that this method of emergency contraception may be less effective in people who weigh 165 pounds or more. Pharmacies stock different brands of levonorgestrel-based pills ($35-49.99) and the Yellowhammer Fund (a reproductive justice organization based in Alabama) sends this EC via mail to people across Alabama for free. Fill out their form here. Since March of 2020, Yellowhammer Fund has sent over 25,000 emergency contraceptive pills to people in Alabama, Mississippi, and the Florida Panhandle.
While levonorgestrel-based pills do expire, they are shelf stable for a number of years. Considering it is most effective when taken as soon as possible after having unprotected sex, it is a good idea to have this EC on hand before you need it.
If you are more of a visual and auditory learner or want to share this information with a friend, this Planned Parenthood video explains the difference between each EC option. We have also created a fact sheet that you can print out and share with friends or post on the backs of bathroom stalls to spread awareness about emergency contraception! Most of the information in this blog was sourced from Bedsider, a program of “Power to Decide.” The Bedsider website contains information about all the different types of birth control methods available and allows visitors of the site to compare and contrast methods so they can decide what the best option is for them. We highly recommend exploring this site for more information!
Featured image by Reproductive Health Supplies Coalition on Unsplash