Everything You Need to Know About Plan B & How it Works

So you’re having sex and having a great time. But then the condom breaks. Or you realize you forgot to take your birth control pill. Or for some other reason, you realize you might get pregnant if you don’t do something. Like, right now.

Luckily, we live in a world where Plan B exists. Hooray! This little pill can save you a lot of hassle. An abortion is much more expensive, and having a kid is like, infinitely more expensive.

However, there’s a lot of confusion about Plan B. How does it work? Is taking it giving myself an abortion? Do I have to wait until the literal morning after to take it?

Let’s clear up some stigma and misconceptions for ya.

Help! What is Plan B?

Plan B or the morning after pill is a form of emergency contraception. This means that it shouldn’t be used as a regular form of birth control, because all other birth control methods are more effective. The morning after pill should only be used when your birth control method of choice fails or in an emergency like sexual assault.

Plan B is just one pill, and you can get most forms over the counter. The most common type of pill is made from levonorgestrel. This is actually the drug that many birth control pills are made out of, just in a higher dose.

When should you use the morning after pill?

Here are some situations when you might want to consider taking a morning after pill.

  • You realize you forgot to take a few birth control pills
  • Your partner doesn’t pull out in time
  • You missed your appointment to get your birth control shot
  • You forgot to change your birth control ring
  • Your partner’s condom broke or slid off 
  • You were sexually assaulted or raped

You should use Plan B as soon as possible after unprotected sex. You definitely don’t have to wait until the literal morning after to take it. In a perfect scenario, you would have some in your medicine cupboard that you could take right after the condom breaks.

If you don’t have any on hand, you’ve sort of entered a race against the clock. The most common form of emergency contraception—levonorgestrel pills like Plan B One-Step, Take Action, and My Way—can be taken within 5 days of having unprotected sex, but they’re much more effective in the first 24-72 hours. 

These pills can lower your chances of getting pregnant by 75-89% if they’re taken within three days of unprotected sex. This is huge, and definitely makes their price tag worth it.

How to get it

Getting Plan B might be easier than getting a flu shot, to be honest. You don’t need a prescription for most types, and it’s sold at most drug stores and supermarkets. Some retailers that carry it include CVS, Walgreens, Rite Aid, Target, and Wal-Mart. Basically, if they sell boxes of condoms and lube there, they’ll probably have the morning after pill.

The brand name called Plan B One-Step usually costs between $40-$50. The generic versions like Take Action, My Way, and AfterPill usually cost less at around $15-$45.

There are some ways to save, though. Plan B One-Step offers a $10 printable coupon. Plus, if you already bought Plan B One-Step, they’ll reimburse you the $10 into your PayPal account if you scan your receipt. 

If you don’t need Plan B right now, you can order it online to stock up your medicine cabinet. It’s a very good idea to have these pills on-hand, especially if your birth control method is just condoms or pulling out. You can order Plan B One-Step and its generics on Amazon, so there’s no excuse to be unprepared.

There are some emergency contraceptive methods that require a little more work to obtain. ella is another type of pill that you need a prescription for. However, it’s more effective than other morning after pills, and it’s effective up to five days after sex. Unlike Plan B One-Step and its generics, it actually doesn’t get less effective as the five day window goes on. You can get ella online using a free prescriber consult, and they’ll provide next day shipping. Otherwise, you can call your doctor. Just make sure you don’t drag your feet and miss the five day window.

Lastly, another form of emergency contraception is a copper IUD. The Paraguard IUD is the most effective form of emergency contraception, which is weird because you never hear about it. It’s 99.9% effective if it’s inserted within 5 days of unprotected sex. Plus, it provides pregnancy protection for up to 12 years! 

Unfortunately, an IUD might be more expensive than the morning after pill. Depending on your insurance and financial situation, it could cost between $0-$1,000 to have one inserted. Planned Parenthood will help you figure out the best option, or you can talk to your gynecologist.

How emergency contraception methods work

Levonorgestrel-based Plan B is made of a synthetic version of the hormone progesterone. The medicine delays or prevents ovulation. Sperm can live around five days in a person’s body, so if the morning after pill can prevent ovulation (or the release of an egg) for that long, you shouldn’t get pregnant. Basically, the synthetic progesterone tricks your body into thinking it’s not time for you to release an egg yet. After the sperm have gone gently into this good night, you’ll be free to ovulate again.

ella also prevents ovulation, but in a different way from Plan B One-Step. Scientists actually don’t really know why ella works, but it has something to do with its effective ingredient ulipristal acetate. It’s thought that the drug changes progesterone receptors in the follicle that surrounds a developing egg, preventing it from moving to the fallopian tubes. This delays or prevents ovulation and decreases your chances of getting pregnant.

If you’re looking for a morning after pill because you made a mistake with your birth control pills, patch, ring, or shot, ella probably isn’t the best choice for you. This is because the hormones in these birth control methods can affect how well ella works.

Don’t try to double up on morning after pills. This will probably just make you sick. And you definitely shouldn’t take Plan B One-Step and ella at the same time or within five days of each other. They can actually counteract each other and not work at all.

A copper IUD doesn’t work like these other methods. Instead, it damages the sperm, making it so they can’t work properly. The copper ions put out impair the sperm so much that they have a veeeery hard time fertilizing, and eggs usually can’t implant. This is why it’s so effective.

How Plan B works for plus-size women

Recently, a credible study came out that suggests that both Plan B One-Step (and its generics) and ella have reduced efficacy among fat women and other people with vaginas, and flat out doesn’t work for some people over a certain weight.

Plan B begins to lose its potency when the person taking it is over 165 pounds. What’s even worse is that it doesn’t work if you weigh 175 pounds or more.

ella is more effective for anyone who weighs more than 155 pounds. However, it may not work as well if you’re over 199 pounds.

The weight of the average woman in the United States is 166.2 pounds. This means several things.

First, there are a lot of fat people who don’t know about this issue, so they take the morning after pill. They think that they’ve done their due diligence and that they won’t get pregnant, but then they end up pregnant anyways.

Second, fat women are getting majorly screwed over. The one form of over-the-counter Plan B is not available to them, making it much more difficult to watch out for their health. 

Unfortunately, the only type of emergency contraception that is guaranteed for plus size people is a copper IUD. This is a huge inconvenience for people who can’t get a Paraguard for a variety of reasons or who just don’t want to. Hopefully there will be a better solution to help fat people manage their reproductive health in the future.

Do emergency contraceptives cause abortion?

Many people get confused about how emergency contraception works, and whether its effect qualifies as an abortion.

It’s important to understand that the morning after pill will not cause an abortion. 

Plan B works in a different way from the abortion pill. The chemicals in the abortion pill—mifepristone and misoprostol—work together to empty your uterus, removing anything that has implanted. 

Plan B simply stops your body from ovulating. This means that there’s no egg for the sperm to possibly fertilize. There’s nothing inside your uterus that can be flushed out.

Birth control is not nearly as highly regulated as abortion in the United States. If you could get an abortion pill over the counter without a prescription, don’t you think people would be up in arms and trying to abolish it? Not only would this over-the-counter abortion pill be met with scorn, but it would also be medically risky, as your doctor needs to give you a pregnancy test before giving you an abortion pill.

The morning after pill does not cause an abortion. Now you can tell that to your annoying conservative aunt on Facebook.

Side effects

Most people take Plan B without any serious side effects. The pill is very safe and people rarely experience any complications.

If you take Plan B One-Step or its generics, you might experience:

  • Nausea
  • Abdominal pain
  • Fatigue
  • Headache
  • Dizziness
  • Menstrual changes
  • Breast tenderness
  • Vomiting

Your next period after you use Plan B One-Step will likely be different from what you’re used to. It may come earlier or later than you were expecting. It might also be spotty, or your flow might be heavier or lighter than you’re used to.

Upset girl suffering from headache. Closeup of young Asian woman with pain grimace holding head and touching temples. Head ache concept

If you throw up within two hours of taking Plan B One-Step, it won’t work. It’s a bummer, but you’ll have to buy a new one and try again, unless you want to utilize another emergency contraceptive method.

ella has similar side effects, which include:

  • Headache
  • Nausea
  • Abdominal or stomach pain
  • Dizziness
  • Fatigue
  • Menstrual pain

If you puke three hours or less after taking ella, call your healthcare provider. They’ll be able to get you another dose.

A Paraguard copper IUD is a more complex commitment, so the side effects could be greater. However, many people have this IUD with little to no side effects or discomfort.

The most likely side effects are annoying, but not dangerous in any way. These can include:

  • Mild to moderate pain when the IUD goes in
  • Cramping or backaches for a few days after it’s put in
  • Spotting between periods
  • Heavier periods
  • Worse menstrual cramps

These side effects should subside after 3-6 months. Hang in there! Set it and forget it birth control is totally worth it.

This IUD can result in pelvic inflammatory disease. This is an infection of the uterus, tubes, and nearby organs. It generally occurs within the first 20 days after placement. It’s treated with antibiotics, but can result in serious side effects including infertility. This issue is rare, but could be more common if you or your partner have sex with more than one person.

Sometimes, Paraguards can be difficult or painful to remove. This might require surgery in severe cases. You might also experience expulsion, which means that the IUD falls partially or completely out of the uterus. This is mostly just an inconvenience, and it isn’t dangerous. However, you should use other birth control methods until you figure out what to do.

Don’t let any of these side effects hold you back from taking a pill or getting an IUD. If you feel it’s the best fit for you, you should get this form of emergency contraception ASAP.

Plan B myths

There are a lot of misconceptions about Plan B and other emergency contraceptives. Let’s debunk some, shall we?

If I take an emergency contraceptive pill today, I’m still covered if I have unprotected sex tomorrow.

Woah, woah, woah. Hold up.

Plan B isn’t a magic pill that makes having unprotected sex okay. 

Emergency contraceptive pills are made to cover one instance of unprotected sex. If you have unprotected sex after you take it, you might have missed the most effective window. You’re opening yourself up to an increased chance of pregnancy, and at that point, was spending $70 and running to the drug store even worth it?

Taking all your birth control pills at once is the same thing as taking Plan B.

Okay, this one has the tiniest bit of truth to it, but that doesn’t mean you should try it at home.

It is possible to take multiple birth control pills to reach the same amount of progesterone required to prevent ovulation. This is because both birth control and Plan B One-Step are levonorgestrel based. 

It’s better to just suck it up and buy Plan B. However, theoretically, if you were in an emergency situation, you could use your birth control pills for the same effect. Like maybe you were on a desert island.

Don’t try to DIY this birth control pill cocktail. Every brand of pill will have a different number of pills that would replicate the Plan B dose. If you take matters into your own hands and guess too few, they won’t be effective. If you take too many, you could get nauseous and just puke them back up.

If you really can’t access Plan B, call your doctor. They might be able to tell you how many BC pills to take to equal one Plan B.

Taking Plan B now will make it harder to have a kid later.

This one must have come from someone who wants to slut-shame women, right?

There’s literally no evidence that taking Plan B multiple times has any impact on your future fertility whatsoever. Don’t let people scare you. You’ll be able to have kids when you want to.

It’s dangerous to take emergency contraceptive pills more than once. Plus, if you take them too much, they won’t work anymore.

If you take Plan B One-Step and then have unprotected sex again, you should still take Plan B! This even applies if it’s during the same menstrual cycle. There are no harmful effects of taking it more than once.

However, it’s not recommended to take ella more than once within one menstrual cycle. This isn’t because it would cause harm to you, but because there haven’t been enough tests to see if it would still be effective.

Emergency contraceptives won’t become less effective the more you take them. They just contain hormones that your body produces all the time to regulate your menstrual cycle. Using it once or 50 times shouldn’t make it work less. 

(Although please don’t take 50 times. More on that later.)

Plan B will screw with your birth control pills.

You can still take Plan B, even if you’re taking hormonal birth control and forget to take some pills. Just because they use the same chemical doesn’t mean you can’t double up. 

There is something important you need to do, though. Once you take your emergency contraceptive pill, you need to restart your pack of birth control pills within a day or two. This is because Plan B messes with your menstrual cycle a little bit. You’re starting over from day one of your cycle, hence the need for new pills.

If you get your birth control pills monthly, call your doctor to get a new prescription quickly after you take the morning after pill. If not, just open up a new pack.

I can only get Plan B when you have an emergency. I can’t stock up.

Plan B One-Step and its generics are available over the counter. That means the cashier won’t ask you any questions about why you need it, and you won’t have to talk to a pharmacist. You can even buy it for a friend of partner. 

Your doctor should be able to write you an ella prescription at your next doctor’s visit, especially if you’re over the weight threshold for Plan B One-Step. That way, you can have the drug on-hand when you need it. Just know that they’ll probably want to make sure you’re using a good birth control method as well.

Stocking up on the morning after pill is never a bad idea. This saves you from having to run to the pharmacy to pick some up when you have an issue. You can keep it discreetly in your medicine cabinet or where you keep your lube and sex toys.

You can use Plan B as your default birth control method.

After you use Plan B, you should contact your doctor about getting on a regular form of birth control like the pill, ring, patch, shot, IUD, or implant. Even though Plan B may seem convenient because you can get it over the counter, it’s not a reliable form of birth control.

Plan B One-Step is only effective 75%-89% of the time. Birth control pills are 99.7% effective if they’re taken perfectly and 91% effective with typical use. IUDs are very effective as well; fewer than 1 in 100 women who have one will get pregnant each year. This is a success rate of over 99%.

Taking Plan B as birth control highly increases the chances that you’ll get pregnant. You’ll probably spend lots of time worrying about whether or not you’re pregnant, too. Taking the morning after pill regularly also exposes you to high levels of hormones. This isn’t dangerous, but might have an effect on your mood.

Plus, Plan B isn’t cheap! This might mean that you take your chances and don’t buy it when you have a problem. Prioritize your mental and reproductive health by getting a prescription for a more reliable form of birth control.

Plan B is a huge step forward for reproductive justice. Women and people with uteruses are able to have more control over when or if they get pregnant than ever before. We shouldn’t stigmatize buying Plan B, but celebrate the opportunity we have to look out for our health.
So next time you’re fooling around, trying out wax play or sniffing used panties, and things don’t go the way you planned, go to the drugstore and pick up some Plan B. Then throw a couple extras in the cart for good measure.