Emergency contraception is a method for preventing pregnancy after unprotected sex or contraceptive failure.

• Emergency contraception has no effect on an established pregnancy and cannot cause miscarriage or abortion.¹
• Dedicated emergency contraceptive pills work best when used as soon as possible after unprotected sex or contraceptive failure, and are effective for up to 3–5 days afterward.²
• Nonhormonal copper IUDs inserted up to five days after unprotected intercourse can also act as emergency contraception,² and recent evidence suggests that levonorgestrel IUDs may be used similarly.³

Use of emergency contraceptive pills 

Between 2008 and 2015, emergency contraceptive pill use increased substantially.⁴ (Please note that these usage data are for emergency contraceptive pills only and do not include use of the IUD as emergency contraception.)

• Women^* reported two main reasons for using emergency contraceptive pills in 2015: Forty-one percent feared that their regular method would not work, and 50% reported having had unprotected sex.⁴

• Use of emergency contraceptive pills increased substantially across almost every social and demographic characteristic examined, including age, race and ethnicity, income level, education, religion, marital status and women’s number of births, between 2008 and 2015.⁴

• In 2015, use was highest among sexually experienced women aged 20–29 and those who had never given birth. Among women in these groups, 35–36% reported having ever used emergency contraceptive pills.⁴
• Between 2008 and 2015, repeat use of emergency contraceptive pills among all sexually experienced women increased from 4% to 10%. Many women who had ever used emergency contraceptive pills had used them more than once (41% in 2008 and 45% in 2015).⁴

Changes in obtaining emergency contraception

• Reliance on a prescription to obtain emergency contraceptive pills fell from 31% in 2008 to 18% in 2015, despite the overall increase in use of this method.⁴
• Sixty-seven percent of women who used emergency contraceptive pills in 2008 obtained them at a health facility or clinic; in 2015, only 40% obtained them in this manner, likely reflecting some of the impact of the change to over-the-counter availability.⁴

Relevant policy developments

Access to and use of emergency contraception has likely shifted as a result of key policy changes.

• The Affordable Care Act’s contraceptive coverage guarantee took effect widely in January 2013. This new benefit eliminated cost sharing for emergency contraception (and other forms of contraception) for privately insured individuals, but only if they obtained a prescription.⁵
• Although the contraceptive coverage guarantee may have alleviated the cost burden for covered individuals obtaining emergency contraceptive pills by prescription, it may have inadvertently shifted the cost burden for others because the guarantee does not cover over-the-counter methods.⁴
• By 2014, the one-pill regimens of levonorgestrel emergency contraception (Plan B One-Step and generic formulas) had been approved for over-the-counter sales (i.e., by a pharmacist without a prescription or age restrictions).⁶