The condom broke last night and I would like to take the morning after pill, but I heard it causes abortion. I’m not sure what to do.



Dear Concerned:

Taking the morning after pill does not cause an abortion. The morning after pill does not stop a pregnancy that has already started, or disrupt a fertilized egg that has already implanted in the uterus. It is not the same pill that is used for medication abortions, or the “abortion pill.” The morning after pill prevents a pregnancy before it starts by interfering with the menstrual cycle or preventing an egg from being fertilized by a sperm. There are two types of morning after pills available, and two types of IUDs that can be used after unprotected intercourse to prevent pregnancy, also known as “emergency contraception.” Use of an IUD for emergency contraception mostly works to prevent fertilization but may also reduce the chance a fertilized egg will implant in the uterus to begin a pregnancy.

One type of morning after pill, known as Plan B One-Step or Next Choice, is available online or from your local drugstore without a prescription. It can be taken up to five days after unprotected intercourse but is most effective the sooner you take it, ideally within three days (the package says to take within three days). The other type, Ella, is available with a prescription. Morning after pills are slightly less effective in overweight or obese women – and for these women the Ella type of pill seems to work better than the Plan B type of pill.

Certain IUDs, such as ParaGard or Mirena, may also be inserted after a broken condom to prevent pregnancy. This is considered “off-label” use because it is not FDA approved for this situation. But it works much better than the morning after pills, provides ongoing contraception, and is effective no matter what you weigh. The IUD generally needs to be inserted within five days after unprotected intercourse.

It is important to consider that use of ongoing effective birth control methods works better than using the morning after pill to prevent pregnancy. But if you choose a method like condoms, you should consider having a back-up package of the morning after pill at home in case a condom breaks, or you don’t use one in the heat of the moment, since the sooner you take the pill the better it works.

– Dr. Z

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