Melanie Cole, MS: Welcome to conversations with MIT Health, I'm Melanie Cole. Joining me today is Jennifer Shark. She's a certified nurse midwife at MIT Health, and she's here to talk to us about emergency contraception. Jennifer, thank you so much for joining us as we're doing this series on birth control, emergency contraception is something that so many people don't really understand. They have questions about it. Tell us a little bit about how it works.

Jennifer Shark: Sure. Emergency Contraception as a general rule works by preventing conception. So there are different methods of emergency contraception and they all go about preventing conception in different ways. So, The type that you take orally disrupts the potential conception by delaying ovulation, or if you're close to ovulation, it will disrupt the production of progesterone, which makes conception very difficult. So that is how emergency contraception that is, oral works. IUDs can also be used as emergency contraception, and they work by disrupting the sperm from getting up into the fallopian tubes to fertilize an egg.

Melanie Cole, MS: Wow. This is so interesting. Are the effectiveness rates, and are there situations in which some forms of emergency contraception are less effective? Whether we're looking at somebody's weight considerations or BMI with Plan B. And tell us a little bit about what you've seen with these.

Jennifer Shark: Absolutely. So in terms of efficacy, IUDs are by far the most effective form of emergency contraception for people who would like to have an IUD for contraception, they are nearly a hundred percent effective in preventing pregnancy within five days of unprotected sex. With the oral pills, it's a little bit more hit or miss. So Plan B, which is kind of the original morning after pill, is a type of progestin that's typically found in birth control pills. And when you. It delays your ovulation by a day or two, which should help to prevent conception.

The problem with Plan B is that there is some evidence that it is ineffective for people who are weigh more than 165 pounds, or who have a body mass index of over 35. I'm not a fan of using the body mass index for this purpose because there are many different things that can go into creating a high body mass index. So we'll usually just go by weight. With Ella, which is the other type of oral emergency contraception, it works for most people, but if you weigh more than 200 pounds, it may be less effective.

Melanie Cole, MS: Is emergency contraception safe? Is this something that doesn't have many side effects or complications? Speak about the safety factor.

Jennifer Shark: Sure emergency contraception is very safe. Plan B is basically as safe as taking a tablet of Tylenol. It has almost no deleterious side effects. Some people may feel a little bit of nausea, but in terms of it doing anything to harm your body, it will not do anything to harm your body. The same is true for Ella, the other oral emergency contraceptive. Some people will have a disruption in their menstrual cycle or may feel a little bit nauseous, but overall there are no major complications which can occur from taking either of these pills.

IUDs are among the safest form of birth control and emergency contraception. because of their lack of estrogen. IUDs, when it comes to risk, the risk is with the procedure. So while an u d itself is safe, there are some risks to having the IUD put in.

Melanie Cole, MS: Do we need a prescription to buy Emergency contraception?

Jennifer Shark: So for Plan B, you do not need a prescription. It can be purchased over the counter. We do recommend that you call us for a prescription if that is the emergency contraception that you desire because it comes to you through your insurance at no cost versus it cost about $50 over the counter. And Ella does require a prescription, so we encourage people to call us. When it comes to oral emergency contraception, Ella is usually considered the best choice.

Melanie Cole, MS: I think one of the biggest questions, Jennifer, is how do I know if it worked? So how long after unprotected sex is emergency contraception effective, and how does somebody know that it worked?

Jennifer Shark: That is a great question. So for all forms of emergency contraception, you want to use them within five days or 120 hours after unprotected sex. Unfortunately, whether or not it works depends on whether or not you have a positive pregnancy test in two weeks. So we use emergency contraception. And then we just have to wait. Usually if you take emergency contraception in the form of a pill, you'll get your period within two weeks. If you don't get your period within two weeks, then you need to take a pregnancy test to see if it fails. In terms of an IUD, the chance of pregnancy after using it with for emergency contraception is almost zero. So again, it's more just waiting for your period, but. With an IUD, you really don't have to worry.

Melanie Cole, MS: For people that might be uncomfortable, can a partner or someone else buy emergency contraception for them? Can people under 18 buy this? Tell us a little bit about some of the regulations that go along with it.

Jennifer Shark: Sure. In Massachusetts, anyone can buy Plan B or any of its generic forms over the counter, at the pharmacy, there is not an age limit that you can be male or female. It does not matter. Your partner can pick it up for you. If you are getting a prescription, the prescription has to be in your name, but as with all prescriptions, you can appoint someone to go pick it up at the pharmacy for you.

Melanie Cole, MS: This is such an interesting topic. And Jennifer, as we wrap up, I'd like you to just kind of summarize the types of emergency contraception that are available at MIT Health, what you would like listeners to know about this option and how that they can get in touch with you.

Jennifer Shark: Sure. So the very first thing I want your listeners to know is that if you need emergency contraception, Please either call the primary care office or OB GYN. A nurse can walk you through the different methods and help you pick the method that is correct for you and have a provider either send a prescription to the pharmacy for you or get you a fit in visit usually in the OB GYN department for an IUD to be placed. If you had been planning to get an IUD any.

Melanie Cole, MS: Thank you so much, Jennifer, for joining us today and really educating us because that was excellent. So informative. 

Listeners can visit Health.mit.edu for more information and to get connected to one of our providers. That concludes this episode of Conversations with MIT Health. Please remember to subscribe, rate and review this podcast and all the other MIT Health podcasts. . I'm Melanie Cole. Thanks so much for joining us today.