Jul 20, 2017

Dr. Jones: Oops, you now have a contraceptive emergency, but your doctor's clinic is two hours away and you don't have the car. The closest pharmacy is an hour away, but the pharmacist is your father-in-law. So what are your options? This is Dr. Kirtly Jones from Obstetrics and Gynecology at University of Utah Health, and this is The Scope.

Announcer: Covering all aspects of women's health, this is The Seven Domains of Women's Health with Dr. Kirtly Jones, on The Scope.

Dr. Jones: Okay, the condom broke or you didn't use protection. What are your options?

Number one, you can cross your fingers and hope you don't get pregnant. If you and your partner are young and healthy, and the "oops" came around your fertile period, and isn't that usually just the case, the chance of getting pregnant is between one and three, and one in four.

Two, you can use emergency contraception. Emergency contraception comes in three types, and they're all quite different. One is a progesterone hormone common in birth control pills that's taken in a higher dose in a pill within 72 hours of unprotected intercourse. One brand name is Plan B, and the others are Take Action and Next Choice One-Dose. These are available over the counter in many pharmacies, but not all, and should be taken as soon as possible, as it won't work after you ovulate and become pregnant.

Another pill, called Ella, is available by prescription, and it works for up to five days by blocking ovulation.

And lastly, a copper IUD can be placed, and it's the most effective, but it requires that you see a clinician who can place it and place it right away. And depending on your insurance, it can be hundreds of dollars, but it offers highly effective contraception that's immediately reversible for up to 12 years.

If you want to get emergency contraceptive pills, you can get them online and delivered to your home. This is not cheap, and you need a credit card, but several websites are available to women around the country, and FedEx delivers almost everywhere. You can Google "emergency contraception online," but be careful as you need a credible and reliable source.

The Princeton University website on emergency contraception is good, and the website, bedsider.org, will take you step-by-step. Both of these can direct you to the best places to order emergency contraception online. Both of these will also give you more in-depth information about emergency contraception.

Ella, the pill that works for up to five days, might be the best choice. Plan B needs to be taken sooner and isn't as effective for women over 165 pounds. You need to go to the websites recommended by the Princeton emergency contraception website or bedsider.org and set up an account.

You need to fill out a questionnaire that might take 10 to 15 minutes, and then fill out shipping and billing information. You need a credit card, and the current price for online consultation, the medication, and the overnight shipping, but probably not on Saturday or the weekend, is $67. It comes in a little box wrapped up in a bigger box, and you have to be present to accept it at your home.

If you want them to send the prescription to a local pharmacy, the one where your father-in-law doesn't work maybe, you can give them the number and it's a little cheaper, but you have to pick it up pretty soon. Don't wait a week.

Many women who would choose emergency contraception have limited access. They don't have a doctor. They don't live near a health clinic that will take drop-ins. Emergency rooms don't consider this an emergency, and it's very expensive to use an emergency room for emergency contraception.

Women might prefer privacy and confidentiality, which they might not have in their local small-town clinic or pharmacy, where everyone knows everyone. Getting emergency contraception online is an option, but it isn't cheap. You need to have a home address to receive the delivery, and you need a credit card.

Of course, we all hope that you and your partner are well-covered with contraceptive methods that are effective and that you don't have to think very much about so you won't even need emergency contraception. But if you need emergency contraception, there are some options, much better than crossing your fingers.

Thanks for joining us on The Scope.

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