nursingisinmyblood

bangstry asked:

Hi! I have a question about emergency contraception. I've heard that Plan B doesn't work for women who are obese or even just overweight. Are there any alternatives can I can ask for at the pharmacy?

themidwifeisin answered:

This is, unfortunately, very true.  Here’s the low-down:

  • Plan B (levonorgestrel): Pill taken ASAP post unprotected sex to prevent ovulation (the releasing of an egg) and therefore prevent conception.  Most effective when taken immediately, can be taken up to 120 hrs (5 days) after unprotected sex.  When taken immediately by people with a BMI of less than 25, Plan B is 70% effective at preventing ovulation.  As the hours pass, it becomes less and less effective.  People with a BMI of 25 or more who take Plan B will become pregnant just as often as if they had not taken Plan B at all.  
  • Ella (ulipristal): Pill taken ASAP after unprotected sex to prevent ovulation (the releasing of an egg) and therefore prevent conception.  Most effective when taken immediately, can be taken up to 120 hrs (5 days) after unprotected sex.  When taken immediately by people with a BMI of less than 30, ella is 85% effective.  As the hours pass, it becomes less and less effective.  People with a BMI of 30 or more, ella is half as effective as it might be for people with a lower BMI.
  • Paragard (copper IUD): IUD inserted into uterus any time within 120 hrs (5 days) of unprotected sex to prevent fertilization of the egg.  It is speculated that the copper IUD may also prevent the attachment of already fertilized eggs to the uterine lining in a small percentage of cases.  Paragard is 99% effective for users of all BMIs when inserted at any time in the 5 days after unprotected sex.  The efficacy does not diminish over time.

These are the three main types of emergency contraception (this is not terminating a pregnancy, it is preventing one).  

How to get emergency contraception:

  • Plan B: Available over-the-counter without a prescription.  Even though the Plan B package directions for the generics say that it’s intended for use by women ages 17 and older, anyone can buy it without needing to show ID. Plan B One-Step usually costs about $40-$50, and the generics cost about $35-$45.
  • Ella: Must be prescribe by a healthcare practitioner. Costs approximately $60.
  • Paragard IUD: Must be inserted by a healthcare practitioner.  Covered by most insurances.

I feel very strongly that this is a major failing of our healthcare system, since I don’t believe it is OK to say, “Well, your BMI is over 25, we’ll just give you a Paragard.”  That’s not equality.  It’s a very different type of birth control, and it should not be the only option.  My soap-box-ing aside, though, Paragrd is the only option for people with a BMI over 30.  People with a BMI between 25 and 30 can use ella.  

Read the whole article about BMI and emergency contraception efficacy here - it is fascinating.

Read about the Paragard IUD here.

Read about the IUD insertion process here.

Figure out what your BMI is here.

:O I did not know that there was an actual relation between BMI and contraceptive pills.