Get Real! Can I Just Use EC as Birth Control?

Using emergency contraception more than once won't do you harm, but Plan B is likely not a workable long-term birth control plan.

LizzyUK2002 asks:

I am
going to have sex with my boyfriend soon, but I am really scared about
getting pregnant. We are going to use a condom but I’m paranoid that
I’m going to get pregnant. I could go on the pill but my mum wont let
me.. so I’m going to ask my friend’s mum, also. If I could get the
morning after pill and take it just in case it won’t harm me will it?

Heather replies:

It
won’t do you harm that once, nor will using emergency contraception
more than once: there isn’t any data at this time which shows single or
repeat use presents health risks beyond those we see with other
hormonal BC. You can take a look at this page or this one for more information on EC, including possible risks or side effects.

But Plan B is not likely to be a workable long-term birth control plan for you.

After all, if you’re going to have sex together once, it’s likely
enough you’ll do so again. You probably can’t be — and probably won’t
want to be — using EC every single time.

EC is very expensive, for starters (over £22 in the UK if you’re
paying for it yourself). It also can tend to result in feeling a bit
under the weather for a few days — and for some women, a few weeks —
and in tossing your menstrual cycle out of whack, which is doubly
stressful for someone terrified about pregnancy. When you’re scared of
being pregnant, that period coming on time is often a serious
sanity-saver.

As well, emergency contraception is really not meant to be used save
for in emergencies and when you KNOW or strongly suspect a birth
control method has failed. It’s not designed for use as ongoing backup
contraception. While the hormones in it are the same as hormones used
in some other methods of in-advance hormonal contraception, when it
comes to hormones, we know that we usually want to do what we can to
put as few in our bodies as possible. The level of hormones in EC is
higher than that in, for instance, birth control pills, so if you want
a hormonal method you can use as a backup regularly, it’s a better idea
to obtain an ongoing method you can use with lower daily doses.

The morning-after pill is also less effective than before-the-fact
hormonal methods, like the birth control pill, the vaginal ring or
Depo-Provera. For people who don’t want to become pregnant, we usually
want to look first to the most effective methods we can use rather than
to those which are less effective.

So, here’s what I see as your options right now.

1) Just wait for partnered sex and/or intercourse until you
CAN do all the things which really are needed for that, like getting
regular sexual healthcare and being able to use whatever birth control
method you need, and until you are more comfortable with and feel more
able to handle the risk of pregnancy which will be present (even when
it’s small) with intercourse no matter what method of birth control you
use.

Sex isn’t going to be very enjoyable for you — before, during or
after — if you’re terrified the whole time, after all, and if it’s not
something you can feel relaxed and safe with, it just doesn’t make much
sense to be doing it. Too, please understand that besides having higher
risks, and additional risks of pregnancy, vaginal intercourse isn’t
something somehow SO different from other kinds of sex. In other words,
if you and yours have what you need to do other things safely, you’re
not going to be getting any less intimacy or pleasure from just doing
those things for now than you would by adding intercourse, especially
since you’re female. The majority of women don’t reach orgasm from
intercourse, and some don’t find it physically or emotionally
satisfying, particularly all by itself.

2) Read up on condoms, both of you. After all, avoiding
pregnancy should be a concern you share and both commit to. Learn all
you can do to use them right, how they fail, and what you can do to
prevent that. By all means, you can keep a packet of EC around for if
the condom fails, and use it then if need be. But really, when you’re
both using condoms properly and consistently, they are not likely to
fail, and you can usually tell when they have. If they haven’t been
used for all direct genital contact, if they slip off into the vagina,
if they break or tear, then you have a possible failure and you can
know when and if any of those things happen and if you’d need to use
EC. With perfect use, condoms are around 98% effective, and doing
things like being sure to use them with additional lubricant, or even
adding a spermicidal film or foam (which you can purchase at the
pharmacy where you buy condoms) are ways to bump up that effectiveness
even higher if you can’t yet access or don’t want to use hormonal
methods.

3) Go and get the sexual healthcare and birth control that
you need, on your own. It’s not actually up to your mother if you do or
do not use a method of contraception. You can obtain contraception
without her company or permission, and use it without her permission as
well.

It appears you’re in the UK. You can go to a GUM clinic for that healthcare and birth control, or to a Brook center,
for instance. That way, you can get what you need, add the condoms, and
feel better prepared. If I guessed wrong, and you’re somewhere else, do
an Internet search for your country, state or province and "birth
control," "contraception," or "family planning," to find clinics near
you.

I’d still suggest sticking with condoms even if you do get an
ongoing hormonal method, though, both because combining two methods
beats one alone and because other methods of birth control don’t give
you any protection against sexually transmitted infections, a
protection you also need which condoms provide. You’ll also need to get
started in the habit of yearly testing for sexually transmitted
infections if you’re already or going to be sexually active (and so
should your boyfriend: both partners need regular testing, not just
one). You can get that healthcare at those places, too.

Finally, I would just be sure this is something you’re really ready
for now. Again, no method of birth control is 100% effective, so one
part of sound readiness for intercourse is feeling and being capable of
handling an accidental pregnancy if it happens. Mind, when you are
using condoms plus another reliable method of birth control, that isn’t
very likely, but it is still always a possibility that we always need
to feel we could at least handle, if it happened. If it doesn’t feel
like you could deal with that yet, then it’s probably best for you to
hold off on sex until you feel more capable of handling that risk.
Sometimes, in our lives, even if we’ve had intercourse before, we may
take a break just because at any given time, we’re not ready to manage
a possible pregnancy or just don’t even want to deal with worrying
about it.

And if your partner can’t wait until you’re as ready as you can get
— including dealing with these risks, having the time you need to get
prepared, and feeling more relaxed about all of this — and this is
seeming like something you feel you have to rush, that’s a big sign
that HE isn’t ready for sexual partnership, either, and that doing this
now would probably be a bad idea. The right partner for any of us, no
matter our age or sexual experience, is always going to be one with the
maturity and care to accept and honor our needs as well as our
limitations at any given time.

Here are a few more links for you that should help out: