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Questions and Answers

Getting a Morning After Pill like Plan B in Montreal

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Morning after pills go by many names. You might see Plan B, Ella, Option 2, or emergency contraception (EC). EC helps when a condom broke, a kind of birth control didn’t work, you had sex without either, or you faced non-consensual sex.

Morning after pills are more effective the earlier you use them. They work best within the first 24 hours after semen got in the vagina. EC pills can help lower your risk for pregnancy if you take them within 5 days.

How do morning after pills work?

Pregnancy doesn’t often happen right after sex. If someone ejaculates inside your vagina, their sperm can live for up to 6 days inside your body. If your body releases an egg (ovulates) in that time, the sperm can meet the egg and pregnancy can start. Morning after pills stop the body from releasing an egg, so the sperm have nothing to meet.

It’s important to know that a morning after pill isn’t an abortion pill. It won’t work if you’re already pregnant or you already ovulated. It also doesn’t protect against HIV or other sexually transmitted infections (STIs).

What kinds of morning after pill are there?

There are two kinds of emergency pills. Copper IUDs can also be used for emergency contraception up to 7 days after, and you can learn more in the last section.

Brands like Plan B and Option 2 use a hormone called levonorgestrel to block ovulation (releasing an egg). These…

  • Are most effective within the first 24 hours
  • Can lower your risk if you take them up to 5 days after
  • Don’t work as well for people with a BMI over 25. BMI is Body Mass Index, and you can Google how to find yours.
  • You can get them at any pharmacy without a prescription, just talk to the pharmacist.

Ella uses ulipristal acetate to block ovulation. It…

  • Is only available with a prescription (so you need to see a doctor or nurse before you go to a pharmacy)
  • Is generally more effective than Plan B or Option 2
  • Is also most effective in the first 24 hours
  • Can also lower your risk for up to 5 days after
  • Is much more effective than pills like Plan B closer to 5 days after
  • Is probably more effective than Plan B for people with BMIs over 25 (they’re still researching it)

How do I get Plan B or Option 2?

You can get emergency contraceptive pills like Plan B and Option 2 without a prescription at pharmacies in Quebec. But, you need to have a consultation with the pharmacist if you don’t have a prescription.

In the consultation, the pharmacist may ask about your last menstrual cycle, when you had sex, and what the situation was. The pharmacist can decide not to give you the pill if you had unprotected sex more than 5 days before, or if you recently had your period. If you disagree with a pharmacist and think you’re at risk and it would help, you can try another pharmacy or go to a youth-friendly clinic like Head and Hands.

How much does it cost?

The cost of this pill depends on the pharmacy and the brand. It has two associated costs:

  1. A ‘consultation fee’, where the pharmacist sees if you need the pill. You do not have to pay the ‘consultation fee’ if you get a prescription from a doctor or nurse before. If you have a valid Quebec health card (RAMQ), this consultation is free. If not, the consultation costs around $10-30.
  2. The cost of the emergency contraception pill itself. This is about 30$. The cost of this pill can be reduced by the provincial drug plan and some private insurance plans.

What if I’m a student?

Since Plan B is an over-the-counter pill, it may not be covered under some Blue Cross or I Have a Plan insurances. You can check by calling them.

If you’re a Concordia Student, Health Services nurses can give you Plan B for $10. You can also see a nurse at McGill to get a prescription for Plan B, saving you the consultation fee. You can check with student health services at your university to see if they can give you Plan B.

How do I get Ella?

Ella is only available with a prescription. But, you can call 811 to find the nearest CLSC with drop-in times, so you can see a doctor and get a prescription in a few hours.

After that, you can go to a pharmacy to pick it up. It typically costs more than Plan B, and can be as much as $90. But your insurance may cover it. It also lowers your risk more, particularly if it’s been closer to 5 days, or for a BMI over 25.

What are the side effects?

Like most medications, Plan B and other pills using levonorgestrel have some side effects. These can include:

  • abdominal pain
  • breast tenderness
  • diarrhea
  • dizziness
  • fatigue
  • headache
  • irregular, altered, or heavier menstrual bleeding
  • migraines
  • nausea
  • vomiting

It’s important to know that if you vomit within 2 hours of taking the pill, it won’t be effective and you’ll have to take it again.

Other options besides the morning after pill

If you’ve already started ovulating, or it’s been over 5 days since you’ve had sex, another emergency contraception option is the copper IUD. It’s also not affected by someone’s BMI (Body Mass Index).

The copper IUD is a tiny T-shaped device. Doctors can insert it into the uterus up to 7 days after sperm got in the vagina, and it stops them from swimming up to the egg. It’s also very effective a kind of birth control. It lowers your risk for pregnancy by over 99% for up to 10 years.

You need a prescription for an IUD and a doctor needs to insert it. This can make it hard to get on short notice. Even though it’s more effective later on, it’s best to start making calls early. Some clinics also need to run an STI test first.

A copper IUD comes with its own set of side effects, and it’s often not covered by insurance.  Since it’s very effective, isn’t affected by BMI, and gives you birth control for years after, it can sometimes be worth it.

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