Can I just use EC instead of other birth control?

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 Corinna 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 people, 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 people with vaginas 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:

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