Ask the Doctor

About Dr. David Toub

David Toub, MD, MBA is a board-certified ob/gyn formerly in practice at Pennsylvania Hospital. He is Chief Medical Officer at MedCases, a company that develops continuing medical education for physicians. A Fellow of the American College of Obstetricians and Gynecologists, he has moderated women’s health forums for Philly Online and Obgyn.net and published numerous papers and articles for physicians and consumers.

Have a question about EC? 

Email Dr. Toub at askthedoctor@raisinghervoice.org or submit your question using our online form.  The question and answer will be posted on this webpage.  Dr. Toub will also email you the answer, unless you specify otherwise.  Your question will be treated confidentially, and we will never reveal your name or email address.  Only questions about emergency contraception and/or sexual assault will be answered.  Please direct other questions to your primary care physician or gynecologist.  Click here to read our Terms of Use Statement and Privacy Statement.

Q:  I’m confused.  Is EC the same thing as the abortion pill?

No, they are not the same. Medical abortion involves a pill called mifepristone (RU-486) that is highly effective in terminating an established early pregnancy in conjunction with another medication called misoprostol. Emergency contraception does not cause abortion; there is no effect on an implanted pregnancy. There is good evidence that emergency contraception primarily works by preventing ovulation and fertilization. It is also hypothesized that EC pills prevent implantation in the uterus (womb). However, that is not the same as an abortion, medically speaking, since pregnancy is defined based on implantation into the uterus. A miscarriage, for example, is something that occurs after implantation, not beforehand.

Q:  Is it normal to bleed after taking EC?

Most women will experience menstrual bleeding within seven days of taking EC. In fact, if you do not have a period within three weeks, you should immediately contact your healthcare provider and obtain a pregnancy test.

Q:  What should I do if I took EC but still haven’t gotten my period?

While most women will experience menstrual bleeding within seven days of taking EC, some women may take up to three weeks, however. If you have not had your period within three weeks, you should contact your healthcare provider and obtain a pregnancy test.

Q: I took EC but still got pregnant.  How did this happen?

Emergency contraception is very reliable, but no medical treatment is 100% effective. With regard to EC, when taken within 72 hours of unprotected intercourse it reduces your chance of getting pregnant by 75-89%. That means that even when used as directed, it does not prevent pregnancy all of the time.

Besides the fact that EC is not 100% effective in general, there are other reasons why you might have conceived. It is very important that EC be taken as soon as possible. For example, EC is around 99% effective if taken within 12 hours after unprotected intercourse. The longer one waits, the less effective EC is in preventing pregnancy. Emergency contraception must be taken on time, exactly as directed. When I was still in practice, I had a patient who had been appropriately directed by her doctor to take her EC tablets 12 hours apart. Her partner, an anesthesiologist, told her to take them 24 hours apart, which is not correct. More likely than not, that contributed to her unintended pregnancy, so it’s really important to take EC as directed.

Email Dr. Toub at askthedoctor@raisinghervoice.org with your own question, or submit your question using our online form.