Step one: Take a deep breath.
You slept through your alarm and barely planted your butt in a seat by the start of 9 a.m. econ class. You pulled a four-hour shift at the university library’s checkout desk before running across campus to meet up with your intramural soccer team. Alone with your shower thoughts, you flip through a mental catalog of sexy-but-not-too-sexy outfit options for tonight’s hang when it hits you: Sh*t. When was the last time I took my pill?
“Juggling the money, time, and transportation needed to deal with a birth control emergency, whether it's running out of pills, needing emergency contraception, or needing a method that you can't access, is a lot for any student," Robin Watkins, CNM, WHNP-BC, tells Elite Daily. According to Watkins, who is also the director of health care at Power to Decide, a campaign to prevent unplanned pregnancy, many colleges do not have a health center on campus or nearby that offers birth control. Students who do have access to one may find that it has limited hours, she says.
If you live on campus, you may be even more concerned about keeping your private business from becoming dining hall tea than about determining how to get Plan B or pregnancy tests in a pinch. And given the country’s inadequate and inconsistent sex education standards, you may not have come to campus armed with accurate information about what to do in a contraceptive crisis. (No, splashing water in your vagina will not help you after a condom breaks.) So Elite Daily has your back with expert advice for how to handle five common birth control scares.
Maybe you couldn’t hear your birth control alarm over the sounds of your friends shouting Céline Dion at karaoke. Maybe your phone was on silent while you crammed for an exam in the library. Once you’ve had that “oh, sh*t” moment of realizing it may have been days since you last took the pill, you need to identify which of the two forms of oral birth control pills your doctor prescribed, according to Dr. Mary Jacobson, M.D.
If you take a combination pill, which contains both estrogen and progestin and is more common, “you need to take your pill within 24 hours of your usual time to remain protected from pregnancy,” Jacobson says. “If you take a progestin-only pill, you need to take your pill within three hours of your usual time to remain protected.”
If you missed two or more pills, Jacobson says you can take the last pill you missed as soon as you remember (even if you have to take two pills on the same day). Then, continue to take one pill per day as you normally would. "Use a backup form of contraception if you are more than three hours late in taking the progestin-only pill and more than two days late in taking the combination pill,” Jacobson adds.
If you constantly miss pills, consider switching to a different form of birth control. Talk to your doctor or campus health center about whether an IUD, patch, ring, or other method may be right for you, Jacobson suggests.
Everyone knows that sexual intercourse is approximately 67% weird friction, so how are you supposed to know if that weird friction was a condom breaking? If you even suspect a condom broke, Dr. Felice Gersh, M.D., suggests being proactive: Get it out of the trash, take it to the bathroom, and fill it up with water. If it leaks, get your hands on emergency contraception ASAP.
It’s important to take emergency contraception as quickly as possible if you know the condom broke, according to Watkins. "Sperm are really efficient swimmers, so any time semen gets inside your vagina or on your vulva, you could potentially get pregnant," she says. Whether you buy emergency contraception at your nearest pharmacy or stop by your nearest Planned Parenthood clinic, “the sooner you take it, the better it is at preventing pregnancy,” Watkins says. You can take it up to five days from when you had sex.
Not to add another layer of complication to all this, but you’ll need to think about STIs, too. "No matter what, if you experience any unusual symptoms or discomfort” after the condom broke, “book an appointment with your provider to get it checked out or take an at-home test,” Jacobson advises.
A light spell of hangover nausea can plant a pesky little seed in the mind of even the most diligent pill-taker: Could I actually be pregnant? If you’re taking your birth control pills correctly, that’s very unlikely, according to Jacobson. "The pill is a very effective means of birth control — up to 99.7% effective for perfect use, according to the [Centers for Disease Control and Prevention] CDC," she says.
“Perfect use” describes how well the method works when it's used in a clinical trial, while “typical use” describes how well the method works when used by real people in real life. The pill is still around 91% effective for typical use, but if you haven’t been as on top of taking it as you’d like and are concerned you may be pregnant, take a test as soon as possible.
There’s nothing shameful about buying a pregnancy test, but if the thought of running into someone at the pharmacy spirals into full-blown paranoia, you can see a doctor at a campus health center. (As Jacobson notes, they legally must comply with doctor-patient confidentiality laws.) And if visiting a student health center is still too close for comfort, you could opt to go off-campus to take a test at a local clinic, like Planned Parenthood.
Studying abroad is sexy. Meeting an attractive local! Dancing in the back of smoky bars until 7 a.m.! Sneaking into said local’s room without waking their parents, who they definitely still live with, because Europe! What’s not sexy: adjusting your birth control pill schedule to your new time zone, and then running out of pills entirely a month into your stay.
Plan to speak with both your doctor and your insurance company about your birth control options before leaving to travel abroad, says Dr. Taraneh Nazem, M.D. "If you're taking oral contraceptive pills, you may be able to get an advance pack or two,” she says. “Otherwise, you can work with a doctor to figure out the best way to obtain medication abroad.”
Depending on where you’re studying, birth control pills may be available locally and easy to access. "Do some research ahead of time around the type of pill you use, the hormone dosage, and the extended cycle," Jacobson advises. "Many countries enjoy far looser regulations around birth control [than in the United States], and don’t require a prescription to obtain a pack of pills over the counter."
If you’d rather not think about birth control at all while you’re abroad, look into longer-acting methods like IUDs or Nexplanon (an implant that goes in your arm). Depo-Provera injections, which last three months, are a good option for a summer program or J-term, according to Nazem.
In an ideal world, every consensual, penetrative sexual encounter would start with a condom and end in an orgasm. But that’s not always the case: One in two sexually active people will contract an STI by age 25, according to the American Sexual Health Association.
"If it’s feasible in your situation, talk with your partner to ask about their STI status," Jacobson says. But you may feel weird Snapchatting someone you barely know and asking when they last got tested. These random hookups happen and are nothing to be embarrassed about. Jacobson says "getting tested right away is the best course of action.”
You can get tested at a student health center or off-campus health clinic, or else buy an at-home STI test kit online or at a pharmacy (a lab will contact you with your results after you mail in the test). But you’ll need to get tested more than once to ensure that you’re safe from a range of STIs, according to Dr. Adeeti Gupta, M.D. "Get tested for STDs stat, and repeat in two weeks, and again in six weeks," she says.
Dr. Taraneh Nazem, M.D., an OB/GYN at Mount Sinai
Dr. Mary Jacobson, M.D., chief medical director at Alpha Medical
Dr. Felice Gersh, M.D., OB/GYN, founder/director of the Integrative Medical Group of Irvine
Dr. Adeeti Gupta, M.D., FACOG, founder/CEO of Walk In GYN Care
Robin Watkins, CNM, WHNP-BC, and director of Health Care at Power to Decide
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