Morning-After Pill & Emergency Contraception in South Africa: How It Works, Time Frame, Side Effects & Cost
- Samantha Pieterse
- Oct 18
- 7 min read
It happens. The condom breaks, you forget a pill, or things just don’t go as planned. The sudden wave of panic you may be feeling is something many women are all too familiar with. But before you spiral into late-night Googling, take a breath. You still have options.
Emergency contraception is any method that helps prevent pregnancy after unprotected sex or a contraceptive slip-up, and exists for when something goes wrong and you need a reliable way to prevent pregnancy. It’s safe, backed by solid research, and more effective than you may think.
In this post, we’ll break down the essentials, like how emergency contraception works, when to take it, possible side effects, and how to access it safely in South Africa.
What Is Emergency Contraception and How Does It Work?
Emergency contraception refers to any method used to prevent pregnancy after unprotected sex or contraceptive failure. It works before a pregnancy begins. Meaning it does not cause an abortion or harm an existing pregnancy.
Depending on the method you choose, emergency contraception does one or more of the following:
Delay ovulation, so no egg is released.
Prevent fertilisation by affecting sperm movement or egg function.
Stop implantation, preventing a fertilised egg from attaching to the uterus.
There are two main types of emergency contraception:
Hormonal methods, such as the morning-after pill, which contain either levonorgestrel (most common) or ulipristal acetate. These temporarily alter hormone levels to delay ovulation.
Non-hormonal methods, like the Copper IUD, which releases tiny amounts of copper into the uterus. Copper is toxic to sperm and prevents fertilisation altogether.
Multiple studies, including some in the British Medical Journal and Contraception, confirm that emergency contraception cannot end or disrupt an existing pregnancy, since it works before implantation occurs.
But timing is important.
Hormonal emergency contraception is most effective within 12–24 hours of unprotected sex, and the Copper IUD offers protection up to 5 days (120 hours) and is over 99% effective, making it the most reliable option overall.
The earlier you act, the higher your protection, and the greater your peace of mind.
💡 Did you know? EC prevents up to 95% of pregnancies when taken within the first 24 hours after unprotected sex.
The Different Types of Emergency Contraception in South Africa
There are three main options available locally. The one you choose depends on your timing, health, and whether you prefer a short-term or long-term solution.
1️⃣ The Morning-After Pill (Levonorgestrel)
This is the most common and widely available form of emergency contraception in South Africa. It contains levonorgestrel, a synthetic form of the same hormone found in many birth control pills, just at a higher single dose.
How The Morning-After Pill Works:
The morning-after pill delays ovulation. This means that the egg is prevented from being released or fertilised.
How Long Do You Have to Take the Morning-After Pill?
The morning-after pill works best within 24 hours (up to 95% effective) and can still work up to 72 hours (3 days) after unprotected sex, though effectiveness drops to around 58%.
Common Morning-After Pill Brands in South Africa:
NorLevo®, Plan B®, Medilevo, Vonel
Side note: If vomiting occurs within 2 hours, a second dose may be necessary.
2️⃣ Ulipristal Acetate
This pill works slightly differently from the levonorgestrel pill. It blocks the effect of progesterone and can prevent ovulation even when you’re closer to your fertile window.
How Ulipristal Acetate Works:
Ulipristal acetate works by temporarily blocking the hormones your body needs to release an egg.
How Long Do You Have to Take Ulipristal Acetate?
Effective for up to 5 days (120 hours) after unprotected sex, and is slightly more effective than the standard morning-after pill if ovulation is near.
Ulipristal Acetate Brands in South Africa:
Ella®
3️⃣ Copper IUD (Emergency IUD)
If it’s been more than three days, or if you’d like ongoing contraception, the copper IUD is your best option.
How The Copper IUD Works:
The Copper IUD (also known as the Copper T) is a small device inserted into the uterus. It works without hormones by releasing small amounts of copper into the uterus, creating an environment that’s toxic to sperm. This prevents sperm from reaching or fertilising an egg, and if fertilisation has already occurred, it can stop the egg from implanting.
How Long Do You Have to Insert The Copper T After Unprotected Sex?
The Copper T can be inserted up to 5 days after unprotected sex. It is over 99% effective, making it the most reliable emergency option. It also offers up to 5 years of pregnancy protection once placed.
At Mums & Bums Clinic, we can discuss whether an IUD is right for you and assist with insertion if you would like to use this method.
The Sooner, the Stronger: How Time Affects Emergency Contraception
Emergency contraception is time-sensitive, and sooner is always better. Here’s how time affects your protection rate:
Even if you’re not sure where you are in your cycle, it’s always better to take emergency contraception than to wait.
Emergency Contraception Side Effects: What’s Normal With the Pill and Copper IUD
Every form of emergency contraception works a little differently, and so do the side effects. The pills use hormones to delay ovulation, while the Copper IUD works mechanically inside the uterus. For both of these methods, most reactions are mild and short-lived; however, it is helpful to know what’s normal so you can plan and know when to check in with your healthcare provider.
Morning-After Pill Side Effects: What’s Normal (and When to Worry)
Most people who take emergency contraception experience only mild side effects that usually settle within 24 hours. They’re often a sign your hormones are shifting slightly, and not that anything has gone wrong.
Common and completely normal side effects after taking an emergency contraception pill include:
Nausea or mild stomach cramps. Taking the pill with a small snack can help.
Fatigue or dizziness. Your body’s adjusting to the temporary hormone surge.
Breast tenderness or bloating. Similar to premenstrual symptoms.
Spotting or a slightly early or late period. A harmless, temporary effect on your cycle.
These symptoms don’t mean the pill didn’t work, and most resolve within a day or two as your hormone levels rebalance. If you vomit within two hours of taking the pill, speak to your nurse or pharmacist. You may need another dose.
Your next period might come a few days earlier or later than expected, but that’s normal. If it’s more than a week late, or if you experience severe abdominal pain, take a pregnancy test or visit your clinic to rule out pregnancy.
💡 Did you know? Less than 1 in 10 women experience side effects beyond 24 hours after taking emergency contraception pills.
(World Health Organization, 2023).
Copper IUD (Copper T) Side Effects: What to Expect After Insertion
The Copper IUD is completely hormone-free, which means it won’t affect your mood, weight, or hormones, but it can cause a few temporary physical side effects as your uterus adjusts.
Mild and normal side effects after inserting the Copper T include:
Cramping or pelvic discomfort for a few hours after insertion (similar to period pain).
Light spotting or irregular bleeding for the first 3–6 weeks.
Heavier or longer periods during the first few cycles.
Mild backache or lower-abdominal pressure as your body adapts.
These symptoms usually ease within two to three cycles as your uterus gets used to the device. Over-the-counter pain relief, such as paracetamol or ibuprofen, and using a warm compress, can help with cramping.
When to contact your nurse or doctor:
Severe, persistent abdominal pain or fever (possible infection)
Foul-smelling discharge
Bleeding heavier than usual or lasting longer than 10 days
If you suspect the IUD has shifted or been expelled
For most women, side effects are minor and short-lived, and the long-term benefit is reliable, hormone-free protection for up to five years.
💡 Want to know more about the Copper T?
Read our full guide: Copper IUD (Copper T) in South Africa: Hormone-Free Birth Control Guide.
How Much Does Emergency Contraception Cost in South Africa?
It’s important to remember that prices vary slightly between different pharmacies and clinics, but here’s a general guide:
At Mums & Bums Clinic, we offer emergency contraception consultations, with privacy and guidance on next steps.
Common Myths About the Emergency Contraception and the Morning-After Pill
“It causes abortion.”
False. It prevents pregnancy before it starts, and it doesn’t harm an existing one.
“It’s dangerous to use more than once.”
Not dangerous, but not ideal as routine contraception, such as the pill, Mirena, Copper T, contraceptive injections, contraceptive patch, and others. Your cycle may become irregular.
“It affects fertility.”
Completely false. It has no long-term effects on fertility or future pregnancy chances.
“You need a prescription to get it.”
Most pharmacies and private clinics offer emergency contraception without a prescription.
Emergency Contraception at Mums & Bums Clinic, Centurion
At our Rooihuiskraal Clinic, we recognise that these moments can be stressful and sometimes urgent.
We’re here to provide:
✅ Same-day access to emergency contraception
✅ Private, non-judgmental consultations
✅ Guidance on long-term contraceptive options that suit your lifestyle
💬 Need advice or access to emergency contraception?
If you’re unsure which option is right for you, or if your period is late after taking emergency contraception, book a consultation. Your care starts with a conversation, not judgment.
FAQs About Emergency Contraception and the Morning After Pill in South Africa
How long after unprotected sex can I take the morning-after pill?
Up to 72 hours (3 days), but it’s most effective within 24 hours.
What if it’s been more than 3 days?
A copper IUD can work up to 5 days after unprotected sex and is the most reliable option.
Can I get emergency contraception without a prescription?
Yes. All emergency contraception methods are available over the counter at most pharmacies and clinics.
Can I take the morning-after pill while breastfeeding?
Yes, levonorgestrel is safe during breastfeeding. If you’re unsure, speak to a nurse first.
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