When Your Patient Can't Find Emergency Contraception

A patient contacts your office in distress. They need emergency contraception, they've tried two pharmacies, and both were out of stock. They're watching the 72-hour clock tick down and don't know what to do.

This scenario is more common than it should be. While there's no nationwide shortage of Afterpill or other levonorgestrel-based emergency contraceptives (EC) in 2026, localized access gaps, brand confusion, and pharmacy stocking decisions can leave patients scrambling.

As a healthcare provider, you're in a unique position to help. This guide provides a practical, step-by-step framework for assisting patients who can't find EC, along with workflow tips to make the process efficient for your practice.

Current Availability of Emergency Contraception

Here's the 2026 landscape in brief:

• Levonorgestrel 1.5 mg (Plan B One-Step, Take Action, My Way, EContra, and others) — widely available OTC at major pharmacy chains. No FDA-listed shortage.
• Afterpill — available through AfterPill.com at ~$25 shipped. Not sold in retail pharmacies.
• Ella (Ulipristal Acetate 30 mg) — available by prescription. Stocked at most pharmacies; also obtainable via telehealth.
• Copper IUD (Paragard) — available for in-office insertion. Most effective EC option (>99%).

For more supply details, see our provider shortage briefing.

Why Patients Can't Find It

Understanding the barriers helps you troubleshoot:

Brand Name Confusion

Patients who search specifically for "Afterpill" won't find it at pharmacies — it's online-only. They may not realize that Plan B One-Step, Take Action, and My Way are identical medications. A quick explanation can immediately expand their options.

Pharmacy Stocking Gaps

Not all pharmacies carry the same brands. Rural pharmacies may stock limited quantities. Some pharmacies keep EC behind the counter (legal, but creates a barrier), and in some states, pharmacist refusal laws can delay access.

Cost Barriers

Plan B One-Step costs $40-50 without insurance, which is prohibitive for some patients. They may have heard that Afterpill is cheaper ($20 online) but can't wait for shipping.

Weight Concerns

Patients over 165 lbs may have read that levonorgestrel is less effective for them and don't know what alternatives exist. They need guidance on Ella or the copper IUD.

What Providers Can Do: 5 Steps

Step 1: Clarify the Product and Timing

First, establish the basics:

• How many hours since unprotected intercourse?
• Is the patient seeking Afterpill specifically, or any form of EC?
• Patient weight — levonorgestrel may have reduced efficacy above 165 lbs

This determines which products are appropriate and how urgently you need to act.

Step 2: Write a Prescription

Even for OTC products, a prescription has tangible benefits:

• Activates insurance coverage — most plans cover EC at $0 cost-sharing under the ACA
• May help if a pharmacist is hesitant to sell OTC (rare, but it happens)
• Enables Ella access, which requires a prescription

Consider writing for both levonorgestrel and Ella, allowing the patient to fill whichever is available.

Step 3: Check Pharmacy Stock

Use Medfinder for Providers to check real-time availability at pharmacies near the patient's location. This prevents sending them on a wild goose chase.

You can also call the pharmacy directly to confirm stock and alert them that the patient is on the way.

Step 4: Recommend the Right Product

Based on timing and patient factors:

• Within 72 hours, weight under 165 lbs: Any levonorgestrel 1.5 mg product (fastest OTC option)
• Within 120 hours, or weight over 165 lbs: Ella (ulipristal acetate) — write a prescription
• Within 120 hours, wants most effective option: Copper IUD insertion if you can accommodate or refer
• Not urgent (planning ahead): Recommend ordering Afterpill online for advance provision (~$25)

For a complete comparison of alternatives, direct patients to our alternatives guide.

Step 5: Connect to Backup Resources

If pharmacy options are exhausted:

• Planned Parenthood — Often has EC on-site; can provide same-day
• Title X clinics — Free or reduced-cost EC regardless of insurance
• College health centers — For student patients
• Urgent care clinics — Some stock EC or can write Ella prescriptions
• Telehealth — Nurx, PRJKT RUBY, and Planned Parenthood Direct can prescribe Ella for same-day pharmacy pickup

Alternatives to Recommend

When levonorgestrel is unavailable or inappropriate, your options include:

• Ella (Ulipristal Acetate 30 mg): Effective up to 120 hours, better for higher body weight. Prescription required. $40-65 cash, $0 with most insurance. Do not combine with levonorgestrel.
• Copper IUD (Paragard): Most effective EC (>99%), also provides 10 years of ongoing contraception. Requires provider insertion within 5 days. $0 with most insurance.

Note: The Yuzpe regimen (combined oral contraceptive pills used as EC) is a historical backup but is less effective and causes more side effects than dedicated EC products. Use only if no other options are available.

Workflow Tips for Your Practice

Integrating EC support into your practice doesn't have to be time-consuming:

Advance Provision During Routine Visits

ACOG, AAP, and AAFP all support discussing emergency contraception during routine reproductive health visits. Consider:

• Adding an EC conversation to annual wellness visits for reproductive-age patients
• Writing advance prescriptions for Ella so patients have one ready
• Recommending Afterpill ($25 online) for patients who want an affordable dose on hand

Create a Quick-Reference Resource

Keep a one-page handout or EMR template with:

• EC product names and where to find them
• Link to Medfinder for Providers
• Local Planned Parenthood and Title X clinic phone numbers
• Telehealth platforms that prescribe Ella

Train Front-Office Staff

EC inquiries are time-sensitive. Ensure your team knows to:

• Triage EC calls as urgent
• Gather the key info (hours since intercourse, weight, insurance status)
• Route to a provider for rapid prescription or counseling

Stock Ella Samples

If your practice has a relationship with Ella's manufacturer, stocking samples can provide an immediate solution for patients in the 72-120 hour window.

Final Thoughts

Helping a patient find emergency contraception is often a time-sensitive, high-stress interaction. Having a clear workflow — check timing, write a prescription, verify stock, recommend the right product, and connect to backup resources — can turn a frustrating experience into a resolved one in minutes.

Tools like Medfinder for Providers make the stock-checking step fast and reliable. And proactive advance-provision counseling during routine visits can prevent the emergency altogether.

For the latest on EC supply and prescribing guidance, see our provider shortage briefing.