The Morning-After Pill: Emergency Contraception for Unprotected Sex
Emergency contraception, also known as the morning-after pill, is an effective method of preventing pregnancy after the sexual act has already occurred. While this form of birth control has attracted some controversy, emergency contraception has been used for over thirty years and is considered safe for most women.
Reasons for emergency contraception
Women usually elect to use emergency contraception when they have reason to believe that their normal birth control method is likely to fail. This can occur when:
• Condoms break during intercourse
• Diaphragms or sponges become dislodged during sex
• The woman fails to use oral birth control correctly
• No method of birth control was used during the sex act
In these cases, it is essential to take quick action in order to prevent pregnancy from occurring.
How the morning-after pill works
Typically, there are only a few ways in which a medication can prevent or reduce the chance of pregnancy. Some birth control pills are designed to prevent ovulation; if no egg is released from the ovaries, then no pregnancy can occur. Other hormonal birth control methods cause the walls of the uterus to thin and become unsuitable for implantation, preventing pregnancy even if conception were to occur. Finally, the third type of birth control pill causes the mucus within the cervix to thicken, preventing sperm from swimming up through the cervix to reach the unfertilized egg. Most morning-after pills incorporate one or more of these hormonal birth control methods in a higher one-time dosage intended to reduce or eliminate the chances of pregnancy after an instance of unprotected sex.
Types of emergency contraception
There are several different types of emergency contraceptive medications, each with its own risks and benefits.
• Plan B – This two pill emergency contraceptive works by stopping ovulation. Each pill contains three-quarters of a milligram of levonorgestrel, a powerful synthetic hormone based on progesterone. Plan B is far less effective for women who have already ovulated. Additionally, the Plan B method should be started as soon as possible after the unprotected sex has occurred. The first pill should be taken within 72 hours for maximum effectiveness, with the second pill taken twelve hours later. Levonorgestrel-based medications cannot prevent pregnancy after implantation has occurred, so time is of the essence where this medication is concerned. In medical studies, Plan B had an 89% success rate in preventing pregnancy. Another brand of morning-after pill, Next Choice, offers the same dosages and active ingredients as Plan B and is, for all intents and purposes, the same product.
• Plan B One Step – Like Plan B, Plan B One Step is a levonorgestrel-based contraceptive product intended to prevent ovulation. However, rather than taking two lower-dose tablets twelve hours apart, the One Step method requires only one higher-dose tablet be ingested in order to protect against pregnancy. The Plan B One Step pill contains 1.5 milligrams of levonorgestrel and is reported to offer protection against unwanted pregnancy for up to 120 hours after unprotected sex; however, as with the regular Plan B method, women should begin treatment as soon as possible in order to achieve the desired results. Plan B One Step has replaced regular Plan B emergency contraceptives in most cases due to its ease of use and longer period of effectiveness.
• ella – Based on the hormone ulipristal acetate, ella is intended to delay ovulation and may also have an effect on the uterine lining, making it less suitable for implantation. This one-dose morning-after pill contains 30 mg of ulipristal acetate, a powerful hormone that affects the progesterone receptors in the body. As with other emergency contraceptives, ella is more effective when taken soon after the incidence of unprotected sex; however, unlike other types of morning-after pills, ella retains a high level of effectiveness throughout the fourth and fifth day after unprotected sex.
• Combined emergency contraceptive pills – In some cases, combined hormonal products can produce effective morning-after contraception. Some physicians recommend taking a larger dose of the regular birth control regimen, usually three or more pills at once, as soon as possible. Combinations of ethinyl estradiol and levonorgestrel have also been tested and have shown good results in preventing pregnancy after sexual intercourse has already occurred. A number of daily birth control pills can be used as effective emergency contraception; some of the most common brands include Lo/Ovral, Low-Ogestrel, Lutera and Seasonale. Health care professionals can provide specific advice on how to use these prescription medications as morning-after pills in an emergency.
Copper-T intrauterine device
In some cases, the Copper-T intrauterine device (IUD) can be used as a form of emergency contraception. If the Copper-T IUD is inserted within five days after sexual intercourse, it can provide up to 99% protection against unwanted pregnancy. This makes it the most effective method of emergency contraception available. However, as with all IUDs, there is a slightly elevated risk of complications including infection and sensitivity to the materials contained in the IUD.
Most pharmacies carry some form of emergency contraception. Plan B, Plan B One Step and Next Choice morning-after pills are available in most pharmacies without a prescription for individuals aged 17 and over, while ella is available by prescription only. Individuals under 16 years of age require a prescription for all types of emergency contraception.
Some religious groups have lobbied against emergency contraception, arguing that it is simply another form of abortion. Emergency contraception is medically distinct from chemical abortion, however, and typically has no effect on already-implanted eggs or established pregnancies. Morning-after pills are intended to prevent pregnancy before it occurs and are not designed to terminate pregnancies already in progress. While some varieties prevent implantation by thinning the uterine lining, this is essentially the same mechanism that allows regular birth control pills to prevent pregnancy when taken before the sexual act.
Emergency contraception is much safer than regular birth control pills in most cases because it is not taken on a daily basis and does not create an ongoing change in hormone levels within the body. The morning-after pill is significantly more expensive than regular birth control, however. As a result, it should not be used as a substitute for an effective and safe method of birth control for sexually active individuals.