Love Thyself

Emergency Contraception

 

by  Andrea N. Price, M.D.   

(c) Copyright, 2001, Dr. Andrea N. Price

If I had a nickel for every time a panic stricken girlfriend has called me in the wee hours of the morning yelling,  ” Andi, I messed up, what do I do now…?”  Well, let’s just say I wouldn’t ever have to go into the office, or rush into the hospital at 2:00 A.M. to deliver a baby again. Yes, at some unfortunate time or another, most women have experienced and regretted unprotected sexual intercourse. Whether it was a broken condom, getting swept away in throes of passion  (yes, this happens, but this excuse doesn’t fly with me), diaphragm slippage, or sex without consent (rape), an unwanted or unplanned pregnancy does not have to be your fate.  Forget about old wives tales such as standing on your head or Coca-Cola douches preventing pregnancy.  Several real options exist in the form of emergency contraception that can be utilized after unprotected sex has occurred. 

Emergency contraception (EC) can drastically reduce the chances of an unwanted pregnancy.   There are two basic forms of emergency contraception available – the “morning after pill” and the intrauterine device  (IUD).

Many of you may have heard of the morning after pill.  It is about 75% effective in preventing pregnancy and is most effective if administered within 60 hours after unprotected intercourse.  The most common type of emergency contraception consists of a higher than normal dosage of certain brands of combination birth control pills.  These pills are called combination pills because they contain a combination of two common female hormones, estrogen and progestin. There is also a second type of morning after pill available that contains only progestin. Two dosages of these pills are administered 12 hours apart as soon as possible and within 72 hours (3 days) after the act of unprotected sex has taken place.  If more than 72 hours (3 days) has elapsed since intercourse, then the morning after pill is no longer an option for you.

Both types of morning after pills work in similar ways.  They may work by either stopping an egg from being released (ovulation), by preventing fertilization of an egg that has already released, or by stopping a fertilized egg from implanting in the soft lining of the uterus.  After intercourse has occurred, and an egg is fertilized, it takes about 72 hours for that fertilized egg to travel from the fallopian tubes to implant itself into the lush uterine lining.  This is where the egg will grow and mature into a full term baby over the next nine months.   The sooner the pills are taken after sexual intercourse, the more likely they are to be effective in preventing pregnancy.

As with any medication, the morning after pill does have certain side effects.  The most common side effects are nausea, breast tenderness, and fluid retention.  Another possibility is that you may experience irregular bleeding after taking the morning after pill.  This may take the form of spotting, or your period may start earlier than usual.  If your next period is late, it imperative that you go to your doctor immediately for a pregnancy test as you may be pregnant.  Also be aware that the morning after pill will not prevent pregnancy if you were already pregnant from previous intercourse, but may not have realized it.  In general these pills are extremely safe, however the progestin only pill may be more appropriate for you if you have a history of liver disease, blood clots, heart disease or certain types of cancer.

Please realize that these pills are no substitute for consistently using a reliable method of birth control.  They are not as effective as regular use of birth control, nor do they help prevent sexually transmitted diseases (STD’s).   Emergency contraceptive pills can be obtained by calling your personal physician (ob/gyn, family doctor, internist), your local emergency room, or Planned Parenthood chapter.  Some physicians even advocate giving their patients a prescription to keep on hand in case of emergencies. Another resource for finding available emergency contraceptive pills in your area is the Office of Population Research Provider Search page, located at   http://ec.princeton.edu/providers/index.html , or call the Emergency Contraceptive hotline at 1-800-584-9911.

The second form of emergency contraception involves having a T shaped copper intrauterine device (IUD) called Paraguard, placed within the uterus within 5 days of unprotected intercourse.  A copper IUD works in preventing pregnancy in much the same way as the emergency contraceptive pills. It may prevent fertilization or implantation of an egg, An IUD has the advantage that it can be placed quickly and easily in a doctors office and remain in place as your primary method of birth control for up to 8 years. It is 99% effective in preventing pregnancy.  An IUD is a great method to consider if you already have children and are in a stable monogamous relationship, therefore at low risk for acquiring a STD.  The drawback to an IUD is that it may result in heavier periods with some increase in cramping.  An IUD is not a good method for you if you have multiple sexual partners, your partner has other partners, or you have a history of STD’s.  A pregnancy test should be performed to insure you are not already pregnant anytime an IUD is inserted.  In the very unlikely event that a pregnancy does occur it will need to be removed immediately.

I would be remiss not to reiterate that emergency contraception should be just that.  Reserved for cases of contraceptive failure and the unfortunate tragedy of sex without consent.  In loving one’s self, it is crucial that consensual sex be accompanied by thought and responsibility.  This means not only using a regular effective birth control method, but also protecting yourself against sexually transmitted diseases by condom use could potentially save your own life. You know the rules - be careful, be safe and be blessed.

Andrea  N. Price M.D.,  F.A.C.O.G.

andi@womenofcolorobgyn.com

www.WomenOfColorOBGYN.com