Wake up to the facts about the morning-after pill

The morning-after pill, also known as the emergency contraception pill (ECP), has been introduced to prevent pregnancy after having unprotected sex, when other contraception fails - such as condom breaks, not taking the birth-control Pill, or sexual assault.

The morning-after pill is not to be confused with the 'abortion pill', otherwise known as RU486, mifestone, or Mifeprex. According to the International Federation of Gynecology and Obstetrics, "EC is not an abortifacient, because it has its effect prior to the earliest time of implantation." Since they act before implantation, they are considered medically and legally to be forms of contraception.

Morning-after pills, sometimes referred to as emergency hormonal contraception (EHC) in the United Kingdom, may contain higher doses of the same hormones (oestrogens, progestins or both) found in regular combined oral contraceptive pills. Taken after unprotected sexual intercourse, such higher doses may prevent pregnancy from occurring.

Mifepristone is another kind of ECP, but is considered an anti-hormonal drug and does not contain oestrogen or progestin.

The phrase 'morning-after' is figurative; ECPs are licensed for use up to 72 hours after sexual intercourse.

The morning-after pill is easily accessible at pharmacies in Jamaica. However, before issuance, individuals are asked a few questions by the pharmacists and are advised about its use. Currently, there are various brands on the market: Postinor, Pregnon, Plan B, Preven, among others.

Wayne Green, pharmacist at Apex pharmacy in Portmore, told The Gleaner that many individuals who come to the pharmacy don't spend time getting counselling, considering it a fallback for casual sex.

However, Green states that the morning-after pill should be used wisely.

"Since the morning-after pill is a mega dose to the regular oral conception and has more side effects, it is highly recommended that women consult with their general practitioner and gynaecologist to get expert advice before using them," Green pointed out.

Forms

Emergency contraceptive pills are drugs that act both to prevent ovulation or fertilisation and possibly post-fertilisation implantation of an embryo. ECPs are distinct from medical abortion methods that act after implantation.

Dosage

The morning-after pill is designed to be taken within 72 hours of intercourse with a second dose taken 12 hours later. It can be started up to five days (120 hours) after unprotected intercourse.

Effectiveness

Effectiveness is a common concern, especially when it comes to EC. The morning-after pill is an effective form of back-up birth control. However, it is not as effective as ongoing use of the Pill, the ring, the patch, the shot or intrauterine devices, when used correctly.

Plan B reduces the risk of pregnancy by 89 per cent when started within 72 hours - or three days - after unprotected intercourse.

Only one in 100 women will become pregnant after taking Plan B if started within three days.

When birth-control pills are used as emergency contraception, they reduce the risk of pregnancy by 75 per cent when started within three days after unprotected intercourse.

Only two in 100 women will become pregnant after taking birth-control pills as emergency contraception if started within three days.

Pros

Prevents unwanted pregnancy with 75 per cent effectiveness.

Does not harm the developing foetus if a woman is already pregnant when taking the regimen.

Offers a safe, non-invasive way to prevent pregnancy in emergency situations.

Serves women's health needs and advances reproductive self-determination.

Can use regular birth-control pills.

Can get pills ahead of time so you have them when you need them.

Easy to use.

Does not affect future fertility.

Emergency contraception is safe. Even though the morning-after pill constitutes the same hormones as the birth-control Pill, it does not have the same risks as taking the Pill or other hormonal birth-control methods continuously. That's because the hormones in the morning-after pill are not in your body as long as they are with ongoing birth control.

You may want to use the morning-after pill if:

The condom broke or slipped off, and ejaculate entered the vagina.

You forgot to take the birth-control Pill, insert your ring, or apply your patch.

Your diaphragm or cap slipped out of place and ejaculate entered the vagina.

You miscalculated your 'safe' days.

You were forced to have unprotected vaginal sex, or were raped.

Cons

Offers no protection against sexually transmitted infections, including AIDS.

No long-term studies to show whether women will be permanently damaged, or risk such diseases as cancer, from chemicals being given in such high doses.

Side effects include nausea, vomiting, infertility, breast tenderness, blood-clot formation and ectopic pregnancy, which can be life-threatening.

Other side effects include nausea, vomiting, anti-emetics, abdominal pain, fatigue, headache, dizziness, breast tenderness and temporary disruption of menstrual cycle.

Because the morning-after pill comprises high-dose female hormones, it's not a good choice for women with a history of stroke, blood clot or high blood pressure.

Related risks

Every woman is different. Due to the risk of serious health problems, women with the following conditions may not be able to use emergency contraception:

Established pregnancy.

Past heart attack or stroke.

Blood clots in the legs or lungs.

Breast or genital cancers.

Liver cancer.

- Compiled by Sonia Mitchell

Additional sources:

www.plannedparenthood.org/health-topics/emergency-contraception-morning-afterpill-4363.html

www.bbc.co.uk/switch/surgery/advice/sex_relationship/sex/morning_after_pill

www.enwikipedia.org/wiki/emergency_contraception

www.crankyeditor.som

www.fwhc.org/birthcontrol

How the morning-after pill works

Morning-after pills contain hormones to stop ovaries from releasing eggs. They also make the womb slippery, so fertilised eggs can't stick to it.

Pregnancy cannot happen if there is no egg. The hormones in the morning-after pill also prevent pregnancy by thickening a woman's cervical mucus. The mucus blocks sperm and keeps it from joining with an egg.

Human conception rarely occurs immediately after intercourse. Instead, it occurs up to several days later, after ovulation. During the time between intercourse and conception, sperm continue to travel through the fallopian tube until the egg appears. This is the benefit that emergency contraception possesses, because it isn't too late to prevent pregnancy.

The active ingredients in morning-after pills are similar to those in birth-control pills, except in higher doses. Some morning-after pills contain only one hormone, levonorgestrel (Plan B); others contain two, progestin and oestrogen. Progestin prevents the sperm from reaching the egg and keeps a fertilised egg from being attached to the wall of the uterus (implantation. Oestrogen stops the ovaries from releasing eggs (ovulation) that can be fertilised by sperm.