Emergency Contraceotion - the Morning-After Pill

Go to Health – the morning-after pill , aka emergency contraception, Plan B

Jessica broke up with her boyfriend, and went off the birth control pill. Three months later they got back together, had a celebratory drink, and had sex without a condom.

Maria and her husband were both in school and working to support their children. When they had sex, the condom broke.

Liza went to a great party, with dancing, liquor, drugs and cute guys. She felt woozy after a drink, and had to lie down in a bedroom. She woke up to find she was being raped.

Fortunately, all these women knew about the morning-after-pill, otherwise known as Plan B , which can prevent pregnancy 89% of the time if taken within 72 hours after unprotected sex. The first pill is taken as soon as possible, and the second 12 hours later. The sooner it is taken, the more effective it is. Side effects can include nausea, abdominal pain, fatigue or headache, but in general are not severe.

Plan B contains a high dose of levonorgestrel, a progesterone-type hormone that is used in many birth control pills. It prevents pregnancy primarily by stopping ovulation (the maturation and release of eggs from the ovaries) or by preventing fertilization of the egg if ovulation has already occurred. Plan B also alters the lining of the uterus, making it less receptive to a fertilized egg.

If a woman is already pregnant, Plan B will not cause an abortion. Also, Plan B should not be used as a regular birth control method, because other methods such as the birth control pill, IUD or condoms are usually much more effective. Plan B is used in emergencies, which is why it is known as emergency contraception.

Plan B is available locally, at the West Marin Pharmacy, Safeway, or Longs. Call first to make sure it is in stock. If you are 17 or older, it is available without a prescription; younger women need a prescription from a doctor. It may be less expensive from a family planning clinic like Planned Parenthood. Men 18 and older can also buy Plan B. Women who rely on condoms, or are forgetful about the birth control pill should have Plan B immediately available in reserve, so they can use it as soon as possible after unprotected sex.

The Copper-T is an intrauterine device (IUD) that some women use for regular birth control, but you can also have it inserted up to five days after sex to prevent pregnancy. It reduces your risk of getting pregnant by more than 99%. Another advantage to the Copper-T IUD is that you can keep it in place to prevent pregnancy for up to ten years. IUDs are a good form of contraception if neither partner has a sexually transmitted disease such as gonorrhea or Chlamydia.

An excellent website for emergency contraception is ec.princeton.edu.

There is a medication that causes abortion in early pregnancy, known as Mifeprex (mifepristone, RU486), which will be described in another of these columns.
Sadja Greenwood, MD