Emergency contraception (EC) is birth control that can
prevent pregnancy after sex; EC methods include pills and the copper IUD. All sexually active young people should
know about these methods. EC can
be used right away or up to 5 days after sex if a woman didn’t use birth
control, a condom broke, or in a situation of rape.
EC makes pregnancy much less likely, but is not as effective
as regular contraceptives - the pill, IUD or condoms. Parents who are worried about EC should know that the
methods are safe, and extensive research has shown that their availability does
not increase the likelihood that a teenager will engage in sexually risky
behavior, such as inconsistent use of contraception or having multiple sexual
partners.
Plan B One-Step and the generic Next Choice One Dose
contain a progesterone-like compound – levonorgestrel – that is found in many
birth control pills. It does not
harm an established pregnancy nor decrease future fertility. EC is most effective when taken within
2 days after unprotected sex, but has some effectiveness up to 5 days
later. The EC pills are less
effective for women who weigh more that 154 pounds. Plan B One-Step and Next Choice One Dose are available
without a prescription to females or males (males don’t take it – but give it
to their partners!) age 15 or older.
Younger people must have a prescription. The cost of Plan B is $40-$50 – probably less at a family
planning agency.
Princeton University has a website that explains EC in
detail – ec.princeton.edu. Some
women feel side effects such as headache, fatigue or breast tenderness after EC
pills- these symptoms generally go away in a day or two. Unexpected bleeding or an early or late
period may occur – these side effects are not dangerous. Pharmacies such as CVS and Walgreens
carry these pills in the aisles containing other family planning methods.
Ella is a prescription EC pill that is more effective
than Plan B. especially for obese women and in situations when more time has
past since unprotected sex. Its
ingredient is ulipristal acetate, which will delay ovulation. It may also work by preventing
implantation of the fertilized egg.
Ella is available online for $40 (including shipping) at www.ella-kwikmed.com. A physician will
take a history on-line and prescribe the
pill. It will be delivered
by FedEx within 1-2 days, signature required. Ella should not be used if the woman has an established
pregnancy.
Copper IUD – this is the most effective form of
EC. The IUD must be placed within
5 days of unprotected sex; it is more effective than pills in preventing
pregnancy and it can remain in place for as many as 12 years. The Affordable Care Act (Obamacare)
promises women contraception without copay. However, the girl or woman must find a family planning
agency (such as Planned Parenthood) or a clinician experienced in IUD
placement.
Medical Abortion Pills – Emergency contraceptive
pills work before a pregnancy has started, so they do not create an
abortion. However, there are two
compounds in current use that can be used for a so-called medical
abortion. Mifepristone – which
used to be called RU486, or the French abortion pill, acts by blocking the
action of progesterone, a hormone needed to sustain a pregnancy. Misoprostol, otherwise known as
Cytotec, is then taken to soften and open the cervix and cause uterine
contractions, expelling the pregnancy.
These two drugs are used together in the first 9 weeks of pregnancy,
under the supervision of a trained doctor or nurse practitioner. Medical abortion is available in
California at many family planning clinics.
In states such as Texas where many women’s clinics have been
shut down, women are turning to misoprostol pills on their own for inducing an
abortion. They are getting the
drug on line, or across the border in Mexico, where it is sold over the
counter. They may have very little information as to proper dosage, but when
bleeding begins they hope to go to a clinic or hospital for a suction procedure
to complete the abortion.
Throughout Latin America, where abortion is mainly illegal, women are
taking misoprostol in this manner.
It is tragic and disgraceful that the situation in our country has come
to this. Women who are desperate to end a pregnancy should not be abandoned by
the medical profession.
You can support Wendy Davis, Democratic candidate for
governor of Texas, who has pledged to reopen family planning clinics if she
wins. Support her through Emily’s
List, or on numerous Internet websites.
Sadja Greenwood, MD back issues on this blog. Check out my novel – Changing the Rules
– at bookstores or Amazon.
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