The Latest in Pregnancy Prevention: Emergency
Contraception Soon to be Available Without
a Prescription
Every day, women in the United States have unprotected intercourse. This may be as a result of contraceptive failure, lack of contraceptive use, or rape. For these reasons, women need fast and ready access to emergency contraception (EC).
In August 2006, the U.S. Food and Drug Administration
approved nonprescription sales of Plan B® emergency
contraception to women age 18 and older. Emergency
contraception, often referred to as "the morningafter
pill" or by it's brand name “Plan
B”, is used to prevent pregnancy after
having unprotected or inadequately protected
sexual intercourse. The emergency contraceptive
drug called Plan B is slated to be available
for over-the-counter purchase by early 2007.
Even though EC has been available by prescription for several years, many women are unaware of its existence, misunderstand its use and safety, do not have convenient and prompt access to it, or do not use it when a need arises.
Courtney A. Schreiber, MD, MPH, an obstetrician and gynecologist who specializes in family planning at the University of Pennsylvania Health System explains that the type of women in need of EC varies, “Emergency contraception is not only needed for those who have had unprotected sex or are victims of sexual assault, but at times women need a “backup” method of contraception when their original choice fails. This may include condom breakage or forgetting to take hormonal contraceptives regularly.”
Dr. Schreiber continues: “It is of the utmost importance for women to understand that a primary form of birth control should always be used when they are not attempting to become pregnant. Emergency contraception is not a substitute for routine birth control. In addition, EC does not protect women from HIV and other sexually transmitted diseases, so if the condom breaks or doesn't make it on, that woman needs to contact her provider.”
How is EC taken?
The emergency contraception drug called Plan B is taken in the form of two pills containing levonorgestrel (a synthetic hormone found in ordinary oral birth control). The first pill should be taken ideally within 24 hours of unprotected sex, but can be taken within 120 hours. Although the directions say to take the second pill 12 hours later, recent studies show that taking the two pills together is even more effective. So it is fine to take both pills at one time.
EC can reduce a woman's risk of pregnancy by 89 percent when taken as directed and is most effective when taken within the first 24 hours after unprotected sex. The sooner EC is taken after unprotected sex, the more effective it is, so ready access is key.
Where does someone buy EC?
Until EC is available to purchase without a prescription, it is recommended that females ask their health care provider for a prescription of Plan B to have on hand since unprotected sex might happen when a doctor's office is closed. This ensures that a woman can quickly take EC if and/or when she needs it.
Once EC becomes available over-the-counter (without prescription), women can simply go to a pharmacy and purchase the drug. However, even when EC is available over-the-counter, females under the age of 18 will still need a doctor's prescription to buy it.
Is EC considered an abortion pill?
No. The emergency contraceptive Plan B is not RU-486 (the abortion pill). Because Plan B works by preventing ovulation, fertilization or implantation, it will not affect an existing pregnancy — EC does not abort a pregnancy.
Are there risks associated with EC?
Plan B is safe and does not contain estrogen. It does not have any significant contraindications. Side effects can include nausea, abdominal pain, tiredness, headache, menstrual changes, dizziness, breast tenderness, and vomiting. These side effects are not very common and do not usually require any other medication.
Clinical follow-up by a health care provider is not needed after EC is taken. However, if a woman's period is more than one week late, pregnancy is possible. If a woman is experiencing persistent, irregular bleeding or abdominal pain she should contact her health care provider to rule out a miscarriage or ectopic pregnancy.
Who should not use EC?
You should not take EC to abort a current pregnancy (it will not work), if you are allergic to levonorgestrol or any of the ingredients in Plan B. You should not use EC for regular birth control.
Dr. Schreiber concludes: “Unplanned pregnancy is a major public health issue in the United States. Women now have a second chance at preventing pregnancy through emergency contraception. Access to Plan B must be readily available so that women can take it within hours of unprotected sex, which is why having EC available without a prescription is so important. All women of reproductive age should know about emergency contraception and be able to access it without delay.”
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