Emergency contraception


Emergency contraception

Emergency contraception (EC) is a last-minute option for couples and women to prevent an unwanted pregnancy. Also known as the morning-after pill, it acts by preventing the foetus from getting implanted in the uterus.

In case the condom ruptures or slips during sex or if the woman forgets to take more than two of her regular contraceptive pills or in case of rape, emergency contraception gives a woman a second chance to protect herself from an unwanted pregnancy.

 The morning-after pill should be taken as early as possible after the intercourse, but certainly within five days. However, if the woman is already pregnant or if there have been multiple acts of intercourse afterwards, it may not be effective. It is ideally only for emergency use and regular contraception, if not used earlier, should be initiated soon after. 

 After taking the pill, the woman will get her periods within seven days after the expected date. If the delay is prolonged further, she must consult a doctor to rule out pregnancy.

 Most women have a misconception that if a pregnancy results from failure of the morning-after pill, it must be terminated. This is untrue. The pill will cause no adverse effects on the baby. Thus if she has changed her mind and wishes to continue with pregnancy, she may do so. n There is no increase in the relative risk of ectopic pregnancy in women who conceive after emergency contraceptive failure.

 Advance prescription or provision of emergency contraception is legal and safe. Its use is not restricted to fertile period only. A woman should not be refused the drug, at any time of the cycle, provided the time frame criterion is met.

 Knowledge and availability of emergency contraception should not be perceived as a promiscuity threat. Rather, adolescents should be counselled and empowered with information about its role in cases of contraceptive accidents or sexual assault. This becomes even more relevant in the light of the National Family Health Survey III, which revealed that 50% women in India are married by age of 18.

 Levonogestrel, the main drug in the morning-after pill, has a reported pregnancy rate of 20% per year when used as the sole means of contraception. This is higher than those of almost all other birth control methods, including the rhythm method and withdrawal. Also the amount of hormone induced into the system would outweigh the amount of hormone taken throughout the cycle with regular oral contraceptives. Hence, the morning-after pill as the sole method of contraception is not recommended.

 Reported evidence demonstrates that making emergency contraception more widely accessible does not increase risk-taking and that women who are the most diligent about ongoing contraceptive use are those most likely to seek emergency treatment.

 If you have had unprotected intercourse with your partner and are concerned about pregnancy, do not hesitate to resort to emergency contraception. It will prevent pregnancy in some women some of the time, and if you do not want to get pregnant anything is better than nothing.

 If policy makers are looking for an intervention that will reduce abortion rates, preventing access of emergency contraception is not the way to go.

They must concentrate on encouraging people to use regular contraception
before or during intercourse, not after it.

 Besides the morning-after pills, Copper intra-uterine device insertion within five days of unprotected sex is said to be the most effective emergency contraception method, and it also provides ongoing contraception. However, you will need to visit a gynaecologist to get one inserted and may have to alter your lifestyle to prevent sexually transmitted infections.

(The author is director & head, Department of Obstetrics & Gynaecology, Fortis Memorial Research Institute, Gurugram)

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