The 72-Hour Grace Pill

The so-called “Morning-After Pill” or “Plan B” is the most misunderstood form of contraception. This brilliant addition to our safer-sex treasure chest is really important to be familiar with, because mistakes do happen, even to the most prepared people.

The name “Morning-After Pill” has become this pills biggest problem. It’s a catchy name, but it leaves many potential users confused about when to take it. The fact is that this pill works as emergency contraception, within 3 days of the unprotected sex act. The sooner you take it, the more effective. And no, you don’t have to wait until sunrise.

So just how effective is it? It’s definitely worth making a noise about: when used within 72 hours of sex, it is 89% effective, in other words, 9 out of 10 women who would have conceived from an unprotected act, will not get pregnant. Your protection is best during the first 24 hour period and then drops over the next days. There is also a chance that it will work more than three days after the sex, so it may be worth a swig considering the options; but after 72, the safety is too low to count on.

One of the reasons that emergency contraception (EC) has gotten a bad rep is that it is often confused with the abortion pill. Well, that’s like equating contraceptive pills to headache pills: they both can save you a major headache, but they really are totally different things.

Emergency contraception works exactly like the pill, in fact all it is, is the equivalent of taking a few pills together. Actually, before it was approved by the authorities to be sold as emergency contraception, many doctors used to prescribe taking a higher than normal dose of contraceptive pills to patients who were in need of it. Basically, doctors have known for years that this is a system that works.

Like the pill, EC works by raising the level of hormones in the blood, so that the body believes it is pregnant. If the egg has not yet been released from the ovary, it will not be released. If the egg was previously released and fertilized in the fallopian tube, the pill will cause it to be expelled, instead of embedding itself in the uterus, and become an embryo.

This is entirely different from the abortion pill, which works within 42 days of conception. The abortion pill, RU-486, actually terminates an existing pregnancy, whereas EC prevents pregnancy from taking.

Since this information is no secret, why are so many politicians, clergy and laypeople making such a massive effort to keep these pills out of the reach of women who want to practice contraception? It all comes down to the same anti-choice world view that ultimately would rather keep a firm connection between sex and reproduction, just like it was in the bible, irrespective of the conditions under which the sex took place (do you honestly believe the Moms and Dads of the Holy Book did not practices Coitus Interruptus?) The moralists want people to take responsibility for their actions (and especially their pleasures) but somehow, in this area, it is always the woman who has to bear the consequences.

A more medically-based argument states that emergency contraception is safer, cheaper and less traumatic to avoid pregnancy than termination would be. And if its opponents are fighting against emergency contraception (just like the original pill opponents did in the 1950′s) as an education exercise, maybe we need to look at who uses emergency contraception to understand what it offers.

A very common reason is forgetting to take to pill. Because the pills we have today have such low doses of hormones, merely forgetting one pill can lower the protection for that month. Another good reason is when a condom tears. Let’s be fair, with correct use a condom should not tear or slip, but since most people never received condom instruction classes, it actually happens pretty often, and then it would be better to do whatever post facto damage control can be done, rather than grabbing a nearby calendar and spending the rest of the month hoping for divine intervention. Another important group of women who need access to emergency contraception are those who are raped or forced to have sex not of their own choice. Progressive rape crisis intervention centres will put EC on the list of medications that these women receive, but if not, they can always turn to the old system of concentrated pills. Since the dosage necessary is pretty specific and needs to be taken at particular intervals, one must consult with a reproductive health specialist and not try to self medicate. The majority of sexual abuse victims do not turn for rape crisis help in real time, so women need to have other access options.

It is true that some women will choose this as their contraceptive choice if they have infrequent sex, and other contraception is not on hand. Well, they will probably choose it once, and when they become familiar with the side effects, reconsider their position. In any case, this is their choice to make. Considering all contraceptive options come with their own side effects, every person (and sadly that is mostly every female person) has to do what suits her body and lifestyle best. EC commonly brings on nausea, dizziness, headaches, breast sensitivity and irregular bleeding. Honestly, with all those delights on offer, who would want to abuse it?

Most important to know is that apart from being effective, it is safe. Even if a woman is already a few weeks pregnant and does not know it, the EC will not cause her fetus any harm. When the EC doesn’t work and a woman gets pregnant and carries the baby to full term, no harm is caused to the baby. Some medical proponents, including the American College of Obstetricians and Gynecologists have gone so far as to recommended that doctors give prescriptions to women when they come for regular check-ups, and keep EC at home for when it is needed.

Champions of women’s health have been fighting for better access to emergency contraception, which means over-the-counter sales. Given the time limit on this method, having to get a prescription from a doctor or getting it dispensed by a pharmacist without a prescription could be the difference between needing or not needing an abortion or having an unplanned child.

In many European countries it has been available for years, but the battle is still raging in the United States. In July 2006, the FDA finally approved emergency contraception sales over-the-counter, thanks to the efforts of women’s health organizations and then Senators Hilary Rodham Clinton and Patty Murray, who pushed all the way up Capitol Hill. Even though the medical authorities have given it the thumbs up, saying its safe enough for every woman to buy at her own discretion, we can only offer the best of luck to women in small, conservative communities, who might find that the only pharmacist within miles has decided that his or her morality knows better than the law. And so the battle goes on…

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