Despite the widespread use of various methods of contraception available inAnguilla, there is still a large percentage of unplanned pregnancies occurring every year. There are several factors for this, but it is felt that the use of the emergency contraceptive pill also known as the morning-after pill (one form of emergency contraception) might help to reduce this high percentage of unplanned pregnancies.
What is the morning-after pill?
The morning-after pillsare drugs intended to disrupt ovulation or fertilization.
The morning-after pill is used to help prevent pregnancy if an individual had unprotected sex — for instance whether the person missed a birth control pill or whether a method of birth control failed, e.g. if a condom burst. The morning-after pill is not a standard method of contraception and should not be used as a regular method of contraception.Using the emergency contraceptive pill repeatedly can severely disrupt your natural menstrual cycle.As the name implies it should be used for ‘emergencies only’.
Morning-after pills do not end a pregnancy that has implanted. Depending on where you are in your menstrual cycle, morning-after pills may act by one or more of the following actions: delaying or preventing ovulation or blocking fertilization.
Morning-after pills can prevent pregnancy because conception typically does not occur immediately after sex. Instead, it may happen up to several days later. During the time between sex and conception, sperm travel through the fallopian tubes until they potentially reach an egg. As a result, using the emergency contraception pill soon after unprotected sex is not too late to prevent pregnancy.
The morning-after pill, to be successful, must be taken shortly after having sex or at least with the next 72 hours.It does not protect you against pregnancy during the rest of your menstrual cycle.
The morning-after pill will not work if the woman is already pregnant. If a woman has a positive pregnancy test the morning-after pill will not work.
Keep in mind that the morning-after pill is not the same as mifepristone (Mifeprex), also known as RU-486 or the abortion pill. Mifeprex terminates an established pregnancy — one in which the fertilized egg has attached to the uterine wall and has already begun to develop.
Types of morning-after pills
There are several types of morning-after pills available.
The progestin-only method uses the progestin levonorgestrel in a dose of 1.5 mg, either as two 750 ?g doses 12 hours apart, or more recently as a single dose. This pill typically works up to 72 hours after intercourse.
The combined or Yuzpe regimen uses large doses of both oestrogen and progestin, taken as two doses at a 12-hour interval. This method is now believed to be less effective and less well-tolerated than the progestin-only method
Ulipristal acetate (known as ella in theUSand Ellaone inEurope). It works for up to 120 hours after intercourse. It prevents pregnancy by delaying or inhibiting ovulation and inhibiting follicle rupture.
How effective is the morning-after pill?
The morning after-pill does not prevent all pregnancies.For both the progestin-only and Yuzpe regimens, the effectiveness of emergency contraception is highest when taken within 12 hours of intercourse, and declines over time. You can discuss the effectiveness of the various types of morning-after pill with your health care provider.
Who can use the morning-after pill?
Most women can use the emergency contraceptive morning-after pill, including women who are breastfeeding and those who cannot usually use hormonal contraception such as the combined pill.
Most experts on emergency contraception state that there are no medical conditions in which progestin-only ECPs are contraindicated. The most common side effect reported by users of emergency contraceptive pills was nausea. Vomiting is less common but can occur. Other mild side effects such as tummy pain and irregular menstrual bleeding may occur.
Can you get the morning-after pill in Anguilla?
The morning-after pill is available at the various government clinics, at your gynaecologist’s offices and various pharmacies on the island. Individuals receiving the morning-after pill should see their health care provider to discuss the various methods of contraception that are available to prevent pregnancies in the future. These include the combined oral contraceptive pill, long acting progestogens e.g. depotProvera (“the injection”), progestins, barrier methods e.g. male and female condoms, and intra uterine contraceptive devices also known as the loop.
Other emergency contraceptions
The morning-after pill is the most common form of emergency contraception used by women, but the copper intrauterine device can also be used as an emergency contraceptive. The copper intrauterine device (IUD) is a small, T-shaped contraceptive device made from plastic and copper that fits inside the womb.
The IUD can be used as a method of emergency contraception up to five days after unprotected sex, or up to five days after the earliest time you could have released an egg (ovulation). This should be inserted by a trained health care provider.
Conclusion
The morning-after pill can be used by a woman to reduce the risk of pregnancy after having unprotected sex. It can be used if another method of contraception has failed, for example if a condom splits or you have forgotten to take one of your contraceptive pills. The morning-after pill is used to prevent pregnancies. It has no effect on an established pregnancy. It is not the same as mifepristone also known as the abortion pill. All individuals who are sexually active are strongly urged to use a standard and reliable method of contraception so as to avoid unplanned and unwanted pregnancies. The morning-after pill should be used for “emergencies” only. It does not protect you against HIV and other sexually transmitted infections.
Ask Your Doctor is a health education column and is not a substitute for medical advice from your physician. Dr Brett Hodge is an Obstetrician/Gynaecologist and Family Doctor who has over twenty nine years in clinical practice. Dr Hodge has a medical practice in the Johnson Building in The Valley.
