Emergency Contraceptive Pills -- Not Just For The Morning After

Each year in the Grey-Bruce area almost 200 teenagers become pregnant and 35% of these pregnancies end in abortion. The most recent survey in 1994 shows women aged 15-19 have the highest proportion of abortions, followed by the 20-24 year age group. Perhaps these numbers could be reduced with awareness of emergency contraception. ECP is a safe, effective method of emergency contraception when taken within 3 - 5 days of unprotected sex or failed birth control.

Sarah had been going with Mark, her boyfriend, for one year. In the last few months, they had started to have intercourse and were using condoms. On the weekend, Sarah and Mark had intercourse and the condom broke. Sarah was terrified of getting pregnant because she was only 17 years old and was planning to attend college in another year. "I had heard that there was this pill you could take after you had sex, so I called the Sexual Health Clinic."

The staff at the clinic told Sarah that she could take the emergency contraceptive pill (ECP) up to 5 days of having unprotected intercourse and the pill would have a good chance of preventing pregnancy.

At the clinic, Sarah received positive counselling about the ECP and about longer term methods of birth control. She was offered the ECP and she decided to take it. "When I took the pill, I felt quite emotional about it," she says. "It wasn’t just taking any pill; it was an important decision."

The last thing she felt she needed at the moment was to be judged. She was glad the counselling she received at the clinic was warm, positive and informative. "I was grateful that I was able to get the pill and be dealt with sensitively at the same time," she says. "No one gave me any lectures."

Afterwards, she felt confident that she had done the right thing. "I felt very relieved that I didn’t have to have an abortion," she says.

The emergency contraceptive pill is available in the Grey-Bruce area - at sexual health clinics, in pharmacies (without a prescription), in emergency rooms at hospitals, at walk-in clinics, and sometimes from family doctors. Unfortunately, a lot of women who need it don’t know about it.

Some people criticize the emergency contraceptive pill, mistakenly thinking it is a kind of abortion. On the contrary, it keeps women from having to seek an abortion.

Dr. Miriam Kaufman of the Hospital for Sick Children explains ECP is birth control rather than abortion because it prevents the fertilized egg from attaching to the endometrium, so a pregnancy never occurs.

The emergency contraceptive pill is considered effective in 75 to 98 per cent of the cases in which it is used, depending on where the woman is in her monthly cycle when she takes it.

It used to be called the "morning after pill" but that name was dropped as being so restrictive that it was actually inaccurate. "It’s not just a morning after pill," Dr. Kaufman notes. "You should take it as soon as possible after unprotected sex, but a wait of up to 5 days appears to have no impact on the method’s effectiveness.

Studies show that young women who have taken ECP don’t use it as a regular method of birth control. They use it, instead, as a back-up when their regular birth control method is unexpectedly not used or is obviously ineffective.

The emergency contraceptive pill can be used as well when the condom rips, when the woman has missed a few days of her birth control pill or when a couple has unplanned, unprotected sex.

Very Safe

The emergency contraceptive pill is very safe, says Dr. Kaufman. "In general, it’s probably safer to take this on a one-time basis than to be on the birth control pill for a length of time, and the birth control pill is pretty safe," she says. "It would only be if someone had breast cancer or ovarian cancer or has had blood clots that you probably shouldn’t use ECP." Women with those health problems could take progesterone alone, without the estrogen, for emergency contraception, Dr. Kaufman suggests. Dr. Kaufman says the American College of Physicians has no reports of major cardiovascular or neurological side effects from use of the emergency contraceptive pill.

Although some people feel that if the emergency contraceptive pill fails and a pregnancy occurs, an abortion is recommended because of the high dose of hormones the fertilized egg was exposed to, Dr. Kaufman disagrees. "There are enough documented pregnancies that have gone to term that we know this is not a problem," she states. "Failure of the emergency contraceptive pill is not an indication for abortion, although a normal outcome to any pregnancy cannot be guaranteed," says Kaufman.

Field Trips

Teachers can be a great help by letting young women know that emergency contraception exists and is not difficult to get. Giving out the phone number of the Sexual Health Clinic can educate a lot of young people in this important area. 

It is especially important right now for word to spread among young women about the existence and availability of the emergency contraceptive pill. Teachers who arrange field trips to birth control clinics help demystify what the clinic is about.

In Crisis

Young women are usually frightened and in crisis when they seek emergency contraception. They need to be treated with a calm and positive manner.

They need to be reassured that they can get the ECP and there’s a good chance that pregnancy will not occur. In a tactful way, you let them know what help exists to prevent a further incident, such as establishing them up with ongoing birth control."

The faster word spreads on emergency contraception and how to get it, the better for everyone. It’s unfortunate there are so many women who don’t know about emergency contraceptive pills and go through the terrible trauma of waiting to see if they are pregnant. The ECP is a much more easier way of dealing with the matter.

Places To Get ECP

1. Emergency Rooms
2. Local Pharmacies (no prescription needed)
3. Walk-In Clinic: 360 - 3^rd Avenue East, Owen Sound - (519) 376-4865
4. Sexual Health Clinic Locations in Grey Bruce