Do you watch the television show
"ER"? During an episode in 1997, Nurse Hathaway (Carol) offered the
option of emergency contraception pills to a young woman who had just been
forced to have sex against her will. It's possible that between 5 and 6 million
people learned about emergency contraception that day.
According to the Kaiser Family Foundation, almost 3 million
unintended pregnancies happen each year in the United States. You can imagine
why -- a condom tears, a diaphragm slips out of position, a woman misses two
birth control pills in a row. Or, a couple has gotten "swept away" in
the momentum of lovemaking and has neglected to use birth control. Perhaps a
rape has occurred. Without treatment, eight in 100 women who have had one act
of unprotected intercourse during the second or third week of their cycle are
likely to become pregnant. With emergency contraception, only two women in 100
would be in the same situation.
By Kimberly Goad
As Amanda Clark, 33, a caterer from Boston, walked down the aisle toward her fiancé, wearing a $15,000 gown and a 7-carat ring, she felt nothing but dread. I don't want to go through with this, she thought, with each step toward the altar.
Just two hours before the ceremony, Clark had gone for a dip in the ocean with her two sisters. When it was time to get ready, Clark wouldn't budge. "I couldn't get out of the water," she says. "It was like knowing you have a work meeting...
There are two types of emergency contraception pills (ECPs).
One is a combination of estrogen and progestin, and the other is a
progestin-only pill. Depending on when they are taken during the menstrual
cycle, ECPs can inhibit or delay ovulation; inhibit transport of the egg or
sperm; or alter the lining of the uterus to prevent implantation of a
How Does It Work?
ECPs, sometimes called the morning after pill, must be taken
within 72 hours of the unprotected intercourse. The pills are more effective
the earlier a woman takes them within the 72-hour time period.
Pills are taken in two doses, with the second dose taken 12
hours after the first. Each dose is one, two, four or five pills, depending on
the brand. You need a prescription to get ECPs, although some medical providers
are now writing prescriptions in advance.
Preven (levonorgestrel/ethinyl estradiol) is packaged
especially for emergency-contraceptive use. It contains both hormones, estrogen
and progestin, and reduces the chance of pregnancy by 75 percent. About 50
percent of women who take them feel nauseous and another 20 percent vomit.
Plan B (levonorgestrel) is progestin-only and has been on
the market since July of 1999. It's more effective than Preven and has fewer
side effects associated with it.
Why Haven't You Heard about ECPs?
Although the Food and Drug Administration declared ECPs to
be safe and effective in 1997, only 10 percent of health professionals discuss
emergency contraception on a routine basis with their patients, according to a
survey that same year by the Kaiser Family Foundation.
Forty-one percent of Americans are still unaware of the
existence of ECPs. In fact, only 11 percent of women aged 18 to 44 have both
heard of ECPs and know that the pills need to be taken within 72 hours of
Remember that we all make mistakes. Unintended pregnancy
crosses all boundaries -- age, race, ethnicity, social class. Experts estimate
that as many as 1.7 million of the over 3 million unintended pregnancies that
happen each year in the United States could potentially be prevented by the use
of ECPs. This includes as many as 800,000 pregnancies that now result in
abortions. Wouldn't you rather keep a supply on hand, just in case? Ask your
doctor about emergency contraception at your next visit.