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Obstetricians Say Morning-After Pills Can Prevent Half a Million Abortions

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WebMD Health News

April 30, 2001 (Chicago) -- Marshalling the influence of the 40,000-strong American College of Obstetricians and Gynecologists, the group's incoming president put out a call to fellow doctors Monday to offer a prescription for the morning-after pill to all women of childbearing age as part of routine office visits.

Thomas F. Purdon, MD, says the increased use of emergency contraception could cut in half the number of unintended pregnancies and prevent "a half million abortions each year."

He says about three million unintended pregnancies occur each year in the U.S. and many end in abortions. Purdon estimates that increased use of emergency contraception, or the so-called morning-after pill -- essentially a high-dose birth control pill -- will "stop hundreds of thousands of abortions."

He issued his call for advance prescriptions for the morning-after pill to doctors attending the annual meeting here of the American College of Obstetricians and Gynecologists (ACOG). The women's health specialists group is celebrating its 50th birthday during the meeting.

Purdon says that over those 50 years, obstetricians and gynecologists have achieved major advances in many areas of women's health but says, "one area where we have not improved [much] is in prevention of unwanted pregnancies."

He says that talking about emergency contraception as part of a routine doctor visit is the best approach to cut down on unwanted pregnancies. Purdon tells WebMD, "this was really brought home to me in my own office the other day. I had a 39-year-old woman who is unmarried and is raising an 11-year-old child. She said she was very interested in emergency contraception even though she is not sexually active."

Anita L. Nelson, MD, professor of obstetrics and gynecology at UCLA School of Medicine, says that for "too long doctors and their patients operated under a don't-ask-don't-tell approach." The result, she says, is that even though obstetricians and gynecologists have known about emergency contraception since the mid-1970s, only 20% of them are including emergency contraception in contraceptive counseling.

Worse, says Purdon, is that only a third of reproductive-age women have heard about emergency contraception and "only 5% heard about it from their doctors."

Currently there are two emergency contraception products available. One, called Preven, is a combination of estrogen and progestin, and the other, called Plan B, contains only progestin. In each case two doses must be taken; the first dose should be taken within 72 hours of unprotected sex, says Nelson.

But the sooner the pills are taken the better they work, says Nelson. "This is especially true with the progestin-only product since in at least one study when the first dose was taken within 12 hours of unprotected sex only one-half of 1% of the women taking it became pregnant. The failure rate increased to 4% when the pill was taken in the last 12 hours of the 72-hour window," she says.

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