Emergency contraception (EC) is an intervention to prevent pregnancy after unprotected sexual intercourse. Formerly known as “the morning after pill,” this older terminology is a misnomer. Not all emergency contraception consists of pills. EC may be initiated up to five days after the act of unprotected intercourse although its efficacy in preventing pregnancy begins to decrease if taken seventy-two hours after the unprotected sexual intercourse. It does not need to be administered in the morning.
There are a number of situations where adolescents should consider emergency contraception. These situations include the following:
- Unprotected sexual intercourse
- Breakage of a condom during intercourse
- Diaphragm or cervical cap becomes dislodged during or after intercourse
- Adolescent forgets to take her oral contraceptives more than two days in a row
- Sexual assault
Emergency Contraception consists of either hormonal pills or the Copper T Intrauterine Device. The intrauterine device can be inserted up to seven days after unprotected intercourse, and it is ninety-nine percent effective in preventing pregnancy in this circumstance. However, the IUD is not recommended for women who have not had children or who are at risk for sexually transmitted disease. It also is expensive to have inserted. Since most adolescents have not had a child, the IUD is currently not an EC option for most teens. However, most teens are able to take a hormonal type of emergency contraception.
When hormonal pills are used for EC, the high doses of hormones disrupt the hormonal patterns that are necessary for a pregnancy. Emergency contraception does not produce an abortion. In fact, there are several ways that EC prevents a pregnancy. In most cases, EC prevents ovulation or release of the woman’s egg. It can also affect the ability of a fertilized egg to implant in the uterus. Most medical authorities consider pregnancy as occurring when the fertilized egg implants in the uterus. As a result, due to either of these reasons, no pregnancy can occur.
Emergency contraception is highly effective when taken within seventy-two hours of sexual intercourse although it can be taken with 120 hours of unprotected sexual intercourse. The sooner the medication is taken after the unprotected intercourse, the more effective is the medication in preventing pregnancy. The effectiveness of the hormonal methods in preventing pregnancy range between seventy-four percent and eighty-five percent if the pills are initiated within the seventy-two-hour period. According to the Food and Drug Administration (FDA), emergency contraceptive pills are a safe and effective means for preventing pregnancy after unprotected intercourse.
There is one packaged emergency contraception hormonal regimen available, and it is called Plan B. Plan B consists only of a progestin hormone-levonorgestrel. One pill is taken within 120 hours after unprotected intercourse and the second pill is taken twelve hours after the first. There is less nausea and vomiting with Plan B compared to estrogen containing pills utilized for emergency contraception.
Beside Plan B, many of the currently available oral contraceptive pills may be used as EC. Some of the brands available for EC include Ovral, Nordette, Levlen Lo/Ovral and Triphasil. One should discuss the dosage with her physician or clinician. The clinician may also prescribe an antiemetic to help control nausea and vomiting that may occur from the estrogen in these pills.
Emergency contraception does not protect an adolescent against sexually transmitted illness. She is also are at risk for pregnancy after using EC until the onset of the next menstrual period. After EC, the menstrual period will come on time or early, but since emergency contraception is not one hundred percent effective in preventing pregnancy, a teen should contact her physician if her period is delayed more than three weeks after EC use. An adolescent should also contact her physician for advice and guidance on a reliable contraceptive method since EC should not substitute for a consistent long-term contraceptive method.
Many physicians who provide care for adolescents either prescribe emergency contraception or will refer patients to someone who will prescribe the medication. Even if a teen is under eighteen years, she may be prescribed EC without her parents’ knowledge or consent. One may also call the Emergency Contraception Hotline to obtain names of clinicians in the local area who prescribe EC. The Association of Reproductive Health Professionals manages the hot line, and the toll free phone number is 1-888-NOT-2-LATE. Information is provided to the caller in English or Spanish.
When a teen contacts a clinician asking for Emergency Contraception, she should be prepared to answer several questions. One should know the first day of her last menstrual period, was the period normal in its length as well as timing and did she have unprotected sexual intercourse within the past seventy-two hours. Some clinicians will prescribe Emergency Contraception over the phone, but this is less likely if the clinician does not know the patient. For some adolescents, it may be necessary to be seen at the clinician’s office where a pregnancy test may be administered. Follow up care can also be arranged so the adolescent will have a continual type of birth control. It is likely that this office visit may be kept confidential if the teen requests the clinician to do so.
Some clinicians will prescribe emergency contraception at an annual checkup. In that case, if the need for EC arises during the year, then the patient will have it readily available. This is a topic adolescents may wish to discuss with their primary care clinician at their annual medical checkup.
Males have a responsibility in wearing condoms at every sexual encounter with a woman and using them in an effective manner. This would obviate, in many but not all cases, the need for their partners to obtain EC.
Related topics:
Birth control, hormonal contraception, oral contraceptives, unplanned pregnancy
