Emergency Contraceptive

by Ren Chats
(Denmark)

American Academy of pediatrics recommends prescription of “the morning after pill” for teenage girls.

Gravity of problem

Half of all the pregnancies are reported to be unintended in a study by Finer LB, Henshaw SK. Disparities in rates of unintended pregnancy in the United States, 1994 and 2001. Perspect Sex Reprod Health 2006;38:90–6.

Teenage pregnancies contribute to the major load of unintended pregnancies. Moreover, the incidence of teenage pregnancy continues to be high over decades.

Pregnancy causes significant negative impact on teenage mother’s quality of life; financial, educational and psychosocial. The babies born to teenage mothers also suffer from wide variety of health issues.

Emergency contraceptive pills to be made easily accessible

In view of the American College of Obstetricians-Gynecologists (ACOG),
easy access to emergency contraceptive pills can significantly bring down the incidence of unintended pregnancy and associated public health issues.

The study by Frost JJ, Singh S, Finer LB. “U.S. women’s one-year contraceptive use patterns, 2004. Perspect Sex Reprod Health 2007;39:48–55” showed that difficulty in procuring the contraceptive pills prescription and the cost involved are the major causes why women fail to use them. Therefore Committee on Gynecologic Practice Opinion 544, December 2012 approves making oral emergency contraceptive pills available over the counter.

Use of emergency contraceptive pills/ the morning after pill

The morning after pill is most effective in reducing the risk of pregnancy when taken as soon as possible (range being up to 5 days/ 120 hours) after an unprotected or under protected sexual intercourse, suspected contraceptive failure and condom breakage or leakage.

Condom alone may not prevent pregnancy, but its use is recommended as the barrier offers good protection against sexually transmitted diseases as well. Click here to download Facts on Condom Effectiveness in STDs.

Availability of emergency contraceptive pills for teenagers

Sexual behavior is commonly prevalent among teenagers and they are at
high risk of contraceptive failure. Therefore emergency contraception offers an essential backup method for them. Boys of 18 and above and girls of 17 and above can freely avail over the counter available “the morning after pill “. Teenagers below 17 years of age require a prescription for its use.
Nevertheless, it has been noted that most teenagers do not use emergency contraception unless it has been explained and prescribed in advance.

In its policy statement on emergency contraception published online on November 26, 2012 American Academy of Pediatrics urges pediatricians and other physicians to educate their teenagers and their parents on use of emergency contraception.

Recommended emergency contraceptive

Levonorgestrel 1.5 mg: No pregnancy test is required before the use of levonorgestrel . The only contraindication to its use is known pregnancy because of lack of utility, not concern for teratogenicity or fetal loss.

Though No medication is without side effects, levonorgestrel has an improved adverse effect profile and increased effectiveness as compared to combined hormonal emergency-contraception methods. Nausea and vomiting is rarely seen with use of levonorgestrel emergency contraceptive as compared to the combination oral contraceptive (Yuzpe) method.

Emergency contraceptive formulations of levonorgestrel are marketed as Plan B, Plan B One-Step (Teva Women's Health), and Next Choice (Watson Pharma).

Why Doctors discourage abortions in favor of the use of contraceptives?
Click here for the answer.

Categories for Medical Eligibility Criteria for Contraceptive Use

"1= A condition for which there is no restriction for the use of the contraceptive method.

2= A condition for which the advantages of using the method generally outweigh the theoretical or proven risks.

3= A condition for which the theoretical or proven risks usually outweigh the advantages of using the method.

4= A condition that represents an unacceptable health risk if the contraceptive method is used.”

U S. Medical Eligibility Criteria for Contraceptive Use, 2010. Centres for Disease Control and Prevention (CDC). MMWR Recomm Rep 2010;59(RR-4):1–86