You had sex. You think you might be pregnant. Now what?
The morning after pill (also known as emergency contraception) is promoted as a quick and easy answer for unprotected sex, but there are some important things you should know before taking the pill.
What it is.
The morning after pill contains the same hormone as regular birth control pills, but the dosage prescribed is several times the strength of a daily birth control pill.1
The morning after pill is not for routine use. Failure rates and side effects increase with repeated use of the morning after pill.2,3
The morning after pill comes in two forms:
- 1. Progestin-only pill
Plan B? (levonorgestrel) is the only FDA approved progestin-only emergency contraceptive. The effectiveness rate is higher and the immediate side effects appear less than the estrogen/progestin combination pills.4 Plan B? still lacks adequate testing to know exactly what its adverse effects are upon a woman's body.
- 2. Estrogen and Progestin combination pill
These pills are known as combined emergency contraception pills (ECPs). Due to high risk of side effects with these pills, as well as a low effectiveness rate, they are not marketed as emergency contraception in the United States.5
What it does.
Plan B? works like a birth control pill. There are three ways a birth control pill can work:
- 1. Stop the release of an egg from the ovary.
- 2. Prevent the fertilization of an egg (the uniting of sperm with the egg).
- 3. Prevent the already fertilized egg (embryo) from attaching to the uterus (womb). This causes an already fertilized egg to be expelled from the womb, causing an early abortion.
When does pregnancy begin?
From the moment the sperm and egg unite in the fallopian tube and fertilization occurs, the genetic make-up of the baby is complete, including the sex of the child. This is the beginning of pregnancy.
Important Warnings
The morning after pill has possible side effects:
- Approximately 1 out of 4 women studied experience menstrual bleeding and nausea.
- Approximately 1 out of 5 women studied experience abdominal pain, fatigue, and headache
Other side effects include:
- Changes in menstrual cycle
- Breast tenderness
- Dizziness
- Vomiting
Also, you may be at an increased risk of having an ectopic pregnancy (a pregnancy developing somewhere other than in the uterus) should you take the morning after pill and become pregnant. Ectopic pregnancies can be, on rare occasion, fatal if you are not able to identify it and get medical attention immediately.6,13
Effectiveness
The morning after pill is not 100% effective:
- The progestin-only morning after pill (known in the United States as Plan B?) can be up to 89% effective.7
- An estrogen/progestin combination pill can be up to 75% effective.5
- Both pills can be taken up to 72 hours after having sexual intercourse but are most effective if used within 24 hours of sexual intercourse.13
Testing
The morning after pill has not been adequately studied and tested. Before this drug can be confirmed as safe, additional tests will be necessary to determine:
- Effects on women under the age of sixteen11,12
- Effects when interacting with other drugs6,14
- Effects on people with preexisting medical conditions6,14
- Effects on women's ovulation and fertility6
- Effects on fetal growth and development6
Though the morning after pill has the same active ingredient as daily birth control pills (progestin), each morning after pill contains .75 mg of progestin, several times the amount contained in a regular birth control pill.1
Other Dangers
Due to the risk of serious health problems, women with the following conditions may not be able to use the morning after pill:
- Established pregnancy
- Past heart attack or stroke
- Blood clots in the legs or lungs
- Breast cancer
- Liver cancer
The morning after pill is not recommended for women who plan to have intercourse within 5 days, are breastfeeding or have given birth in the last 6 weeks, have epilepsy, cardiovascular or kidney disease, migraine headaches, diabetes, or hypertension.9
The morning after pill will not work as intended if your pregnancy has already proceeded to the point of implantation.8 You should take a pregnancy test before taking the morning after pill.
You Have Options
Only eight out of one hundred women will become pregnant after a single act of intercourse during the middle two weeks of their menstrual cycle (during the approximate time of ovulation).10 By taking the morning after pill, you may be putting yourself at risk for no reason. If you are pregnant, there are other positive options besides taking immediate steps to end your pregnancy. The caring people at Highland LifeCare Center are available to answer your questions and help you make an informed decision. Call us at 651-695-0111.
* MAP information is cited from the brochure "The Morning after Pill", Care Net, Sterling, VA
1. http://www.fhi.org/en/RH/FAQs/ECP_faq.htm
2. http://www.go2planb.com/ForConsumers/Index.aspx
3. http://www.who.int/mediacentre/factsheets/fs244/en/
4. http://ec.princeton.edu/questions/dose.html
5. http://ec.princeton.edu/info/ecp.html
6. http://www.go2planb.com/PDF/PlanBPI.pdf
7. http://www.go2planb.com/ForConsumer/TakingPlanB/Default.aspx
8. http://www.go2planb.com/ForConsumer/ImportantSafetyInformation.aspx
9. http://www.fwhc.org/birth-control/ecinfo.htm
10. http://www.webmd.com/hw/birth_control/hw252717.asp
11. http://www.fda.gov/cder/drug/infopage/planB/planBQandA.htm
12. http://www.fda.gov/cder/drug/infopage/planB/planB_NALetter.pdf
13. "Emergency Contraceptives are Linked to Ectopic Pregnancy Risk." Practice Nurse. February 14, 2004
14. "Progestins-For Contraceptive Use." Advice for the Patient: Drug Information in Lay Language. 2005.
