Emergency Contraception In Brief!

As a gynaecologist, something that I really hate doing is medical termination of pregnancy. After all, I wanted to be a doctor to save lives, not to take one. Couples, at times unmarried young girls, come with unwanted pregnancies asking for medical help for termination of the same. I do understand how stressful the situation is and the associated confusion, worry and guilt.

According to the first national study of the incidence of abortion and unintended pregnancy in India, an estimated 15.6 million abortions were performed in the country in 2015 (this is the documented data, the actual figures must be much higher). This translates to an abortion rate of 47 per 1,000 women aged 15–49 years. 1 Though India was the first country in the world to launch a National Programme for Family Planning in 1952, more than 6 decades later the unmet need for modern methods of contraception* was still as high as 20.4% in 2015.2

No contraceptive method is absolutely foolproof but it is strongly recommended to use a modern contraceptive method regularly. Yet the majority of couples at some point of time have faced the grim situation when they either didn’t use a contraceptive in the heat of the moment or the contraception that they had been using failed and the act of pleasure ended up giving a lot more headache than they had asked for. And then the lady would wait for her periods (never wanting them as badly as in that cycle) and in case she would miss them then the management of an unwanted pregnancy- either by termination or by continuing with it halfheartedly would follow. A termination besides causing physical discomfort and carrying its own inherent medical risks also causes a lot of mental stress, emotional disturbances and disrupted family life. Instead of leaving everything to nature isn’t it better to be more proactive and opt for “EMERGENCY CONTRACEPTION”. I was going through the patient information leaflet by the NHS for emergency contraception and found it pretty useful, hence sharing the important information from the same.3

What is emergency contraception?

It’s a contraceptive which can prevent pregnancy after unprotected sex or if the contraception you have used has failed – for example, a condom has split or you have missed a pill.

What are the options available for emergency contraception?

1. Emergency contraceptive pill (the “morning after” pill) which can be either a tablet of Levonorgesterol 0.75 mg (common brand names: I pill, Unwanted 72, etc.) or a tablet of Ulipristal acetate 30 mg (its availability for this purpose is still an issue in the Indian market)
2. Intrauterine contraceptive device (IUD or “the coil”, commonly available as Cu- T, Multiload, Mirena, etc.)

Some quick facts about emergency contraception:

• You need to take the emergency contraceptive pill within 3 days (Levonorgesterol, 0.75 mg- single dose) or 5 days (Ulipristal acetate, 30 mg- single dose) of unprotected sex for it to be effective – the sooner you take it, the more effective it'll be.
• The IUD can be fitted up to 5 days after unprotected sex, or up to 5 days after the earliest time you could have ovulated, for it to be effective.
• The IUD is more effective than the contraceptive pill at preventing pregnancy – less than 1% of women who use the IUD get pregnant.
• Taking the emergency contraceptive pills can give you a headache or tummy pain, your breasts can feel heavier and more tender, you can feel nauseated or you might actually puke, your acne can worsen and you can have mood swings.
• The emergency contraceptive pill can make your next period come earlier, later or more painful than usual.
• If you're sick (vomit) within 2 hours of taking the levonorgesterol tablet or 3 hours of taking ulipristal acetate, go to your GP, pharmacist or gynecologist, as you'll need to take another dose or have an IUD fitted.
• If you use the IUD as emergency contraception, it can be left in and used as your regular contraceptive method.
• If you use the IUD as a regular method of contraception, it can make your periods longer, heavier or more painful.
• You may feel some discomfort when the IUD is put in, but painkillers can help.
• There are no serious side effects of using emergency contraception.
• Emergency contraception doesn't cause an abortion.

So that’s a brief summary about emergency contraception. Though quite effective it still doesn’t ensure you cent percent that you won’t conceive- you might still end up having an unwanted pregnancy. But at least you play your best card and decrease the chances of getting pregnant by opting for emergency contraception. Also, the pills should not be exploited and should be used only as an “emergency” and not as a habit or in place of a regular contraceptive.

So let us all show some more maturity and the next time you end up having unprotected sex, don’t panic but act wisely and go for an emergency contraceptive ASAP!