After years of health classes, hall programs and those uncomfortable "we need to talk" sessions with mom and dad, most college students know their options when it comes to preventing pregnancy. Condoms, the Pill, spermicides...we all know this by now, right? But what do we do if these fail or if we fail to use them? Most women and their partners assume that the only thing they can do is cross their fingers and pray that a broken condom or forgotten pills won't result in one of the 3.5 million unwanted pregnancies that occur in the U.S. each year. That's because they probably don't know about emergency contraception. They probably don't know that it is possible to prevent pregnancy from occuring, even in the event of contraceptive failure or unprotected sex.
Since the late 60s, emergency contraceptive drugs, usually called "morning after" pills, have been available to patients who fear that unprotected sex, rape or contraceptive failure might result in an unwanted pregnancy. In fact, a high dose of certain commonly prescribed birth control pills, taken 72 hours after sex, can reduce the risk of pregnancy by more than 75%. The problem is, most women have never been informed of this simple and extremely important option.
The type of oral contraceptives used for morning after protection are completely legal and prescribed by most women's clinics and student health centers for use as regular, one-a-day birth control pills. However, while there are over 50 types of birth control pills available in the U.S., but very few can be used for emergency contraception. The most common ones used as morning after pills are Ovral, Lo-Ovral, Triphasil and Nordette, manufactured by Wyeth-Ayerst Laboratories.
Normal usage of these birth control pills prevents pregnancy by increasing hormone levels in the blood, which halts ovulation. Emergency contraception‹essentially an overdose of these pills‹prevents pregnancy by dramatically and rapidly elevating a woman's hormone levels, making it impossible for a fertilized egg to implant in the uterine wall. Dosages vary: to be effective, two doses of Ovral must be taken within 72 hours of unprotected intercourse, followed by another two doses 12 hours later. The other brands require four doses in these time slots and only the yellow Triphasil tablets are effective for this purpose. These pills are available by prescription only but most doctors will prescribe them for morning after use if asked to do so. Consulting a doctor is extremely important when taking these pills as emergency contraceptives‹patients who ordinarily should not take oral contraceptives (smokers, diabetics, and women with kidney, liver and circulatory problems) should practice emergency contraception only under close medical supervision. In addition, the sudden change in hormonal levels brought on by an overdose of Lo-Ovral or Triphasil can cause a range of unpleasant side effects, the most common being nausea and vomiting. Most doctors will prescribe an anti-vomiting drug along with emergency contraceptives to ease discomfort and ensure that the pills being taken are not regurgitated.
Women's health care providers also stress that morning after pills, although not dangerous, are not meant to be used as a regular method of contraception. "These drugs are not supposed to be a substitute for personal responsibility," commented one gynecologist I spoke with. "If you have intercourse you should use birth control before and during sex. If accidents occur, we're lucky that the emergency option exists, but it's a safety net, not a parachute." In addition, morning after pills do nothing to stop HIV transmission, the most serious risk associated with unprotected sex or broken condoms. We are lucky that morning-after contraception exists, but why do so few women know about it? The answer is mainly political. Many anti-abortion groups have called this type of emergency method "abortion," because of their belief that life begins at conception. Hence, any method that prevents the implantation of a fertilized egg (including emergency contraception and IUDs) destroys human life. The anti-abortion lobby in the United States has consistently tried to prevent Wyeth-Ayerst and its clients (which include almost all American clinics, hospitals and health care centers) from promoting these pills as emergency contraceptives. Fearing political backlash and protests by an increasingly violent anti-abortion movement, Wyeth-Ayerst does not state anywhere on the package that their birth control pills can be used as emergency contraceptives‹even on the part of the label which is supposed to list the drug's "risks and benefits."
In an effort to inform the public, including health care workers, of the benefits of emergency contraception, the American Public Health Association and the American Medical Women's Association recently asked the Food and Drug Adminstration (FDA) to require Wyeth-Ayerst to publicize the fact that Nordette, Lo-Ovral and Triphasil can be used as emergency contraceptives. Correct labeling and usage of these pills could‹ according to James Trussel, director of Princeton's Office of Population Research‹prevent 1.7 million unwanted pregnancies per year. Since about half of unwanted pregnancies are terminated, proper use of these drugs could prevent 800,000 abortions annually.
Emergency contraception is, in a crisis, one of the most reliable methods of preventing
pregnancy. Political controversy has kept the public from being educated about its usage.
Despite this, the number of doctors and women's health care providers who offer
morning after contraceptives is rising as awareness of their safety and effectiveness
becomes more widespread.
For more information about emergency contraception contact a doctor or
gynecologist at: