Emergency Contraception

OK, now I think it's time to approach a more sensitive topic, but one that I think the public really needs more education about.  Yesterday in the news there was a lot of hubbub about Plan B, one available emergency contraceptive pill, and its failure to become truly over the counter.  For several years, Plan B has been available to women ages 17 and over without a prescription, although it is still kept "behind the counter" and you have to ask the pharmacist for it.  For those 16 and under, a prescription is still necessary.  The FDA made a recommendation to make this medication available to anyone without a prescription, but yesterday it was announced that this would not be happening.

Definitely a controversy-stirring topic...

First, I think it's important to explain what the "morning-after pill" is and how it works.  The most widely-used emergency contraceptive is levonorgestrel, or brand-name "Plan B".  It is a progestin hormone that acts to delay or inhibit ovulation.  If taken within 72 hours of unprotected intercourse, it prevents around 75% of unintended pregnancies.  Levonorgestrel has not shown any harmful effects on an already established pregnancy, and does not cause an abortion.  All it does is decrease the chance that an egg is released while there are live sperm in the reproductive tract.  There is some speculation that emergency contraception may also inhibit sperm transport through the reproductive tract, or make for a "hostile" environment for sperm, as well as make the endometrium (the uterine lining) less receptive to an already fertilized egg.  These theories have not been scientifically proven.

It is not difficult to take, and side effects are minimal.  The most common side effect is irregular bleeding.  Because ovulation is inhibited, cycle length is also altered.  Some women may experience nausea and vomiting and/or breast tenderness.  Because it does not contain estrogens, the woman's risk for blood clots is not increased.  It's also important to remember that emergency contraceptives do not always prevent pregnancy. 

While not every woman is comfortable using emergency contraception, I think that it's an important part of family planning.  If unintended pregnancies are prevented, there will be fewer elective abortions.  I personally believe that the morning-after pill should be available to all women without a prescription.  Numerous studies have shown its safety, and the 16-and-under population is most likely to benefit from prevention of an unintended pregnancy. 

Here's a link to the American College of Obstetricians and Gynecologists patient education sheet regarding emergency contraception...http://www.acog.org/~/media/For%20Patients/faq114.ashx

Obviously, this topic will spark a lot of debate...I welcome your comments.