The Morning after Pill: All You Need to Know About Emergency Contraception

Did you just have sex with your partner & realized that the condom broke? or you missed your contraceptive pills this cycle? or worse, sadly was the sexual contact without your consent? Oops……the next question that comes to the top of the mind is - Will I get pregnant now? What can I do to prevent it?

So, while the act of intercourse comes as a natural instinct to most people, the concept of birth control is not that natural and needs to be acquired & practised properly. Sadly, most families tend to remain quiet about the topic of sex & birth control, hence young people are completely lost when such sexual accidents happen.

We need to go past the thought that sexual intercourse is only meant for reproduction. Sexual intercourse is a physical act that both married and unmarried couples can indulge in for pleasure, regardless of any intent of procreation. Besides, not everyone enjoys the thought of getting pregnant after sex & not all of the couples are in marital unions. Even when a woman is married, she might not be ready for a baby.

Ideally, it is recommended to always use a reliable, regular contraceptive method before you initiate a sexual contact with anybody, but sometimes, your regular method may fail or you might miss your tablets or simply forget to use any contraception before sex in the heat of the moment. In such instances, you must turn to emergency contraception.

In this informative article we shed some light on the subject of 'Emergency contraception.' Here we have tried to answer all your queries regarding this subject. So, let's dive right into the topic.

Defining Emergency Contraception

Emergency contraception refers to a method of birth control that is used for preventing unwanted pregnancy after unprotected sex.

Ideally, a woman needs to use the emergency contraceptive method within 72 hours to within 5 days of unprotected intercourse. The sooner it is taken, the more effective it will be.

Emergency contraception can be taken in the form of:

1. ​An oral tablet taken for 72 hours to 5 days.
2. An Intrauterine Device may be inserted by the doctor for this purpose within 5 days.

Are these methods 100% sure to prevent pregnancy?

Well, nothing is 100% sure in this world but yes, they are fairly effective. Typically, the failure rate of an IUD is only 0.1 to 0.8 % and studies show that women who used the Emergency pill had a pregnancy rate of 1.2 – 2 %.

Who should use Emergency contraception?

Emergency contraception can be taken after unprotected intercourse by women who wish to avoid a pregnancy and who face any of the below situations:

• Indulged in unprotected sex with their partner
• Forgot to take their regular birth control pill (three or more pills)
• If the couple used a condom but it slipped or ruptured
• Have been sexually assaulted/raped
• Had an IUD, but it got expulsed or dislocated

In all these instances, you must consider adapting Emergency contraception if you wish to avoid a pregnancy

How does an emergency contraceptive pill ( Morning-after pill ) work?

The word ‘ Morning-after’ is actually a misnomer as you need not wait until the next morning to take the pill. In fact, the sooner you take it, the better it is at preventing a pregnancy. Also, it may be taken upto 3-5 days after the act and will still be effective. You might wonder how a tiny pill can safeguard you from unwanted pregnancy.

For a pregnancy to happen, the sperms need to travel from the vagina, up into the uterus & reach the fallopian tube where any one sperm fuses with the female egg/ ovum & forms the zygote.

This process of the union of an egg/ovum and the male sperm is called fertilization and is the beginning of pregnancy. The fertilized ovum travels down through the fallopian tube to a woman's uterus, where the implantation takes place.

Implantation is the process where the embryo attaches to the uterine lining to receive nourishment for growth.

So an Emergency pill works in one of the following ways:

1. ​It prevents the release of the egg from the ovary ( i.e prevents ovulation).
2. It prevents the fertilization of the egg by the sperm.
3. It may alter the lining of the uterus to inhibit implantation of the pregnancy.

There are two types of emergency contraceptive pills:

1. ​The Progesterone only pill- It is available over-the counter and contains the hormone Levonorgesterol 1.5 mg. It must be taken within 72 hours of unprotected intercourse to prevent pregnancy.
2. The Selective Progesterone Receptor Modulator ( SPRM )- It can be taken only with a doctor’s prescription and contains Ulipristal 30 mg. It can be taken within 5 days of unprotected sex.

The Side Effects of Emergency Contraceptive Pills

Every woman experiences different side effects. One woman may feel nausea, while another might feel cramps in her lower belly or back.

Headache, breast tenderness, dizziness, spotting, irregular bleeding& fatigue are some of the side effects of taking the morning-after pill.

Can the morning-after pill cause an abortion?

No. If a woman is already pregnant, the pill cannot terminate an existing pregnancy.

Does the pill protect from HIV/AIDS?

The morning after pill cannot save you from sexually transmitted diseases ( STD). The man/ woman must wear a relevant condom during the sexual act in order to prevent STD’s.

What About Intra-Uterine Devices?

Intrauterine device is a tiny T-shaped device which is inserted inside the uterus. It takes about 5 to 15 minutes for a doctor to insert this device into your uterus. This process can be done anytime within the first 5 days of unprotected intercourse and is the most effective form of Emergency contraception. Additionally, it provides ongoing contraception for the next few years, depending upon the type of IUD that has been inserted.

How does an IUD work?

Intrauterine devices alter the micro environment of the genital tract.

1. ​They alter the cervical mucus & prevent the sperm from reaching the egg.
2. They induce an inflammatory response in the lining of the uterus ( i.e the endometrium ) & make it less receptive for the embryo.
3. The inflammatory response also alters the functioning of the muscle of the uterus & fallopian tubes.
4. These effects also disturb the union of the egg & the sperm in the genital tract and inhibit fertilization.
5. Hormone releasing IUD causes a thinning of the endometrium & makes the cervical mucus thicker, thus preventing both fertilization & implantation.

Are there any side effects of IUD’s?

Some spotting and cramping are expected after the insertion of IUD but usually these are minor & easily managed with medications.

Sometimes the insertion of an IUD may be associated with an infection and it may require antibiotics for treatment

Rarely, an IUD may get displaced or perforate the uterine wall or may be expelled spontaneously. These conditions also require intervention by your doctor & you must visit your Gynaecologist if you develop any foul smelling vaginal discharge or severe abdominal pain or fever, heavy bleeding etc.

A major advantage of getting an IUD inserted is that it provides you reliable, ongoing protection against future pregnancies for the next few years. A hormonal IUD will work up to 5 years whereas the copper IUD works up to 3- 10 years, depending upon what is the concentration of copper in it. If you are not planning to have babies for the next few years, consider getting an IUD inserted. Even if you do wish to plan a baby in the near future after this menstrual cycle, your doctor can easily remove the IUD and the fertility returns soon.

Final Thoughts

Take a deep breath!
If you had unprotected sex recently, there is nothing to worry about, help is always at hand if you look for it. So do not hesitate to talk to your gynaecologist and opt for a mode of Emergency birth control which suits you, also remember to discuss various other safe options for regular use in order to avoid a pregnancy till the time that you are ready for it. After all, it is your life & you should be the master of your life, not a victim.