There is no such thing as a perfect contraceptive, and there will always be human error and issues with consistency and compliance. There is more risk taking reported when alcohol and drugs are used. Although taking “morning after” contraception improves efficacy, emergency contraception is available for several days after unprotected sexual intercourse.
There are currently two types of emergency contraception:
Hormones The Emergency contraceptive pill are most commonly now progestogen-only (e.g Levonelle in the UK).
This hormone is the one also found in some oral contraceptive pills. Emergency contraceptive pills should be taken within 72 hours of unprotected sex and the earlier they are taken the better. they can still be effective after 72 hours but the earlier the better. They prevent or delay ovulation and may alter the lining of the womb so that a fertilised egg is less likely to implant.
Progestogen-only emergency contraception
Research by WHO in 1998 compared progestogen-only emergency contraception with the more usually prescribed combined oestrogen-progestogen EC. The research found that the progestogen-only pills prevented a higher percentage of expected pregnancies than the combined pills, with fewer women reporting nausea and vomiting.
Most women can use the method, because it has demonstrated very few side effects, and has few contra-indications.
Emergency contraceptive pills can be used more than once. There is no upper or lower age limit. Almost all women can use emergency contraceptive pills safely. Emergency contraceptive pills are not suitable as a regular form of contraception for three main reasons
they are not as effective as using contraception on a regular basis because reliability depends on how soon it is taken and the time of administration in relation to ovulation. some women experience side effects such as nausea or vomiting, more so with the older method PC4 (combined pills) they do not offer protection against sexually transmitted infections
Intra - uterine devices (IUD’s).
A Copper IUD (rigid or “frameless” (e.g.Gynefix) can be inserted as an emergency contraceptive for up to five days after unprotected sex, or within five days of the earliest calculation of ovulation.
Intrauterine devices alter the lining of the womb so that a fertilised egg does not implant And/or may alter the movement of sperm to prevent egg and sperm meeting.
Emergency contraception is not abortion. Pregnancy begins at implantation. Abortion takes place if a fertilised egg has already implanted into the lining of the womb. Emergency Contraception may prevent ovulation or fertilisation of an egg, or prevent a fertilised egg from implanting in the womb. Therefore emergency contraception (hormonal or IUD) prevents pregnancy. It is not abortion.
However some people believe that life begins when the egg is fertilised or even before the egg and sperm meet. For personal and religious reasons any contraception may therefore be unacceptable to some people. Teachers of SRE therefore need to be aware of the alternative natural methods including abstinence from sexual intercourse, if pregnancy is not desired.
Many pharmacies now sell emergency contraceptive pills over the counter, although the cost can be prohibitive to young people. There is a Teenage Pregnancy Coordinator in each locality who will be able to outline the local implementation strategies for improving access and training of professionals to work with teenagers to prevent pregnancy and the spread of sexually transmitted infections. Contact us for any further information about this.
