Emergency Contraception Essay Research Paper Emergency Contraception

Emergency Contraception Essay, Research Paper

Emergency Contraception in the United States Today

November 2, 1998

In a world today where unplanned or unintended pregnancies occur in exuberant numbers there is a great need for a solution. Emergency contraception is one that comes to mind. In the United States approximately 3.2 million of the total six million annual pregnancies are accidental, half of these ending in abortion (Lindberg, 1997). Eighty percent of teen pregnancies are unintended, and each year, one in nine young women aged 15-19 become pregnant; more than half become mothers. Widespread use of emergency contraception could prevent an estimated 1.7 million unintended pregnancies and 800,000 abortions each year (”Planned Parenthood,” 1998). As of September 1998, the Federal Drug Administration (FDA), which regulates the introduction of new drugs into the marketplace, has approved a total of 10 brands of combination-hormone pill brands suitable for use as emergency contraception pills. For those who are unable to take the hormone pills there is an option of an intrauterine device. Raising awareness of emergency contraception and allowing health care workers to provide emergency contraception pills to patients who may be at need in the future could dramatically decrease the numbers of unintended pregnancy and all the consequences that result.

Emergency contraceptive pills are ordinary birth control pills containing the hormone estrogen and progestin. They are also called postcoital contraception or “the morning after pill.” Emergency contraception Pills (ECP’s) can prevent pregnancy after unprotected intercourse by as much as 75% when the first dose is taken within 72 hours and the second dose taken 12 hours later (Klima, 1998). ECP’s affect the menstrual cycle. Administering oral contraceptives as emergency contraception at or near time of ovulation, when pregnancy is most likely to occur, appears to disrupt the ovarian function, which results in an absent or dysfunctional luteal phase (Klima, 1998). Another option would be the insertion of a copper intrauterine contraceptive device within 5 days of unprotected intercourse (Skolnick, 1997). The intrauterine device (IUD) causes an inflammatory response, making it difficult for implantation to occur on the endometrium (Klima, 1998).

For thousands of years, human beings have been willing to take the risk of pregnancy while having sexual intercourse to later find themselves searching for a remedy after the fact. Remedies once believed to aid in achieving postcoital contraception include herb douches, sneezing, hopping, jumping, and dancing. These remedies date back to 1500 B. C. (Morgan and Deneris, 1997). In the 1920’s scientists found that estrogenic ovarian extracts could prevent pregnancy in mammals (Klima, 1998). This lead to a solution for veterinarians when horses and dogs mated accidentally. In the 1960’s clinical use of postcoital estrogen alone was first documented as a treatment for victims of sexual assault (Morgan and Deneris, 1997). In the 1970’s, a Canadian physician named Yuzpe began to study the combination of ethinyl estradiol with a progestin. This became known as the “Yuzpe regimen” and is accepted as the gold standard in emergency contraception (Morgan and Deneris, 1997).

The Yuzpe method of emergency contraception is often considered the best regimen because of its lower incidence of side effects as compared to estrogen (Morgan and Deneris, 1997). Although the side effects of ECP’s are not serious, they may effect whether a client will be able to complete the regimen which could decrease the effectiveness of the method (Klima, 1998). Nausea is the most common side effect associated with emergency contraceptive use and occurs in 50-70% of women who use the method. In addition, approximately 25% of women will experience vomiting (Klima, 1998). Antiemetics may be given to reduce the nausea and vomiting. Breast tenderness, irregular bleeding, and headaches may also occur. These side affects usually begin to disappear one or two days after the second ECP has been taken (”Planned Parenthood,” 1998). Women may also experience a change in the length and timing of their next period. If ECP’s are used frequently, periods may become irregular and unpredictable.

The IUD is often considered the most effective form of emergency contraception and the only method that provides long-term contraception. However, because of the risk of pelvic inflammatory disease in women who are at risk for sexually transmitted diseases (STD’s) makes it difficult to find women who can be given an IUD (Morgan and Deneris, 1997). In other words, victims of sexual assault or promiscuous women should be discouraged from using an IUD until screening for STD’s can be done. Along with STD’s, limitations should be made to women who have a history of ectopic pregnancy, or severe dysmenorrhea, or menorrhagia. Some side effects for IUD insertion may include abdominal discomfort, vaginal bleeding or spotting and infection. Possible side effects of IUD use include heavy menstrual flow, cramping, infection, infertility, and uterine puncture (”Planned Parenthood,” 1998).

Other types of emergency contraception include “mini-pills” and mifepristone. “Mini-pills” as they are often called are progestin-only pills. They are a good option to those who can not take estrogen and are not good IUD