 |
|
|
|
||||||||||||||||||||||
 |
 |
|
|
||||||||||||||||||||||
 |
|
||||||||||||||||||||||||
 |
Home > Education > Students > Q&A on the Morning-after Pill | ||||||||||||||||||||||||
Morning-after Pill |
|||||||||||||||||||||||||
|
The morning-after pill is the commonly used name of Levonelle-2. Levonelle-2 is actually two pills containing levonorgestrel, which is a progestogen, a substance like the naturally occurring female hormone progesterone. The morning-after pill can be taken up to 72 hours after unprotected sex and the two pills are taken 12 hours apart. The morning-after pill is officially labelled as ‘emergency contraception’1. Schering, the company that distributes Levonelle-2 says, "The precise mode of action of Levonelle is not known"2. However, Schering says that it is thought to work in two possible ways; If ovulation has not occurred the morning-after pill may delay ovulation or if ovulation has taken place it may prevent fertilisation of an egg that has been released. If ovulation and fertilisation have taken place the morning-after pill will prevent the fertilised egg implanting in the womb by causing the wall of the womb to disintegrate and come away.
When the morning-after pill acts to prevent ovulation or fertilisation it is a contraceptive i.e. it is contra to conception. However, if an egg has already been fertilised the embryo created, if left to his/her own devices, will implant in the woman’s womb and grow and develop for nine months until birth. If a woman takes the morning-after pill when fertilisation has already taken place then it will cause an abortion, the embryo’s life will be ended because it will not be able to implant in the womb and gain the nourishment it needs to grow and develop. Any woman who takes the morning-after pill will not know whether fertilisation has taken place or not. She therefore will not know whether she has prevented conception/fertilisation or if she has in fact had an abortion. The morning-after pill cannot properly be called a contraceptive, as it does not work as a contraceptive in every case. The morning-after pill is effective in 85 percent of cases, i.e. it will prevent or terminate pregnancy in 85 percent of cases. It is less effective the longer the time lapse since having sex. Schering say that it is 95 percent effective used within 24 hours of having sex, 85 percent effective between 24 and 48 hours after sex and 58 percent effective between 48 and 72 hours after sex4. If a woman does become pregnant despite taking the morning-after pill Schering warn of the risk of ectopic pregnancy,5 i.e. the baby implanting and growing outside of the womb, usually in the fallopian tube. Each of the two pills contains 750 micrograms of levonorgestrel. The woman takes the two tablets twelve hours apart. In twelve hours the woman is taking a dose of 1500 micrograms of levonorgestrel. Schering also make an ordinary progestogen-only contraceptive pill called Norgeston, which like Levonelle-2 contains only levonorgestrel. The daily dose of levonorgestrel in Norgeston is 30 micrograms6. The morning-after pill contains fifty times the amount of hormone as this ordinary contraceptive pill. Side effects of the morning-after pill include nausea (23.1%), low abdominal pain (17.6%), fatigue (16.9%), headache (16.8%), dizziness (11.2%), breast tenderness (10.8%), vomiting (5.6%), irregular bleeding and diarrhoea (13.5%)7. There have been no long-term clinical trials on the effects of the morning-after pill and its repeated use. There have been no trials on the effects of the morning-after pill on girls under the age of 14, and very few girls under the age of 16 have been included in trials. Trials such as that by the ‘Task Force on Postovulatory Methods of Fertility Regulation’ have been carried out on women where the majority have proven fertility8. We do not know what effect the morning-after pill will have on the fertility of younger women who are still developing. We have no evidence of the long-term effects of using the morning-after pill and so we do not know if it is safe. The morning-after pill does not protect against sexually transmitted diseases, which are spreading fast. It may even discourage young people from using condoms, as they know that they can get a ‘quick-fix’ the following day. From 1 January 2001 the morning-after pill could be bought from a pharmacy without a prescription. There have also been trials in Lothian Health Board of giving the morning-after pill away for women to keep at home in case of an ‘emergency’, and in England where supermarket pharmacies were supplying the morning-after pill free of charge and prescription-free to girls under the age of 16. A pharmacist can sell the morning-after pill to a woman after she completes a questionnaire of nine questions. Of these nine questions only three relate specifically to the woman’s health; what other medicine is she taking; does she suffer from bowel disease or liver problems; has she ever had an allergic reaction to levonorgestrel. The other questions relate to whether the woman is over 16, when she had unprotected sex and when her last period was9. The pharmacist therefore cannot possibly know the full medical history of the woman and therefore whether she has any conditions that indicate that she should not take the morning-after pill. Neither pharmacists nor family planning clinics have to inform the woman’s GP that she has been given the morning-after pill Pharmacists are allowed to sell the morning-after pill to women of 16 years of age and over. Schering, the company who distributes the morning-after pill states that Levonelle-2 is not recommended for use by girls under the age of 16 without medical supervision10. Any woman who desperately wants the morning-after pill, believing that it will solve her ‘problem’ will answer the pharmacists’ questions the way she thinks she should in order to get the pill. A fourteen year-old girl can easily make herself look 16 and so the pharmacist can unknowingly supply the morning-after pill to girls under the age of 16. We do not know the dangers that this may pose for the health of young girls, but we do know that the people who make the pill recommend that girls under the age of 16 should not use it without medical supervision. By excluding the girls’ GP we have no way of protecting her from any unforeseen circumstances or effects. By supplying the morning-after pill over the counter without a prescription it is made more easily available. This means that women are more likely to use it on more than one occasion, it no longer becomes ‘emergency contraception’ but something that women are happy to know they can fall back on. Easier access to the morning-after pill therefore creates a less responsible attitude to sex as well as allowing teenage boys to put greater pressure on young girls to become sexually active earlier, since this pill will protect them from any ‘unwanted consequences’. In the 1990s in the UK there was a five-fold increase in the number of prescriptions for the morning-after pill and yet in 1998 we saw the highest number of abortions ever. In the year 2000 nearly one million courses of the morning-after pill were supplied to women in the UK. With the morning-after pill available from pharmacies from 1 January 2001 the number of pills supplied in the year 2001 was thought to exceed 1 million11. In spite of this there has been no real fall in the number of abortions and the number of teenage pregnancies since the mid-1990s has remained fairly constant. Use of the morning-after pill only hides the true number of teenage pregnancies and the true number of abortions, since we do not know how many women taking the morning-after pill are actually pregnant and therefore have their pregnancies aborted. 1 Department of Health and the British National Formulary,
Section heading 7.3.1 SPUC Scotland Paper 4 
|
|
|||||||||||||||||||||||
 |
|
|
|
||||||||||||||||||||||
