You may have heard of emergency contraception, better known as the “morning after” pill, for a woman who has had unintended, unprotected, or forced sex and is concerned about the possibility of pregnancy. What exactly if the morning after pill, and how effective is it?
“Morning after” pills contain the same types of hormones found in oral contraceptives, but they are specially packaged and intended to be used within the first seventy-two hours after intercourse. The first brad approved by the Food and Drug Administration (FDA) for this purpose was Preven, which is no longer being manufactured. It contained both estrogen and progestin packaged in a kit with four pills and a pregnancy test (to ensure that a woman wasn’t already pregnant from a previous sexual contact, in which case the pills would not be used). Two of the pills were to be taken within 72 hours after intercourse; the remaining two twelve hours later. Preven reduced the likelihood of becoming pregnant by 75%. About half of the women who took this combination became nauseated, and one in five experienced vomiting. While Preven is no longer available, some health-care providers will recommend multi-tablets doses of each combination oral contraceptives, although they are not approved by the FDA for this purpose.
The only brand now approved in the United Stated specifically for emergency contraception is marketed under the name Plan B. It consists only of progestin and is reported to have higher rate of effectiveness in preventing pregnancy while provoking less nausea and vomiting. (Preven, Plan B, or any other combination of oral contraceptive pills that might be used as emergency contraception does not protect against sexually transmitted infections.)
How does the “morning after” pill work? That depends on the time in a woman’s cycle when they are taken. They may prevent ovulation—the release of the egg from the ovary—or they may delay ovulation until sperm is no longer capable of fertilizing and egg. (Sperm cells survive about five days.) They may also interfere with the movement of egg and sperm within the fallopian tube or with the actual union of egg and sperm. All of these mechanisms are truly contraceptive—that is, they prevent fertilization, the union of egg and sperm that starts a new human life.
It is also possible that “morning after” pill have their effect after fertilization, by changing the lining of the uterus so that the fertilized egg—a new human in the first few days of life—cannot implant within it. This mechanism is not truly contraceptive, because conception has already occurred, but rather represents a very early abortion. Promoters of emergency contraception pills state that these medications do not cause abortion, but this claim is based on their definition of pregnancy as beginning with the implanting of the fertilized egg within the uterus. For those who hold that human life begins at conception, however, any medication or device that prevents a new life from continuing in its normal development would be considered abortifacient, or abortion inducing.
Because a new human life deserves to be protected at its earliest stages—even in the most difficult circumstances—the various mechanisms by which these emergency pills might work create a real dilemma, because it is possible to know which of them might be acting in a particular case. This is particular difficult if a woman has been the victim of a sexual assault. Obviously, this type of medication is not intended to be used on a regular basis or as a primary form of birth control. When deciding whether or not to use this type of medication in a crisis situation, a woman should seek and prayerfully consider counsel from her family, her physician, and her pastor.