Emergency Contraception

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Emergency Contraception

"My partner & I made love last night & we used a condom," read the e-mail to AVSC's Web site. "Only after, we found there was a hole in the condom. Now is not a safe period for me, & I'm scared I'll get pregnant. Please tell me what to do."

A method fails; a couple forgets to use contraception; a woman--one of the hundreds of thousands of women raped each year--is further traumatized by the fear that she may become pregnant as a result of the attack.

For all of these people, emergency contraceptive pills--also known as "morning-after pills"--can provide a solution.

The pills, which can be used to prevent an unintended pregnancy after unprotected intercourse, have had very limited worldwide use since they were introduced as emergency contraception in the 1970s. But a recent announcement by the U.S. Food and Drug Administration (FDA) promises to help make emergency contraception more available to women in the United States.

Six Regimens Approved

On February 25, 1997 the FDA formally announced that six brands of combined oral contraceptive pills, when taken in specified doses, are safe and effective for use as emergency contraception. By taking increased doses of the pills within 72 hours of unprotected sex, a woman can reduce her chances of becoming pregnant by at least 75%.

As a result of the FDA determination, pharmaceutical manufacturers may now apply to include the pills' use for emergency contraception as part of the drug labeling information.

Expanded Access to Information

Changing the labeling could have a profound effect on women's access to the method. Although physicians may prescribe drugs for an "off-label" use and may explain this use to an individual client, they are prohibited from providing off-label information under other circumstances, including during training of other providers or in printed materials.

Next year, a contraceptive pill is expected to be marketed exclusively for use as emergency contraception in the U.S. This is something that could only have happened as a result of the FDA action.

"This FDA ruling will further the goal of making emergency contraception more widely available," says Dr. James Trussell, a leading expert on emergency contraception at Princeton University.

Global Efforts Seen

With the FDA announcement, the U.S. joins the worldwide push to make emergency contraception an option for women. In the past few years, campaigns have been under way in many countries to educate providers and the public about the method.

AVSC and other organizations receiving U.S. support to assist family planning efforts overseas are playing their part in contributing to these global efforts. All AVSC medical staff have received information about emergency contraception, and AVSC will be incorporating the method into all future materials and provider trainings, where appropriate.

The Medical Perspective

The battle over abortion has played a role in limiting access to emergency contraception in the U.S., since some have argued that the method works by terminating pregnancy.

But among medical experts, there's no disagreement--emergency contraception does not induce abortion. As the Consortium for Emergency Contraception, a collaboration of international organizations, explains, "Medical science considers that a pregnancy has begun once implantation of a fertilized egg in the lining of a woman's uterus is complete.... Emergency contraceptives are ineffective once implantation has begun; they cannot cause an abortion if the woman is already pregnant."

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