Emergency Contraception

Sometimes people aren’t given a choice about whether or not to have sex. If you are female and are raped, there are some contraceptives designed for just that situation.

Emergency contraception is birth control that prevents pregnancy after sex, which is why it is sometimes called “the morning after pill,” “the day after pill,” or “morning after contraception.” It is appropriate to use in cases of rape, or in cases where a condom breaks or slips off during use.

The name is a bit misleading—you don’t have to wait until the morning after. You can use emergency contraception right away or up to five days later.

Emergency contraception makes it much less likely you will get pregnant. But emergency contraceptives are not as effective as other forms of birth control, like the pill, implant or IUDs. So if you are sexually active or planning to be, do not use emergency contraception as your only protection against pregnancy.

In addition, emergency contraception does not protect against sexually transmitted diseases — only condoms do.

Your options for emergency contraception include:

  • emergency contraceptive pills (also called “morning after pills”) and
  • the Copper-T Intrauterine Device

Three types of emergency contraceptive pills are available: combined estrogen and progestin pills, progestin-only pills, and anti-progestin pills.

Combined estrogen and progestin pills are no longer available as dedicated emergency contraceptive pills in the U.S., but certain regular combined oral contraceptive pills may be used as emergency contraceptive pills. However, you should consult with a medical practitioner to determine the correct timing and dosage, as this varies by brand. The Princeton University webpage at http://ec.princeton.edu/countryquery.asp also has information on this topic.

In the U.S., progestin-only emergency contraception is available over-the-counter (e.g., at Amazon or a drug store) without age restrictions to either women or men. Look for Plan B One-Step, Take Action, Next Choice One-Dose, My Way or other generic versions in the family planning aisle.

Anti-progestin pills may also be available outside the U.S., but inside the U.S. a prescription is needed.

A common side effect of emergency contraceptive pills is nausea and vomiting. If you experience vomiting within 3 hours of taking one, contact your physician or pharmacist right away. Another dose may be recommended.

The Copper-T is an IUD that a trained clinician inserts into the uterus up to five days after sex to prevent pregnancy. The Copper-T IUD does not affect ovulation, but it can prevent sperm from fertilizing an egg. It may also prevent implantation of a fertilized egg.

As emergency contraception, the Copper-T IUD is much more effective than emergency contraceptive pills, because it reduces the risk of getting pregnant by more than 99%, whereas the morning after pills are only 88% effective. Another advantage to the Copper-T IUD is that you can keep it in place to prevent pregnancy for up to ten years.

If you have pelvic inflammatory disease (PID) or an active gonorrhea or Chlamydia infection, IUD insertion is not recommended. However, if you have an asymptomatic gonorrhea or Chlamydia infection, IUD insertion is considered safe.

For more information on emergency contraception, visit: http://ec.princeton.edu/emergency-contraception.html

Pregnancy is only one risk of rape—disease is another risk that applies to both women and men that are raped. If you are raped you should visit a medical practitioner and consider a course of treatment against bacterial infections.

Preventive treatment for gonorrhea, chlamydia, and trichomonas usually includes three antibiotics. Some are taken once, while others are 1-3X daily for 7, 10 or 14 days, depending on the antibiotic.

Preventative treatment for HIV may also be recommended, but must be initiated early. Your medical practitioner will discuss the risks of both the potential for getting HIV, as well as the risks of the antiviral treatment, and recommend a course of action.

The risk of contracting HIV will vary for vaginal versus anal rape, whether or not the skin was torn, and whether or not there were multiple assailants. The CDC recommends preventive treatment if the mouth, vagina, anus, or non-intact skin (e.g., a cut) was exposed to the assailant’s blood or bodily fluids.

Preventive treatment for hepatitis B may not be needed if you were previously vaccinated, but if not, one vaccine dose is given immediately, followed by additional doses one and six months later.

We know that it will be difficult to share your story with a medical practitioner, but avoiding STD and pregnancy are worth the effort. Whether or not you tell the police or prosecute is another matter, but at least get medical care and counseling to help you with this traumatic event.

For more information, visit:

https://www.uptodate.com/contents/care-after-sexual-assault-beyond-the-basics

The Rape, Abuse and Incest National Network can help you locate counseling and support services near you. They also provide hotlines, which are very helpful in rural areas where clinics may be very sparse. See https://centers.rainn.org.


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