Emergency Contraception

Treble-Up: Use 3 Forms of Contraceptive

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Emergency Contraception

CHAPTER 10

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 in which a condom breaks or slips off during use or when a pill was forgotten.

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 infections—only condoms do.

Your options for emergency contraception include:

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

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

Pills combining estrogen and progestin 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 web page 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.

Antiprogestin 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 three 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 or twelve years.

If you have pelvic inflammatory disease (PID) or an active gonorrhea or Chlamydia trachomatis 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 who 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 infections usually includes three antibiotics. Some are taken once, while others are taken one to three times daily for 7, 10 or 14 days, depending on the antibiotic.

Preventive treatment for HIV may also be recommended, but must be initiated early. Your medical practitioner will not only discuss the potential risks of getting HIV and the risks of treating it with antiviral therapy but also 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 nonintact 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 STIs 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. The network also provides hotlines, which are very helpful in rural areas where clinics may be very sparse. See https://centers.rainn.org.


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