Half of all women aged 15-44 have experienced at least one unintended pregnancy. It is estimated that half of all unintended pregnancies could be prevented by widespread use of emergency contraception (EC)1. Despite this, in Lithuania, very few women know about EC, and only some of them have ever used emergency contraceptive pills. Emergency contraception is a safe and effective method of birth control that prevents pregnancy after sex. The most common EC method is Emergency Contraceptive Pills (ECPs). In some cases, a copper intrauterine device (IUD) also can be used as emergency contraception. All emergency contraceptive methods must be used within five days of unprotected sex

Emergency Contraceptive Pills

ECPs are made up of the same hormones found in regular birth control pills and are taken in a short, elevated dose. ECPs prevent pregnancy. They do not cause an abortion. ECPs are most effective when taken as soon as possible after unprotected intercourse. Women should keep a packet of ECPs at home to use when they need them. ECPs are not intended for regular contraception.

ECPs treatment consists of a two-dose regimen of ECPs. Standard ECP dosing is to take the first pill as soon as possible within 72 hours (3 days) and the second pill 12 hours later. Important new research has shown that the ECPs also are effective if both pills are taken in a single dose as soon as possible but not later than 72 -120 hours (five days) after unprotected intercourse. If it is easier for you to take both EC pills at one time rather than waiting 12 hours to take the second dose, you may do so. You may also wish to consult the doctor about ECPs. The sooner you take ECPs, the more effective they are. Taking the two doses together immediately is as effective and obviates the risk of forgetting or delaying the second dose.

Efficacy

Postinor brand ECPs reduce the chance of pregnancy by 85 %. They are not as effective as consistent and correct use of most modern contraceptive methods (condoms, pills, injectables, IUDs, sterilization, etc.). If a woman uses ECPs frequently, her chance of becoming pregnant is higher than if she uses most regular contraceptives. This is why ECPs are not substitution for regular contraceptives.
When inserted within five days of unprotected intercourse, copper IUDs are the most effective method of EC; they reduce the risk of pregnancy by more than 99%.

How Do Emergency Contraceptive Pills Work?

ECPs are contraceptive agents, which may work primarily by delaying or inhibiting ovulation, they also may work by, inhibiting fertilization, or preventing implantation of the fertilized egg in the uterus. Pregnancy is defined as starting at implantation. If a woman is already pregnant, ECPs will not disrupt the pregnancy and will not harm the fetus.

If you have unprotected sex after using ECPs, they will not protect you. Use a regular contraceptive method to prevent pregnancy in the time.

ECPs do not protect against sexually transmitted infections.

What is the Difference between ECPs and the "Abortion Pill"?

ECPs should not be confused with mifepristone, or the "abortion pill". ECPs prevent implantation from occurring and will not work if a woman is already pregnant. Mifepristone is used as a medical method of terminating a pregnancy.

Side Effects and Contraindications of ECPs

Nausea/Vomiting: Some women may experience nausea and vomiting. Providing an anti-nausea medicine 1 hour prior to administering the first dose of the ECPs reduces the risk of nausea. If vomiting occurs within 1 hour after the woman has taken either dose of ECPs, some clinicians may advise a repeat dose. In cases where vomiting makes oral administration impossible, the repeat dose may be administered vaginally (inserted high in the vagina).

Other side effects may include short-term fatigue, headache, dizziness, breast tenderness, or a change in the timing of next period. These side effects generally do not last more than 24 hours.

Contraindications: According to the World Health Organization, there are no medical contraindications to ECPs. ECP use can be considered even for women who have medical conditions that make ongoing use of combined oral contraceptives unwise.

A woman should avoid using the pills if she is already pregnant, but ECPs will not end a pregnancy and will not harm the fetus.

How to Obtain ECPs

Emergency contraception pills in Lithuania can be bought in pharmacies, with the doctor's receipt. A pelvic exam, pregnancy test, or office visit is not necessary. But it is good to have EC in advance. Therefore it is recommended to ask doctor advance prescription of EC during routine gynecologic visits. Because of the time-sensitive nature of ECPs, prescriptions given in advance will improve patient access and options.

A woman can begin using any hormonal contraceptive immediately after ECP use, or she can use a barrier method until her next period begins. If your period is more than a week later than expected or if you have any cause for concern, see your doctor. To avoid fear of becoming pregnant in the future, consult with the doctor about regular contraception.

The Copper IUD

Cooper-bearing IUDs can be inserted up to 5 days after unprotected intercourse as an alternate method of emergency contraception.

Family Planning and Sexual Health Association protects human reproductive - sexual rights and is interested to insure, that every person should have information about reproductive health, quality services would be accessible, and everybody could make free and informed choice in reproductive health area.

This work was funded by Program for Appropriate Technology in Health (PATH) as part of its Small Grants Program.

1 Fact sheet on EC. The "Best Kept secret" in Women's Health. Can now be every woman's back - up Plan. www.backupyourbirthcontrol.org.