It is important, then, for educators and physicians to not only inform women that the pill exists, but they must also explain how it works and why it should be used.
Emergency contraception in pill form is a dose of estrogen and/or progestin, generally taken in two doses twelve hours apart following intercourse. Currently the IUD method of emergency contraception has been largely replaced by pill regimens either a combination of estrogen and progestin or progestin only (Grimes, & Raymond 2002). Depending on the timing of administration the mode of action of these oral regimens differs. Taken before ovulation, emergency contraceptives prevent ovulation. There is also a possibility that the hormones affect the mucus of the cervix effectively trapping semen, or possibly even affecting the mode of transport of sperm to ovum (Grimes, & Raymond 2002). If the emergency contraceptive is taken after ovulation it is possible that the hormones result in an alteration of the biochemical makeup of the endometrium and the function of the corups lutem which inhibits fertilization. There is no evidence though of long-term alteration following treatment with oral emergency contraceptive (Trussell, et al., 1997).
One of the most significant and resilient controversies surrounding the use of emergency contraception is the fear that an oral contraceptive regimen is actually early medical abortion. It is this fear which accounts in large part for many individual's hesitation in use. This fear however is unfounded. Emergency Oral Contraceptive is ineffective once a pregnancy has been established (Grimes & Raymond, 2002). The "pill" as it is commonly called works only in the time between intercourse and establishment of a pregnancy which is a window of approximately one week. The preemptive biochemical alteration resulting from the oral hormone prevents conception from taking place, thus it is not actually interrupting or terminating a pregnancy simply preventing one from beginning. There are however, a number of religious and political groups who promote the idea that emergency contraception is chemical abortion. It is this stigma along with similar erroneous beliefs which prevent those individuals who need the medication from actively seeking it.
The direct correlation between misinformation regarding oral contraception and the number of abortions in an area is supported by the 1995 scare that certain birth control pills were responsible for doubling an individual's risk of developing potentially life threatening blood clots. In the aftermath of this scare which was later shown to be unfounded, the UK alone saw a 9% increase in the number of abortions (Harper & Ellerton, 1995). Such concerns have historically become widely circulated and have been fairly resistant to debunking because so little is known conclusively about the oral contraceptives mode of action as well as the potential long-term side effects of years of hormonal manipulation.
This misconception of how oral emergency contraceptives work as well as the lack of open discussion regarding regimens such as the popular "Morning After Pill" make it difficult for women to acquire the pills. These oral regimen are also not specifically labeled by the FDA for emergency contraception and as such their wide spread availability has been restricted...
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