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Emergency pill safe only if used as directed

health-and-fitness Updated: Dec 10, 2011 22:33 IST
Sanchita Sharma
Sanchita Sharma
Hindustan Times
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The Obama administration's overruling scientific opinion to block non-prescription sale of emergency contraception or "morning-after pills" at chemists has outraged many who want it easily available to prevent unwanted pregnancy after unprotected sex. Unlike in India, where emergency contraceptives are sold along with chewing gum and condoms to everyone without prescription, these pills can be sold without prescription in the US only to those 17 years or older with proof of their age.

In India, emergency contraceptives - sold under frequently advertised brand names such as i-pill, Unwanted 72 and Option 7, to name a few - contain low doses of levonorgestrel, a synthethic form of the hormone progestogen cuts chances of unwanted pregnancy if taken within 72 hours of unprotected sex, contraceptive failure, forgetting regular contraception or rape. The sooner its taken, the more effective it is, with the emergency contraceptive being 95% effective if taken within 24 hours of unprotected sex, 85% if had between 25 to 48 hours, and 58% if taken between 49 and 72 hours.

Levonorgestrel works in three different ways, depending on the time of the month for you. It stops an egg from being released from the ovary; if already released, it prevents the sperm from fertilising it; and if already fertilized, it stops it from attaching itself to the lining of the womb. Medically speaking, a pregnancy is established only after the fertilised egg attaches itself to the womb and since the pill has no effect on a woman already pregnant, it is not an abortion pill, insist its manufacturers.

There's no doubt that emergency contraception serve a need. Though India was among first few countries in the world to allow abortion till 20 weeks of pregnancy under the Medical Termination of Pregnancy Act in 1972, an estimated 5 million illegal abortions take place. For every legally-induced abortion, 10 or 11 are done in unlicensed clinics or by unqualified people. And though abortion is successful in 95% cases, it kills 20,000 women each year, reports IPAS, a non-profit group working to reduce abortion-related mortality. India has the world's largest number of unsafe abortions-5 million a year- or a quarter of the global total.

The use of contraception and emergency contraception could end most of these deaths and unwanted pregnancies, but things are not so simple. The real problem is only 56.3% sexually-active people use contraception in India, shows National Family Health Survey Data-3 (2006). The rest either go for unsafe abortions, or if they can afford it, use emergency contraception to prevent conception.

While pharmaceutical companies tell you emergency contraception carries has no major side effects other than nausea, vomiting, headache, abdominal pain and unexpected vaginal bleeding that last for a day or two, they conveniently omit what its misuse can lead to.

Pop advertising and easy availability at chemists have made it a substitute for regular contraception-such as contraception pills, intra-uterine devices, condoms and spermicides-especially among young people who do not have regular partners. Frequent use-more than once or twice a year-causes fluctuations in hormonal levels and may cause infertility over time.

With over 30 countries worldwide, including the UK and France, having approved its non-prescription use, there's no doubt about its safety. Provided, of course, that women treat it for what it has been tested and approved for: a pill strictly for use in an emergency.