You are sitting having dinner with your family when an I-pill ad plays among the commercials on TV and all the members begin to feel uncomfortable.
Parents are hoping their kids aren’t having sex in the first place, and pray that the kid will never have to face any such problems of unwanted pregnancy and abortions.
The kids on the other hand are guilty of having sex but are also praying that nothing ever goes wrong and the girl doesn’t get pregnant.
So everyone is wishing for the same thing then why not talk it out? It would save a lot of problems that occur due to misconceptions and lack of knowledge about how to safely prevent pregnancy.
Many young sexually active couples confuse these emergency contraceptive (EC) pills with oral contraceptives or birth control pills. Or consider it to be an alternative to contraceptive. EC pills are taken if, and only if, another method of contraception is forgotten or has failed to function properly. They are to be taken in case of ‘emergencies’ only, and not to be mistaken as a normal contraceptive.
What is an emergency contraceptive and what does it do?
You can prevent pregnancy after intercourse by taking Emergency Contraceptive pill (also known as the Morning After Pill or EC). In India we have brands like I-pill and Unwanted 72.
The Emergency Contraceptive (EC) Pill works by giving the body a short, high burst of synthetic hormones. This disrupts hormone patterns needed for pregnancy. It affects the ovaries and the development of the uterine lining, making pregnancy less likely. Depending upon where the woman is in her menstrual cycle, the hormones prevent pregnancy in different ways. It prevents ovulation (the egg leaving the ovary and moving into the fallopian tube). It blocks the hormones needed for the egg to be fertilized. It may affect the lining of the uterus and alters sperm transport which prevents sperm from meeting the egg and fertilizing it.
But, they are not 100% effective.
Side effects of taking the pill
I-pill contains female hormone, levonorgestrel, a progestogen that helps to prevent the ovulation of the egg in the uterus thus preventing the pregnancy. There are many side effects experienced like nausea, vomiting, headaches, delaying or early occurrence of menstrual cycle, lower abdominal pain and in some cases excessive vaginal bleeding.
The ads that promote the use of emergency contraceptives only create fear of pregnancy and abortion among the youth and may push them to use the pill without proper guidance.
Dr. Sangeeta Pikale, Gynecologist says, “EC pills as the name suggests is for emergencies only and I am definitely against its advertisement, it seems to appear as an easy way out for unprotected sex. It does not protect from sexually transmitted diseases e.g. HIV and so may mislead the youth.”
The ads are not informative enough about how and when the pill should be taken. Due to over-the-counter availability, without prescription, it is easily accessible to the couple even though they may or may not know how to effectively use it, which may further cause problems.
Moreover the pills are not 100% effective. They can be used up to 120 hours (5 days) after intercourse. It is most effective within the first 24 hours. But, Emergency Contraception reduces the risk of pregnancy only by 75 - 89%. EC does not protect against Sexually Transmitted Diseases (STDs), including HIV/AIDS.
But of course the ads are necessary to inform people about the existence of such an emergency pill as an alternative to an unwanted pregnancy.
Dr. Aniruddha Malpani, famous Gynecologist and Infertility Specialist says “I-pill ads are not misleading. It is just an emergency contraceptive pill and is a tool which one can opt to avoid unwanted pregnancy, there is nothing wrong in the ads according to me”.
How and why these pills get misused?
Usually young couples experimenting sexually, without proper knowledge, fall prey to such ads. Why:
- Not educated - They are not properly educated about sex and are probably not adequately aware of unprotected sex and how the pill needs to be used in the case of fear of pregnancy. They are also very often mistaken to be birth control pills which, unlike ECs, are taken in cycles to prevent pregnancy.
- No warning or disclaimer – The package comes with no clear instructions. And the couple also does not talk it out to any elder or doctor, as having sex before marriage is looked down upon in our society. So misinformed teenagers use their own limited discretion and may use the pills wrongly or when not necessary. Couples even after marriage may be shy to talk about it and end up misusing the pill.
- Fear of pregnancy/ “Safe side” – Young couples are sexually active and they fear that even after doing everything right - what if she gets pregnant? Should she take a pill “just to be on the safe side?” So even in situations where the pill could probably have been avoided, out of fear the pill is misused. But the reciprocations could be catastrophic. The hormonal imbalance will cause her greater problems in the future.
- Availability- It is easily available over the counter and doesn’t require a doctor’s prescription. It is affordable and hence offers what is perceived as an easy escape for those who have unprotected sex.
Situations where an EC may be required
- Condom break – Condom breaks are a common occurrence during sexual acts and under such conditions taking an EC would be required.
- Carried away – In situations where things got out of hand and you didn’t use protection. But Emergency Contraceptives do have side effects and don’t protect from STDs so it is advisable to wear a condom to be safe.
- Forced intercourse – Even though ECs cannot protect from diseases they can keep you from an unwanted pregnancy that may occur after an untoward incident.
- Intoxicants-influenced – Avoid getting intimate when intoxicated. Or make sure you use a condom. But under situations where neither has been exercised you may need to use an EC.
Safer methods of precaution to avoid use of an Emergency Contraceptive:
- Male condoms – Use male condoms during the intercourse to prevent any sperm deposits and unwanted pregnancy.
- Female condoms – When the man isn’t ready to wear a condom or cannot wear a condom another option is the female condom. It is similar to the male condom only it is worn in the vagina. It protects from diseases and unwanted pregnancy. It is not as popular and is more expensive than a male condom.
- Spermicides – These can be in the form of gels, foams, creams, etc. They are to be applied in the woman’s vagina 30-40 minutes before the intercourse and they kill the sperms preventing them impregnating the egg. They are only 70-90% effective and work better when clubbed with a condom. Some condoms come with lubricated spermicides. Together they prove to be a very effective way of contraception, should the condom break and the user does not notice it.
- Oral contraceptives\ birth control pills - Birth control pills, also called oral contraceptives, contain hormones like estrogen and progesterone. They need to be taken in monthly cycles to prevent pregnancy. They are again not advisable as they mess with the woman’s hormones. And there are complications if a pill is missed on a day. But many women, especially married women, prefer to be on oral contraceptives. These pills however do not protect from STDs (Sexually transmitted diseases).
- Abstinence – For couples that are still young the best option would be to abstain from an intercourse itself. Other forms of pleasure can be substituted or maybe some healthy distractions. There are physical problems as well as psychological factors involved. But if the couple still wants to go ahead with the act then it must be done safely.
Instead of using emergency contraceptive pills like I-pill to avoid pregnancy as an ‘emergency’ measure it would be better if couples are educated in the concept of ‘safe sex’. It is always a better option to prevent situations which could lead to an unwanted pregnancy rather than resort to ‘morning after’ pills.