Most contraceptives are used before or during sexual intercourse. Still, no method of birth control is 100 per cent effective. Sometimes a condom breaks or a woman forgets to take her birth control pills. This is called contraceptive failure. Once in a while, a couple may realize that they had intercourse without using any birth control. If a woman does not wish to get pregnant, emergency contraception may be able to stop pregnancy from happening.
Emergency contraception is a method of birth control that is used after intercourse but before implantation. Implantation happens when a fertilized egg becomes attached to the lining of the uterus. According to the Society of Obstetricians and Gynecologists of Canada (SOGC), this is the moment when pregnancy begins. Emergency contraception allows one last chance to prevent pregnancy.
Two kinds of emergency contraception are available.
Hormonal emergency contraception - Doses of the female hormones estrogen and progesterone (in birth control pills such as Ovral ª) or progesterone alone (Plan Bª) can be taken within 72 hours of intercourse to prevent pregnancy. Only Plan Bª is available without a doctor's prescription.
Non-hormonal emergency contraception - A copper intrauterine device (IUD) can be placed in the uterus by a doctor within seven days of intercourse to prevent pregnancy.
Roughly half of all pregnancies are not planned. About half of unplanned pregnancies are not wanted and many of these end in abortion. In 1998, over 100,000 Canadian women, many in their teens or early twenties, underwent abortions. Plan Bª was changed from prescription to non-prescription status to reduce unwanted pregnancies and abortions.
Plan Bª works best when taken within a short time after unprotected sex. Since time is of the essence, easy access to this medication is important. Pharmacists are the most accessible health care professionals. Many pharmacies are open long after doctors' offices have closed for the day. A woman who wants to take Plan Bª does not need a check-up from a doctor. Pharmacists, as drug experts, have the knowledge and skill needed to understand when women may need emergency contraception. Pharmacists can also provide women with the information that they need to take Plan Bª correctly.
Plan Bª contains a type of progesterone called levonorgestrel. A woman who has had unprotected intercourse or contraceptive failure and does not wish to become pregnant, can take one tablet as soon as possible and a second tablet 12 hours later. It is best if Plan Bª is taken within 72 hours of unprotected sex. It may work up to 120 hours or five days after unprotected intercourse, but the chance of pregnancy is greater.
Plan Bª works in more than one way. It can slow or stop ovulation - the release of an egg from a woman's ovary. It can prevent sperm from reaching an egg, and it can stop sperm and an egg from coming together (fertilization). Plan Bª may also prevent a fertilized egg from attaching to the lining of the uterus. Once implantation occurs, Plan Bª will not work. Plan Bª does not have any effect on an implanted embryo (egg and sperm). Since Plan Bª will not cause an abortion, it is not an abortion pill.
A woman of childbearing age who needs emergency contraception can take Plan Bª. Both teenagers and women in their forties can safely take Plan Bª. A pharmacist can help a woman decide if Plan Bª is a good option by asking her some questions. She will be asked if she has any drug allergies or medical conditions, or if she is taking any medications. It is important to find out when the unprotected sex took place. The pharmacist will also ask whether she might already be pregnant. Again, Plan Bª will not interrupt an established pregnancy. If a woman who is already pregnant takes Plan Bª, it will not harm the growing fetus (unborn baby).
If 100 women have unprotected sex during the middle part of their menstrual cycles, on average eight of them will become pregnant. If these women were to take Plan B, only one would become pregnant. Plan Bª is most effective within the first 72 hours of unprotected sex or contraceptive failure. However, it may still work if taken within 120 hours or five days. Plan Bª does not work as well as other preventative methods of birth control, such as a condom with spermicidal (sperm killing) lubricant or birth control pills.
Usually a woman will get her next period about two weeks after taking Plan Bª. Sometimes her period will be a little earlier or later than expected. If a woman does not get her period within 21 days of taking Plan Bª, she should see her doctor for a pregnancy test.
Keep in mind that Plan Bª will not work to prevent pregnancy if intercourse happens after it is taken. A reliable method of birth control must be used instead. Unprotected sex can put women at risk of sexually transmitted infections. Plan Bª will not prevent these types of infections.
Like any medication, Plan Bª can have side effects. Some women may have some bleeding from the vagina a few days after taking Plan Bª. This is normal and will go away. Some women may feel nauseated. Taking a dose with food may help to lessen nausea. Vomiting is fairly uncommon with Plan Bª. If a woman vomits within one hour of taking Plan Bª, she must take a replacement dose. If she vomits more than an hour afterward, a replacement dose is not needed. Gravolª, a medicine that reduces nausea and vomiting, may be helpful. Other side effects of Plan Bª include cramps, tiredness, headache and breast tenderness.
Almost all women can safely take Plan Bª. It does not interact with most other medications. Women who take blood thinners or have diabetes may need to monitor their conditions more closely after taking Plan Bª. A woman who is breastfeeding can take Plan Bª without risk of harm to her infant. Usually, even women who have medical conditions like liver disease or cancer can safely take the emergency contraceptive pill. In all of these instances, it would be a good idea for the woman to talk to her doctor about taking Plan Bª.
Your pharmacist is a great person to talk to if you think you need emergency contraception. Discussions are always private and confidential. Your pharmacist can also give you information about different birth control methods or refer you to a local birth control clinic. Sometimes situations may require a pharmacist to refer you to a doctor. If necessary, a pharmacist can provide you with a phone number for a sexual assault crisis center.
Your family doctor is a good source of information about emergency contraception and Plan Bª. More information about birth control and other sexual health topics can be found at www.sexualityandu.ca.