The Morning After Pill: What You Should Know Now

Seeds of Peace Participants

There's a new set of pills on the market that could prevent you from getting pregnant, after you've had sex. Never heard of them? Join the club....most women haven't.
Since the mid-sixties, doctors have been using high doses of hormones to prevent women from getting pregnant after unprotected sex. My friend Stacie, who worried for about a week after a condom broke in the middle of sex, could have gone to the local clinic and taken five pink pills that would've prevented her from getting pregnant. But like millions of other women in the United States, she didn't know about Emergency Contraception (EC) -- also known as the Morning After Pill.
The Morning After Pill is a misnomer -- EC is usually more than one pill, and you can take them up to three days after having sex. EC works the same way that birth control pills do - by temporarily disrupting the normal hormone patterns that are necessary for pregnancy to begin. They are a high dose of progesterone and/or estrogen, about the same amount as five days worth of birth control pills. The problem is that many women still don't know what EC is, much less that it is easily available at most clinics and doctor's offices. "There's a lot of ignorance about EC," Anna Mautz of the California Abortion and Reproductive Rights Action League (CARAL) explains. "A recent study found that 89% of women don't know enough about EC to use it properly."
Many people confuse EC with Mifepristone (also known as RU-486 or the French abortion pill) even though their effects are very different. RU-486 ends a pregnancy that has already started; EC prevents a pregnancy from happening in the first place. Even the press confuses EC and RU-486 -- but EC won't even work if you're pregnant.
Teens who have been through sex education in school are starting to learn about EC, but are often still confused about it. That's dangerous, because EC needs to be used within 72 hours of having unprotected sex to prevent pregnancy. I talked to two youth counselors about EC. Grace Kim works at Planned Parenthood and Jenny Manriquez works at New Generation Health Center. Both clinics are located in San Francisco. While Kim said that most teenagers who attend her reproductive workshop knew about EC, they don't often know that it can be used up to three days after having unprotected sex.
Many people confuse EC with Mifepristone (also known as RU-486 or the French abortion pill) even though their effects are very different. RU-486 ends a pregnancy that has already started; EC prevents a pregnancy from happening in the first place.
Manriquez, who works with seventh and eighth graders, said, "not even half of them know about EC. They might have heard of a pill so you won't get pregnant...but they are scared, they confuse it with the abortion pill. They're like, 'How's this pill gonna work?' and they won't believe that their parents won't find out."
Both Kim and Manriquez say that fears about confidentiality are a major factor keeping young people, especially young women, away from health clinics and access to EC. As Kim said, "Even though our youth clinics are completely confidential, some young women feel like having their parents find out is a bigger risk than getting pregnant."
Kim says that women who have support from their parents about having sex
feel comfortable seeking out health care and family planning services for
themselves. Mautz, of CARAL, says that women don't use EC for the same reasons they don't use birth control in the first place. "Young women are the least likely of any age group to use birth control. Sex can be stressful or scary as well as fun, and that makes it easy for young people to simply put off thinking about it," she points out.
"People think, "It'll never happen to me. They don't pay any attention to it until they need it, and then it's too late."
This is where EC comes in. While some conservative groups have worried that EC will encourage young people to be less responsible about sex and pregnancy, the women I talked to believed that EC empowers young women to fight denial around safe sex and pregnancy. Mautz cited three studies showing that there was no evidence of increased unprotected sex among women who use EC. "The only difference they found was that women who had access to EC were more likely to use condoms than birth control pills, which helps protect them from STDs."
When we're young, we're anxious about admitting the emotional and physical risks around sex, and that denial makes us less likely to take care of ourselves. According to both youth counselors, young people are likely to use "pseudo-birth control" methods, or the kind you don't need to go to a clinic to practice.  Manriquez said that many couples used the "pull out" method to try to keep themselves from getting pregnant. Kim said that some girls would use a calendar to follow their menstrual cycle and prevent pregnancy. But neither methods protect against STDs and both are much less reliable than birth control pills and condoms.
Taking EC means taking some very active steps to take care of yourself, and that can inspire some girls to change their overall habits. Instead of just passively waiting for your  period to come, it involves taking a proactive step  -- especially if you are already in a clinic to get it. Mautz says, "EC gives young women another tool to be responsible...It helps young women take control of their reproductive choices."
While some conservative groups have worried that EC will encourage young people to be less responsible about sex and pregnancy, the women I talked to believed that EC empowers young women to fight denial around safe sex and pregnancy.

What's more, Grace Kim pointed out that women who go through the stress of waiting for their periods and the paranoia of a pregnancy test only to find out they are not pregnant can sometimes get the sense that they are immune. "They think, 'I got lucky, it must be OK' (to have unprotected sex)."
Plus there's the fact that most women experience nausea after taking EC, making a strong, memorable impression. "Its not something you'd want to use for regular birth control," says Kim, "it does make you feel sick." Some doctors prescribe Dramamine to combat the nausea, but either way it's a powerful memory. Kim points out that EC can also be a very important tool for one particular group of women: "EC is especially empowering for women who have been victims of acts of violence, like rape. It gives them back control."
So how can you get EC? At this point you still need a prescription. Anna Mautz recommends that women ask their doctors for an advance prescription for EC, so they can have it on hand if it becomes necessary. Many doctors are happy to do this. The advanced prescription is useful because EC is most effective 24 hours after sex, and sometimes getting to a doctor within that time frame is not possible.
There is also a new law in California that allows pharmacists to dispense EC over the counter if they have a relationship with a provider of OB/GYN care. Most clinics also have EC on hand (check out www.choice.org to find clinics in California) -- but you may have to ask for the "morning after pill."
"The biggest barrier between women and EC is ignorance," Mautz said in conclusion. "Many receptionists at doctor's offices don't even know the proper name and will only understand 'morning after pill.'"
So how to get the word out? "Tell your friends, and tell your doctors," says Mautz. "Sometimes it's up to us women to educate our providers and friends about our own health care."
For more details on how EC works, download an EC guide on Choice.org.



Abigail Machson Carter Abby Machson-Carter is a college runaway, spending a semester in San Francisco to try to learn about the natives. She works for the American Friends Service Committee and the California Abortion and Reproductive Rights Action League trying to help save the world. She is a freelance writer for Wiretap Magazine.

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