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Post-coital Contraception
A woman who does not want a child, but has engaged in coitus without using any contraceptive method, or who knows that her method has failed, can still use “post-coital contraception”. This means either the prompt insertion of a copper-releasing IUD or taking emergency contraception pills (ECPs), the so-called morning-after pills. Actually, this popular term is quite misleading, since the woman has about 5 days after coitus in which to act, i.e. more time than just a “morning after”. Nevertheless, the sooner she acts, the better. Especially in cases of rape or incest, this “emergency contraception” is the best way to avoid pregnancy and thus, perhaps later, an abortion. However, emergency contraception does not necessarily prevent an ectopic pregnancy.
The pills (high dosages of estrogen and/or progestin) are marketed under various brand names and must be taken within three to five days after coitus. They are taken in two doses, 12 hours apart. This will prevent any fertilized egg from being implanted in the uterine wall. The pills are available without prescription in a number of countries, but by no means in all. However, there is growing pressure from many sides to abolish the need for a prescription everywhere. Indeed, in the meantime, some women have used regular contraceptive pills for post-coital contraception. Depending on the particular brand, they swallowed 2-5 of these pills in a single first dose and, 12 hours later, again in a second dose. However, in cases like these, expert advice is necessary to determine exactly how many pills of which brand should be taken in each dose, otherwise they may not work and/or their side effects could be severe. Even where there are no medical objections, there may be very unpleasant temporary side effects, such as nausea and vomiting. In some cases, other after-effects have been reported. However, many women would rather endure those than the worry about an unwanted pregnancy. Still, it is obvious that neither these high-dosage pills nor emergency IUD insertions can be used as regular means of contraception. Besides, a frequent use of the pills will cause a woman’s menstrual periods to become irregular and unpredictable.
Effectiveness: fairly effective
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