by Susan Yanow, LICSW and Amy Lucid, LICSW
As social workers, many of us see teenagers and women who are worried about becoming pregnant when they don’t want to be. When a client tells us that she has had recent unprotected sex or is a survivor of rape, we need to be familiar with the medical as well as the social and psychological resources that are available to these women.
One important medical resource is emergency contraception, commonly called "the morning after pill.” Emergency contraception (EC) can prevent unintended pregnancy up to 72 hours after a woman has had unprotected sex. Although for many years women on college campuses knew that certain combinations of birth control pills could be used as emergency contraception, there are now two new products on the market: Preven, a combination of estrogen and progesterone, and Plan B, a progesterone-only regimen, which make using emergency contraception easier for most women. Both are packaged as two pills; one dose is taken within 72 hours after unprotected intercourse, and a second dose 12 hours after the first dose. The pills are more effective the sooner they are taken after unprotected intercourse. If taken within 72 hours, emergency contraception reduces the risk of pregnancy by as much as 89%.
In most states, emergency contraception is available by prescription only (it is available over-the-counter in Washington state and some parts of California). However, many sexually active women may want to obtain and fill a prescription should they need to use either EC regimen. Many clinics provide emergency contraception, but it is available in only 50% of Massachusetts’ hospital emergency rooms. To find the nearest available EC provider, clients can call 1-888-NOT-2-LATE. The caller punches in her zip code and is given a list of all providers of EC in her area.
We have learned that almost all women can safely use EC, although the progesterone-only regimen is preferred for women who are breastfeeding or are unable to take estrogen. There are no long term or serious side effects from using EC. About 50% of women who take the combination estrogen-progesterone EC regimen experience nausea and 20% vomit. Many physicians include a prescription for anti-nausea medication along with EC. Other side effects of combination EC (Preven) include fatigue, headache, dizziness, and breast tenderness. Most women find that side effects from the progesterone-only EC regimen (Plan B) are minimal. However, few pharmacies carry Plan B at this time, so women usually have to purchase it directly from a clinic.
Social work staff in hospitals and health centers need to make sure that the physicians and nurses that we work with are knowledgeable about emergency contraception, and are willing to let women know about it and to prescribe it. Helping our clients prevent an unintended pregnancy can be a valuable part of supporting their right to self-determination.
Susan Yanow is the Director of the Abortion Access Project, based in Cambridge MA. Amy Lucid is the Manager of Counseling Services at Planned Parenthood League of Massachusetts.
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