Emergency contraception: a “fire extinguisher” for unintended pregnancies

The American College of Obstetricians and Gynecologists defines emergency contraception, also known as post-coital contraception and the “morning after pill,” as “a therapy for women who experience an act of unprotected sexual intercourse.” It has been estimated that post-coital contraception could reduce the number of unintended pregnancies by 2 million and the number of induced abortions by 1 million. Several methods of emergency contraception are widely accepted including an estrogen-progestin combination, progestin only, mifepristone (RU486), and the copper intrauterine device (IUD). The major side effects of post-coital contraception include nausea, vomiting, and menstrual cycle abnormalities. Currently, the biggest obstacles to post-coital contraception in the United States are limited experience among practitioners and lack of awareness and accessibility among patients. Analogous to a fire extinguisher in homes, emergency contraception requires immediate access for success. There is a nationwide campaign, supported by major national medical organizations, to increase physician acceptability and to make hormonal emergency contraception available over-the-counter, thereby increasing visibility and patient convenience. Until the availability improves, it is prudent for physicians to prescribe emergency contraception as well as provide prevention counseling during routine visits.