As a young woman with the goal of one day having kids, I try to be as conscious and literate about my body as possible.
With that in mind, I’ve written a lot about contraception and why being aware of its effects is important information we should all have. Every woman’s body is obviously different, which is why having all the information possible to make informed decisions is the best way to start our body literacy journey.
In all discussions about contraception though, we have to acknowledge that there’s a dominant narrative at play — one that appeals to our culture perhaps more than what we’re really searching for. A large part of that conversation, which for some reason isn’t as widely discussed as it should be, is what happens when contraception isn’t used or fails.
The supposed answer to this is what’s commonly known as the morning after pill (read: the morning after unprotected sex) and is meant to prevent pregnancy. There seems to be a lot we don’t know, but the information is out there. Here’s what it says.
The Vagueness around the Morning After Pill
The colloquially-acknowledged morning after pill is more clinically known as emergency contraception, and it was approved by the Food and Drug Administration in 1998. A federal study in 2013 found that even as the use of more mainstream contraceptive methods like implants and IUDs was increasing, an estimated 5.8 million women in America, aged 15 to 44, had used emergency contraception.
Though that number of women fell between that wide age range, emergency contraception is most commonly used by women ages 20-24, and by women who are white or Hispanic and college-educated. In the years since that study was conducted, we have to realize those numbers could have changed, but it still provides a keen insight into the explosion of the morning after pill’s use within the last decade since it was first approved by the FDA.
An estimated 5.8 million women in America, aged 15 to 44, have used emergency contraception.
The morning after pill (commonly referred to as MAP) is just that — meant for one instance, and not meant to be used as prescribed contraception and taken regularly. In fact, there are deleterious effects for those who do use the morning after pill as their own personal form of contraception. According to the WHO, these effects include weight gain, gallbladder complications, increased risk of ectopic pregnancy, high blood pressure, and ovarian cyst enlargement, to name a few.
The Population Research Institute (PRI) theorizes that because many brands of emergency contraception are available, oftentimes without a prescription, and found easily in most drug stores, it’s more common to overdose or misuse MAP. The PRI also surmises that it’s difficult to grasp how many women have used MAP on a global scale.
Here’s What the Morning After Pill Actually Does
Emergency contraception is used assuming that other contraceptive methods, such as condoms or withdrawal, have failed. At the apparently frightening risk of becoming pregnant, we’re encouraged to be quick to buy the morning after pill assuming it’ll work effectively without any real knowledge of what’s in it and how it works.
Emergency contraception essentially is comprised of the active ingredient levonorgestrel, a hormone which prevents the fertilization of an egg by the sperm, which then prevents the development of an embryo, and thereby prevents pregnancy after unprotected sex. The hormone, which belongs to the group of hormones we know as progestins, is most effective when taken within 72 hours of unprotected intercourse, as many brands will indicate. Common side effects of MAPs include nausea, fatigue, breast tenderness, and headache. If those symptoms develop into light or heavy bleeding, cramps, pelvic pain, or absent menstruation, a medical professional should be consulted.
The active ingredient levonorgestrel prevents the fertilization of an egg by the sperm.
There’s much discourse on whether or not emergency contraception should be considered abortifacients, which cause the spontaneous abortion of an already implanted embryo after fertilization has occurred. Proponents of emergency contraception have called this concern a “religious liberty myth,” but these concerns, whether they’re related to religion or not, are valid in some instances. (Additionally, why we continue to politicize open conversations on reproductive health and the agendas which continue to harm women is equally alarming.)
Though we absolutely should not confuse levonorgestrel with mifepristone, the ingredient in the abortion pill, the FDA found during trials for the morning after pill Ella that Ella (when taken specifically before or during ovulation) did allow eggs to be fertilized in some instances, thus creating an embryo, and then destroying the embryo thereafter. This likely didn’t stop its approval by the FDA due to our society’s obvious inability to clearly and distinctly agree on semantic terms used in this kind of discourse like fetus, embryo, etc. Interestingly enough, Ella requires a prescription from a doctor while many other MAPs don’t. Also, Ella can be taken five days after unprotected sex, which is a much wider window than the normal 72 hour one.
Actions Have Consequences...Surprising, Right?
No women should be denigrated for an action made in fear and without all of the information available given to them. For so many of us, whether we’re too young or not where we want to be financially, an unplanned pregnancy is the hardest and scariest thing we can face.
But at times, we also seem to tap dance around these kinds of hard truths, which is a missing facet of the modern reproductive health debate and monumental in its importance. That truth, however simplistic it sounds, seems to be widely disputed, but nevertheless it’s this: sex can in fact lead to pregnancy. However, the availability and normalization of contraception has persuaded us otherwise, so we turn a blind eye to it, thereby putting ourselves at a huge disadvantage when instances like unprotected sex and unplanned pregnancy crop up.
Sex can in fact lead to pregnancy.
It’s natural and instinctive to make decisions grounded in our response to fear and the unknown. But before we do, acknowledging the original purpose of sex (which has now evolved into something else entirely) gives us a sense of the gravity of the decisions we make, especially when it comes to who we make them with.
Millions of women are using emergency contraception. Many of them are college-aged and in their early twenties. They’re likely not ready for pregnancy and kids, and likely not ready to commit to the kind of responsibility that co-parenting inevitably brings with their sexual partners.
It’s natural to be afraid. Uncertainty and the way it can grip us is one of the most crippling things we can experience. Sex is a mature decision, one that can leave us with its consequences long after a one night decision. Recognizing and facing that pregnancy may be one of those consequences is a level of maturity that continues to be missing from our decision on who to sleep with, if at all.
This is exactly why it’s never been more important to be body literate when it comes to contraception. Knowing our bodies and how each decision could affect us, whether in the short or long run, gives us an invaluable sense of security when it comes to making these decisions.
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