The Morning After Pill

More than a year after its introduction into India as an over the counter (OTC) drug, the Emergency Contraceptive pill seems to have become quite popular. Marketed by atleast 2 pharmaceutical companies, namely Cipla (i-pill) and Mankind (Unwanted-72), awareness about their existence among women who can watch TV has become widespread. 

Emergency contraceptive pills (ECPs)—sometimes simply referred to as emergency contraceptives (ECs) or the "morning-after pill"—are drugs that act both to prevent ovulation or fertilization and possibly post-fertilization implantation of a embryo. Hence they are distinct from medical abortion methods that act after implantation. As its name implies, EC is intended for occasional use, when primary means of contraception fail. Since EC methods act before implantation, they are medically and legally considered forms of contraception.

ECPs contain the hormone levonorgestrel, a progestin, alone in a single dose of 1.5 mg (as in i-pill) or a high dose combination of estrogen and progestin that are contained in routine contraceptive pills. When taken within 72 hours of unprotected sex, the pill offers 89 per cent protection from an unwanted pregnancy. Its effectivity is better if taken early after the intercourse. It is available without a prescription at all chemist outlets. Some side effects do occur: although they are usually mild: around 50% of women experience nausea. Some vomit or may have mild abdominal pain, dizziness, mild swelling of breasts or irregularity in the next period. Patients witha rare disorder called porphyria,can experience serious side effects. The drug is contraindicated in women with thrombotic conditions, history of stroke, liver disease or breast cancer. The pill does not protect from HIV infection.
The reason for the pill’s popularity among women is the following statistics. Around 78 % of the prgnancies in India are unplanned. The woman is faced with the choice of continuing with the unwanted pregancy or to seek an abortion, facilities for which are not easily available everywhere. Apart from being expensive and risky even in the best of centers, preganant women land up getting 5 million unsafe abortions in India every year, many dieing of their consequences. The ECP taps into the need for emergency contraception in this scenario, as a safer, cheaper and more effective option. The pill provides the woman an opportunity to decide for herself on her reproductive life and physical and emotional consequences coming off her sexual act. It could be a great saviour for victims of rape, forced sex or contraceptive failure
Concerns have however been raised about promoting the “Pop-a-pill the morning after’ culture which could popularizing and encourage sexual promiscuity, risky sexual behaviour and adventurism especially among young women. These could help spread diseases like AIDS. Further, many women frequently resort to this pill as a substitute for planned long term contraception.In England, teenage school girls can freely ask for the pill by sms after an unprotected sexual intercourse. Many conservatives would argue that teaching responsible behaviour and traditional values to young girls would be more appropriate. The Vatican has discouraged the doling out of these pills in many parts of the world.
The pill, atleast for the present, seems to be here to stay, breathing a spirit of liberalization and control in women who feel better equipped to modify their destinies with it. The long term societal consequences of the pill will however become more clear with time.

 As published in HT City ( Hindustan Times)