Tag Archives: Next Choice

Five Things to Know About the Morning-After Pill on Its 20th Anniversary

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Medication portion of PREVEN Emergency Contraceptive Kit. Photo: Smithsonian Institution

In 1993, the New York Times Magazine posited that the morning-after pill might be “the best-kept contraceptive secret in America.” Even many doctors had no idea there was a fallback contraceptive that could be used shortly after unprotected sex or cases of rape.

In many ways, the morning-after pill had been right in front of U.S. doctors for decades. In terms of chemical composition, it was not much different from standard birth control, using the same main ingredients — synthetic hormones — in higher doses. Moreover, many of their colleagues in Europe and Asia had already been prescribing morning-after pills for years.

In 1998, years of research and advocacy led to the first FDA-approved morning-after pill.

Here, however, the secret was still largely intact. A 1994 study by the Kaiser Family Foundation revealed that two-thirds of American women had never heard of the morning-after pill or other forms of emergency contraception (EC). Less than 1 percent had ever used them.

There was an information shortfall in large part because there was no contraceptive that was approved by the U.S. Food and Drug Administration (FDA) specifically for emergency use. Some providers worked around that absence by using the chemically similar estrogen and progestin medications that were approved for regular birth control. By upping the dosage, they created a suitable morning-after pill on their own. But drug makers couldn’t label or market those birth-control pills for emergency, post-coital use, since they weren’t FDA-approved for that purpose. It also spelled problems for federally funded clinics. Federal dollars couldn’t pay for an off-label medication hack, a makeshift morning-after pill that wasn’t officially approved. Continue reading →

No, the Morning-After Pill Is Not the Abortion Pill

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The other week, I was talking to a family member about the threats to contraception access in this country, “thanks” to our new president and his fanatical administration. He thought it was ridiculous that abortion opponents also fight tooth and nail to put obstacles in front of birth control — after all, reliable contraception prevents unintended pregnancies, which itself prevents untold abortions. It seems like a win-win for everyone, regardless of where their opinion on abortion falls.

The morning-after pill prevents pregnancy. The abortion pill ends pregnancy.

Then he said, “Of course, I understand them not wanting tax dollars going toward the morning-after pill, since that causes abortion.”

I had to stop him right there: “Nope.” A bit self-conscious of appearing to be a persnickety know-it-all, I summarized the vast differences between the morning-after pill and the abortion pill — differences that many people, even full supporters of reproductive rights, don’t understand. Opponents of abortion and contraception exploit this misunderstanding, pretending these two pills are one and the same, hoping to elicit “compromise” from “reasonable” people. Compromises that harm real people with real lives and real families. Just as women’s health opponents have been so successful at chipping away at abortion access, so too do they hope to erode access to contraception.

The morning-after pill and the abortion pill are completely different medications, used for different purposes and made up of different ingredients. Let’s look at a quick rundown of the two. Continue reading →

Contraception Then and Now

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When it comes to contraception, one thing is for sure: We’ve come a long way! And while the future might have even better things in store, like reversible male birth control, superior condoms, or remote-controlled implants, a look into the past reveals that modern contraceptors have a bevy of fantastic options to choose from. Unlike couples who had to forgo contraception or obtain birth control from the black market, nowadays Americans wishing to prevent or postpone pregnancy can select from a variety of legal, effective, and increasingly accessible family-planning methods.

While the history of birth control is fascinating, today’s contraception is the very best.

Let’s look at some old-fashioned birth-control methods and see how they stack up to their modern-day counterparts.

Linen and Guts vs. Latex and Polyurethane Condoms

Most people think of female condoms as new inventions, but the first condom recorded in history was made out of a goat’s bladder and inserted into the vagina — way back in 3000 BC. Ancient civilizations, from the Romans to the Egyptians to the Japanese, made penile sheaths and caps with a variety of materials, including linen, leather, lubricated silk paper, intestines, and tortoise shells. Linen and intestines remained popular through the Renaissance era.

A condom, with user manual, 1813. Photo: Matthias Kabel

Charles Goodyear might be most famous for tires, but his discoveries in vulcanizing rubber also led to the development of rubber condoms in the mid-1800s. Unfortunately, the Comstock Act of 1873 outlawed the manufacture and sale of contraception, and condoms were driven into a shadow economy. In the 1880s, New Yorkers might have been lucky to find black-market condoms made from surplus animal intestines, which were manufactured by Julius Schmid, a German immigrant who otherwise specialized in sausage casings — before his business was shut down by the New York Society for the Suppression of Vice. Condoms weren’t legal in the United States until the Crane ruling of 1918, just in time for the 1920 invention of latex, a form of rubber that was much stronger and more elastic — and with a shelf life of five years vs. rubber’s three months. By the 1920s, Schmid was once again on top of the condom game, peddling brands like Sheik, Ramses, and Sphinx.

Condoms made out of intestines are still on the market, sold as lambskin or “natural” condoms. However, they are not recommended for STD protection: Just as intestines need to allow nutrients to enter the body from digesting food, so too are viruses able to pass through condoms made from intestines. (Sperm, on the other hand, are thought to be too big.) These days, latex is the gold-standard material for condoms, while polyurethane can be used by people with latex allergies. Condoms constructed with these modern materials protect users from unintended pregnancy as well as many sexually transmitted infections, such as HIV and chlamydia. Continue reading →

Let’s Talk Contraception: Dispelling Myths About Emergency Contraception

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EmergencyContraceptionSince 1998, when the Food and Drug Administration first approved the morning-after pill, there have been controversies about its sale and use. Initially, age restrictions were enforced to regulate its sale, and some hospitals and pharmacies refused to provide it to their patients. After considerable pressure from public and medical groups, emergency contraception (EC) is available for sale to anyone at their local pharmacy, with the exception of ella and the copper IUD, both of which require prescriptions.

Emergency contraception is widely available, easy to use, and safe!

And yet, after almost 20 years of remarkably safe use, there are still myths regarding its safety, actions and use. Let’s look at some of those myths right now!

First, there are misunderstandings regarding EC’s availability:

Myth: EC is hard to get and you need a prescription.

Since 2013, most ECs are available to buy in pharmacies over the counter to anyone, regardless of age or gender. There are two exceptions: If you need ella, another morning-after pill, you do need a prescription, and the copper IUD requires placement by a health care provider.

Myth: There is only one type of EC available.

There are several different pills available, such as Plan B One-Step or generic equivalents. These all contain levonorgestrol, a progesterone hormone that is also in many other contraceptives. Ella contains ulipristal acetate and works effectively and evenly up to five days after unprotected sex. Ella is dispensed with a prescription. The copper IUD also needs a prescription but is the most effective EC when placed within five days of unprotected sex. It is recommended for obese women or women who have had several episodes of unprotected sex, and its contraceptive effect lasts 10 years. Continue reading →

Contraception in the Zombie Apocalypse

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The zombie hoard approaches. Photo: Caio Schiavo

The zombie horde approaches. Photo: Caio Schiavo

If you’ve watched a zombie movie with your friends, you’ve probably talked about what kinds of weapons you’d be packing in case of a zombie apocalypse. The Centers for Disease Control and Prevention even has a list of supplies you’ll need for a zombie preparedness kit, which includes smart choices like water, duct tape, and bleach. (I would add toilet paper to that list. How you’ll miss it when you’re on the run!) But how many of you have discussed birth control?

You’ve probably picked out which weapons to use during the zombie apocalypse. But have you chosen a birth control method?

Even if your greatest dream is to have a baby, you must admit that the zombie apocalypse is the worst time to be pregnant, give birth, and raise a child. Fleeing and hand-to-hand combat can be a drag while pregnant, and childbirth can kill you, especially without access to trained personnel or hygienic supplies. And if you do manage to birth a baby into this cruel new world, diapers can distract from more pressing duties, and the infant’s cries can attract undead attention.

When you’re in hardcore fight-or-flight mode, taking a pill at the same time every day might be difficult, and besides, a supply of pills can take up valuable backpack real estate. Plus, even if you find an abandoned pharmacy to raid, birth control pills and condoms come with expiration dates and can be affected by high temperatures. The same goes for contraceptive patches and rings. For these reasons, you need a contraceptive method that’s well suited to the zombie apocalypse. Besides abstinence, what are your options? Continue reading →

Let’s Talk Contraception: Emergency Contraception

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The Centers for Disease Control and Prevention (CDC) recently reported that 1 in 9 American women — 11 percent — has used the “morning-after pill.” This means that in the United States, 5.8 million sexually active women between the ages of 15 and 44 have used emergency contraception, an increase in use of 4.2 percent from 2002. Most women say their reasons for using emergency contraception are because they engaged in unprotected sex or feared that their method of contraception failed.

The best way to prevent pregnancy is reliable birth control. But sometimes we need a back-up method.

It has also been reported that half of all pregnancies in the United States are unintended. For that reason, the availability of a range of contraceptive options is very important. Emergency contraception is the last choice for a woman to decrease her chance of becoming pregnant after unprotected sex. There are several products available for emergency contraception in the United States. There are many options, and they include:

  • regular birth control pills in specific doses
  • PlanB One-step
  • Next Choice
  • ella
  • copper IUD or intrauterine device (Paragard)

The Yuzpe regimen, which used ordinary birth control pills in specific combinations, was named after a Canadian physician who developed the method in the 1970s. Several brands of birth control pills are approved for this use to prevent pregnancy. This method uses the combined estrogen and progesterone hormones in your regular birth control pills in certain prescribed combinations.

Research showed the progesterone component of contraceptive pills was most effective at preventing pregnancy, so Plan B was developed as a two-pill regimen of levonorgestrel (a type of progesterone). When Plan B was first released, it consisted of one pill taken as soon as possible and another taken 12 hours later. Plan B One-Step, the newest version of Plan B, now has the same dosage of levonorgestrel in just one pill. It should be taken as soon as possible after unprotected sex. This one-dose regimen has been shown to be more effective with fewer side effects. Continue reading →