Morning-after mantra

All you wanted to know about the emergency contraceptive pill now available over the counter

It’s the reassuring answer to the panic that sets in after a night of unbridled passion. And it’s available over the counter. But i-pill, the first single-pill emergency contraception to be marketed in India, has triggered interest as well as a flurry of questions. How safe is it? How does it work? What are the consequences of its misuse? We spoke to a few doctors to help you make an informed choice the morning after.

If taken within 72 hours of unprotected sex, it averts pregnancy. “An i-pill tablet can work in any of three different ways depending on where you may be in your menstrual cycle: It may stop an egg being released from the ovary; if an egg has been released, i-pill may prevent the sperm from fertilising it or if the egg is already fertilized, it may prevent it from attaching itself to the lining of the womb,” explains Dr Sujata Dalvi, consultant obstetrician and gynaecologist, St Elizabeth Hospital, Mumbai.

Is it the same as an abortion pill? No. An abortion pill works in two stages after a woman has conceived and the fertilized egg attaches itself to the womb. “An abortion pill first detaches the egg and then removes it. I-pill simply does not let the egg fertilise and is ineffective if the pregnancy is established,” says Dr Dalvi.

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No, it’s not a “no side-effect pill”. Nausea, vomiting, lower abdominal pain, a feeling of breast tenderness and headache are some common side-effects and they persist for a day or two. It could also lead to unexpected vaginal bleeding but this is not dangerous and should clear up by the time of the next period. i-pill might also cause the next period to come early or later than normal, say the product literature. “However, if the periods are delayed by more than a week, go in for a pregnancy test. Moreover, if the pregnancy persists even after consumption of i-pill, it is best to go in for an abortion. There are chances that the pill may adversely affect the overall growth of the fetus,” warns Dr Dalvi.
But don’t get tempted into popping the pill all too often. It’s not an alternative to regular contraception. Doctors say it should be used rarely.

“This pill contains levonorgestrel, a synthetic progestogen used as an active ingredient in some hormonal contraceptives, and should be used in emergencies. Repetitive use of such formulations can not only lead to excessive vomiting, nausea and irregular periods in the initial stages but can even lead to ovary dysfunction in the long run,” says Dr Rinku Sengupta Dhar, consultant obstetrician and gynaecologist at the Sitaram Bhartia Institute of Science and Research, Delhi.

In a country where about 78 per cent pregnancies are unplanned, 25 per cent unwanted and almost five million unsafe abortions carried out every year, the morning-after pill is an important tool for women to take control of their lives. But bottomline: don’t make it a habit.