EC - The Best Kept Secret
  by Lenox Powell

What is considered to be the best kept secret in reproductive health care? Don't know? It's time to let the "secret" out so that women, and men, can be better informed. The secret is "EC" and stands for Emergency Contraception. It was once known as "the morning after pill." However, emergency contraception can actually be taken up to 120 hours (5 days) after unprotected intercourse. Despite its enormous potential to reduce unplanned pregnancies, anti-choice groups, whose goal it is to eliminate abortion, oppose its use, falsely claiming that it is an abortifacient. In fact, EC, if widely available would reduce the rate of abortion in our country by fifty percent.

If you are a fan of the show Felicity, you may have seen the episode where the character Julie is a survivor of date rape. After her consultation with a nurse she is given two pills, one of which she takes 12 hours after the first pill. This, unbeknownst to most people, is EC. Women who have been sexually assaulted have a particularly compelling need for quick and easy access to EC. Approximately 700,000 women are raped each year in the United States, and about 32,000 will become pregnant as a result (Holmes, et al., 1996). Alarmingly, there is mounting evidence that some hospitals, especially religiously affiliated hospitals, are not providing EC to sexual assault survivors. This practice is counter to the standards outlined by the American Medical Association, which state that women who have been sexually abused should be counseled about the risk of pregnancy, and offered EC (AMA, 1995).

Emergency contraception pills (ECPs) - the most common method of EC - contain hormones (progestin) that reduce the risk of pregnancy when taken in two doses, 12 hours apart, after unprotected intercourse. The sooner the medication is taken, the more effective the treatment. ECPs are safe and effective at reducing the risk of pregnancy. ECPs have been found to be 75%- 99% effective depending on method, where the woman is in her period cycle and length of time after the unprotected sex.

ECPs should not be confused with mifepristone, a medicine used for medical abortion (commonly known as RU-486 in Europe). ECPs will not induce an abortion in a woman who is already pregnant, nor will they affect the developing pre-embryo or embryo. Emergency contraception prevents pregnancy by inhibiting ovulation, preventing the egg and sperm from meeting, or by preventing implantation into the uterus. Again, its effectiveness and function depend on where a woman is in her cycle.

Despite its long history of safety and efficacy, knowledge about EC is woefully limited among the general public. Nine out of 10 American women do not know enough about EC to effectively use it - unless hospitals advise women who are brought to the emergency room following sexual assault about EC, women will be unlikely to know enough to ask for this vital treatment.

So remember, if you, your partner, or someone you know has sex without using protection, if the condom breaks, or if sexual assault is a factor, Emergency Contraception is here and has been here for a very long time. Now, the "secret" is out, so spread the word!

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