Sometimes sex can happen so quickly that everything seems blurred in a haze of excitement. Sometimes when you're caught up in the moment, a condom slips off or breaks, the Pill is forgotten, or no protection is used at all. Rather than forget about it, a guy and girl suddenly panic, wondering if there is anything they can do to prevent unplanned pregnancy after sex?

Yes, and the answer lies in emergency contraception.


Know Your EC
Emergency contraception (EC)-a.k.a. the "morning-after" pill-is a pregnancy-prevention method that young women can take after unprotected intercourse. If there is an accident with contraception, if a contraceptive method is skipped, or if a woman is the victim of sexual assault, she can take EC within three days (72 hours) of unprotected intercourse to prevent pregnancy. The sooner she takes EC, the more effective it is.

EC comes in the form of emergency contraceptive pills (ECPs). There are two types of ECPs; one uses estrogen and progestin and is sold under the brand name Preven while the other type is progestin-only, and sold under the brand name Plan B.

Preven is 75-percent effective and Plan B is up to 89-percent effective at preventing pregnancy, according to Not-2-Late.com, the Emergency Contraception Web site run by the Office of Population Research at Princeton University and the Association of Reproductive Health Professionals. Plan B causes fewer side effects (like nausea and vomiting) than Preven, so it's generally the preferred method.

"ECPs work better the sooner they are taken. They are back-up protection and should not be used for regular contraception," says Dr. James Trussell, director of the Office of Population Research and creator of Not-2-Late.

Emergency contraception prevents pregnancy mainly by preventing or delaying ovulation or, in some cases, preventing a fertilized egg from implanting in the uterus. But EC will not affect a pregnancy if it's already implanted in the uterus, so it is not the abortion pill (RU-486). It is intended for emergencies. It is not a regular method of birth control and does not protect against sexually transmitted diseases (STDs).


Getting EC
A pivotal issue about EC is access: Right now, women need a prescription to get EC in all but five states (Alaska, California, Hawaii, New Mexico, and Washington). In these states, women can get EC directly from some pharmacists, thereby eliminating the delay in having to see a doctor or health care provider first for a prescription.

New recommendations from two U.S. Food and Drug Administration (FDA) panels may result in expanded access for all women. On December 16, these panels recommended that Plan B be made available to women over-the-counter (without a prescription). The FDA commissioner is expected to accept the recommendations, making EC available to young women across the U.S. over-the-counter in the near future.

This potential change in young women's access to EC is groundbreaking news for many EC advocates, including Jane Boggess, Ph.D., director of the Pharmacy Access Partnership, which works to improve women's access to EC.

"While it is ideal that young people postpone sexual activity as long as possible, the reality is that many young people are sexually active. Because of their high rate of condom use, and the prevalence of rape, it is important they know about emergency contraception and how to get it in a timely way," says Dr. Boggess. "Providing better access to EC would give young women a second chance to prevent unplanned pregnancy."

Many young women agree, including Michelle, from Aloha, OR, who learned about EC while researching contraception online and who understood the benefits of EC use after a friend took it.

"With EC, young women will have a safety net when there wasn't one before. If they have greater access to EC, it won't matter where they are-they'll be able to walk into a drug store at 2 a.m. and prevent an unplanned pregnancy," says Michelle. "They won't have to worry about making an appointment, missing school or work, finding a doctor, or having to make tough choices later on about an unplanned pregnancy."


Acting Quickly
Lieschen, from Boulder, CO, is one young woman who avoided such a tough choice by taking EC after a condom mishap.

"I used EC after a condom slipped off my partner and stayed inside me," says Lieschen, who had learned about EC at school.

Right away, she "got EC from my town's local teen clinic, where everything is done on a sliding scale, so I wouldn't have to worry about affording it."

The average cost for EC is $20-25, according to Not-2-Late, and the average cost of a clinic visit is $30-35. But most Planned Parenthood and other family-planning clinics have "sliding-scale" fees that help young people, like Lieschen, afford EC and other contraception.

"It was definitely worth it," says Lieschen. "EC takes away the wonder of, 'Am I pregnant or not?'"


Reducing Statistics
EC can do more than take away the wonder: recent research by the Alan Guttmacher Institute shows that EC "averted over 100,000 unintended pregnancies in 2000, including an estimated 51,000 abortions."

Other proponents of greater access to EC include Dr. James Trussell, who served on one of the FDA panels. He says over-the-counter access for young women is important since the pills are more effective the sooner after unprotected sex they are taken.

"Having first to see a doctor guarantees that women will have to delay taking the pills, especially when unprotected sex occurs on weekends or holidays, thereby reducing effectiveness," he says.

Dr. Trussell adds that "making ECPs available over-the-counter is a powerful signal to women that they are safe."

Boggess views greater access to EC as a youth-rights issue.

"As a youth in the health-care system, you have a right to get accurate information about birth control, including EC; get confidential family-planning services, including EC; and know where and how to get it, whether from a pharmacist, doctor or clinic."


Staying Connected
For more on EC, check out Contraception 911.
And,
read up on the Back Up Your Birth Control campaign.


- Danny Mitarotondo, 17, of Bridgewater, NJ, is an editor for SEX, ETC., the national newsletter and Web site written by teens, for teens, on sexual health issues, published by the Network for Family Life Education at Rutgers, The State University of New Jersey.

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