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A 2022 UN report states that India accounts for more than one in seven unintended pregnancies globally. Another report by a global research agency, Guttmacher, shows roughly 121 million unintended pregnancies occurred each year between 2015 and 2019. Now imagine the plight of the women who go through the trauma of unwanted pregnancies or abortions that emotionally and physically drain a woman’s body. There are ways to avoid pregnancy by using the right means, but mistakes do happen. Now one of the first things that a woman knows should be done is to take a contraceptive pill as soon as possible after unprotected sex to reduce the risk of unwanted pregnancy. But what if you miss the deadline?
How do emergency contraceptive pills work?
First let’s understand how emergency contraceptive pills work. According toDr Jyoti Sharma, Consultant – Obstetrics And Gynaecology, Manipal Hospital, Gurugram, “It is important to take a contraceptive pill if someone doesn’t want to get pregnant and yet engages in unprotected sex. ECPs, or ‘morning-after pills’, work best when taken within 24 hours; they can still be useful if taken within 72 hours (about 3 days).” In India, two different kinds of tablets are available: one that includes ulipristal acetate and the other that contains levonorgestrel. Pharmacies have pills, which come under levonorgestrel pills that are readily available. For the best results, they should be consumed within 72 hours. For ulipristal acetate pills, a prescription is needed, and it is more effective and can be taken in 120 hours. “Please note that ECPs should not be used on a regular basis and cannot protect you against STDs.”
Dr. Arwa Mohsin E., Senior Consultant Obstetrician & Gynecologist, Fortis Hospital, Richmond Road, Bangalore further adds, “Usage of Levonorgestrel, an over-the-counter pill is best within 72 hours of unprotected intercourse and Ullipristal Acetate a prescription medication can be used up to 120 hours or five days of unprotected intercourse, amongst the medications available. Yuzpe regime of oral contraceptive pills (E.Estradiol & LNG) also is best consumed early.” Talking about how they work, Dr Jyoti adds, contraceptive pills, also referred to as birth control pills, primarily prevent ovulation. Sperm cannot fertilize in the absence of eggs, thus preventing pregnancy. These pills also thicken the mucus in the cervix, making it hard for the sperm to enter the uterus. It has no major side effects and is usually well tolerated. Some common side effects are headache, lower abdominal pain, nausea, fatigue, dizziness, breast pain, vomiting, menstrual changes.”
But what if one misses taking the dose on time?
Over-the-counter pill is best taken within 72 hours but the same drug can be taken but has reduced efficiency up to 5 days. Drugs that act up to 5 days or 120 hours is Ullipristal Acetate. A Copper Intrauterine Device or a LNG -Intrauterine Device are very good options if one has missed the time of 5 days and the pregnancy test is negative as they can still be used. Added advantage is the continuity in contraception benefit that these two methods provide. Beyond this, one must wait for the next menstrual cycle and if missed do a urine pregnancy test. Accordingly, one may go for abortive measures, if pregnant, Dr Arwa explains.
Contraceptive pills are not foolproof
Raising alarm on the misuse of such tablets, Dr Arwa adds, “A misconception is that emergency contraceptive pills are 100% effective, but it is not so. Pregnancy risk after emergency contraceptive pills varies from 0.1% to 2.6%. Often married couples rely on emergency contraceptive pill for contraception which is an unhealthy trend as it also affects the cycle regularity.”
It is important to consult a doctor before starting any contraceptive pill to see if it’s the right method for you. Routine check-ups help in managing any side effects.
Difference between combination pills and progestin-only pills
There are two main types of contraceptive pills: combination pills and progestin-only pills. On one hand, combination pills are commonly used and are taken in a 21-day cycle, whereas progestin-only pills can be taken continuously.
While contraceptive pills are highly effective when taken properly, they also have some side effects like tenderness of the breast, nausea, and spotting. Some women also experience mood swings and headaches. Some more serious side effects include blood clots and heart attacks, especially in women who smoke or have a history of hypertension or cardiac conditions.
It is important to consult a doctor before starting any contraceptive pill to see if it’s the right method for you. Routine check-ups help in managing any side effects.
What if one misses the correct timing of the dosage? What should be one’s next step to prevent an unwanted pregnancy?
These are the steps that you should take if you skipped the contraceptive pill:
Combination Pills
1. Missed One Pill:
Take the forgotten tablet as soon as you remember.
Follow the rest of the of the instructions to complete the course.
2. Missed Two or More Pills:
Take the most recent pill as soon as you remember.
Take the remainder as prescribed.
For the next 7 days, take extra contraception.
Progestin-Only Pills (Mini-Pills):
1. Missed by More Than Three Hours:
Take it as soon as you recall.
Take the rest as normal.
For the next 48 hours, use additional contraception.
It’simportant to seek medical advice
If you have forgotten to consume pills, consider other options with your doctor. Moreover, options like an intrauterine device contraceptive implant or injections might be more suitable to provide long-term protection.