Q: What does the morning-after pill do?
MARGARET POLANECZKY, MD: In a woman who has yet to ovulate, it prevents the egg from being released. Remember, sperm can live for a couple of days in the Fallopian tube. So if we can keep that egg from being released, we can prevent pregnancy. If ovulation and fertilization have occurred, it may prevent the egg from implanting.
Q: What is in the morning-after pill?
MARGARET POLANECZKY, MD: The morning-after pill consists of high doses of estrogen and progesterone together in various combinations-basically, two doses, twelve hours apart. Up until now, we've been having patients use their birth control pills to the same effect. But now, manufacturers put it into a small package, along with a pregnancy test and instructions, so it's easier to use.
Q: Why do you have to take the morning-after pill within seventy-two hours of intercourse?
STEVEN SPANDORFER, MD: We know that the egg itself survives twelve to twenty-four hours. Sperm is probably most viable in the first twenty-four to seventy-two hours. So you're really trying to get it at the time when the sperm and egg are most viable.
Q: How effective is it?
MARGARET POLANECZKY, MD: The morning-after pill will reduce the chance of pregnancy from about 8 percent to about three percent. It is approximately a 75 percent reduction in the chance of getting pregnant after a single act of intercourse.
Q: What are the side effects of the morning-after pill?
STEVEN SPANDORFER, MD: As anybody who has taken just a regular birth control pill knows, one pill can make you feel nauseous. So when you're all of a sudden taking double that dose a few times over, you can feel very nauseated. In fact, a lot of patients will feel too nauseated to take the second dose. Some patients may want to take an anti-nausea medication. Twenty-five percent of women who take the morning-after pill experience vomiting, which can reduce the pill's effectiveness.
MARGARET POLANECZKY, MD: The good news is that there is a new form of morning-after pill, called Plan B, which is progesterone only. We know that this method has a much lower incidence of nausea and vomiting, around 10 percent, and may actually be more effective. It's available through the Emergency Contraception Hotline Providers, and will hopefully soon be available in pharmacies.
Q: How much does emergency contraception cost?
MARGARET POLANECZKY, MD: It's around twenty dollars, and you need a prescription.
Q: Are there populations of women who should not take the morning-after pill?
STEVEN SPANDORFER, MD: It is not the best type of contraception for somebody who has active cancer of some sort, or active liver disease, or undiagnosed vaginal bleeding.
Q: There was concern that some people would use this as birth control. Do you feel this could become a problem with the morning-after pill?
MARGARET POLANECZKY, MD: I've never seen anyone using this method more frequently than they need to. Certainly the nausea tends to discourage that among many women.
