How effective is the Morning After Pill, really?
How reliable is the Plan B back up?
When it comes to female reproduction and contraception, age-old myths continuously crop up, leaving us even more flustered than we ought to be.
Whether it’s the pull-out method, menstruation as a baby barrier, or the maximum time women can use the morning-after pill, navigating sexual health can be tricky.
A further complicating factor unbeknownst to a majority of women is that weight plays a role in the efficacy of the Plan B method.
Though we know that no method of contraception is 100% reliable, a combination of myths, stigma, and lack of education, has created the assumption that emergency contraception, is utterly successful if one is willing to face the pharmacist and the embarrassment to obtain it.
And yet, 45% of pregnancies in the UK and the United States are unintended occurrences.
Though a healthy sum of these will be celebrated surprises, it’s still a worrying tell-tale sign that something surrounding contraception is wrong, whether that’s the potency itself, or the public knowledge.
A Princeton University study published last year stated that the efficacy of the emergency contraceptive pill is 50–100%, a highly ranging and vague statistic from which they concluded that the effectiveness is “difficult to validate.”
The morning-after pill works by doing three things; it stops the release of the egg from the ovary, it inhibits fertilization, and it prevents the egg from attaching to the uterus.
Most commonly, there are two different brands, Levonelle and EllaOne. The main difference between the two is the operational window, as EllaOne can be taken within 120 hours of unprotected sex, and Levonelle only 72 hours.
As the mechanism of the emergency contraceptive pill works by preventing ovulation, the point of a woman’s cycle is vital in assuming its success. If a woman is already ovulating upon taking the pill, the chances are incredibly high that it will not work.
Similarly, if taken in the perfect conditions, the pill only has a success rate of 95%, which is lower than on-going contraceptive methods such as condoms, the combined pill, and the coil.
Though it is stated that the emergency contraceptive pill can be used up until 72 hours following intercourse, after the 24-hour window, the efficacy drops to a worrying 89%.
A further complicating factor unbeknownst to a majority of women is that weight plays a role in the efficacy of the Plan B method, making it difficult to provide a more precise estimate for the prescription.
If a woman weighs between 75 and 80kg, there is a higher risk of the contraceptive failing, and it has been advised that medically obese women take double the standard prescription.
The lack of knowledge provided for women reflects an archaic concern that women may become careless with on-going contraception if Plan B is too readily available.
The 2019 study on the issue explained that the effectiveness of the Plan B method is increasingly difficult to test.
To examine this issue, an accurate time of intercourse and the point of the cycle is necessary, and women can sometimes report these details inaccurately. Furthermore, placebo trials would be profoundly unethical.
They managed to find, however, that if the typical woman used emergency contraceptive pills for a year, the risk of pregnancy would rise to 20–35% and that few studies advocate that access to the morning after pill reduces the rate of pregnancies and abortions.
Though not used enough, the plan B method is only moderately effective, and a combination of studies reported different results on its effectiveness. However, it seems that about 1 in 20 women still fall pregnant after using it.
Founder of the British Healthcare company Bupa, Dr. Paula Briggs said that the morning-after pill is “incredibly difficult to be certain about.”
Something that isn’t always made clear, Dr. Briggs further explained, is that the copper coil is a “much more effective than emergency hormonal options.”
It works up to five days after unprotected sex, and it can be taken up to five days after the predicted date of ovulation, and also provides on-going contraception. However, this option isn’t always available for all women.
The best solution for women is to monitor their cycles, via applications such as Natural Cycle, or to monitor discharge. When a woman is ovulating, the discharge is a stringy plug of thick, creamy mucus.
The factors involved in testing the efficacy of the emergency contraceptive pill are complicated, and ultimately the lack of knowledge provided for women reflects an archaic concern that women may become careless with on-going contraception if Plan B is too readily available.
These misconceptions and judgments surrounding women’s sexuality result in uneducated decisions, unwarranted fear, and shame.
The lack of information that shrouds sexual health is simply another example of the never-ending policing of women’s bodies, and it is jarringly evident that we haven’t advanced as much as we wish.
Ultimately, as a last resort, the efficacy of the morning-after pill is irrelevant, and it is a final opportunity to avoid pregnancies that women are, and should always be, entitled to.
