Morning after Pill - Pro and Contra - Assignment Example

Morning after Pill MORNING AFTER PILL Introduction Each day across the world, particularly in the United s and other western nations, women have taken their access to non-prescribed morning-after pill, also e-contraceptives, for granted. The opposition to the morning-after pill in America is especially high, especially where it can be accessed without the approval of a doctor or medical staff, as well as sans prescriptions (Prescott, 2011). The morning-after pill and its widespread availability has led to women becoming more engaged in sexual activity, especially unsafe sex, as well as the abuse of the pill by women not educated in its use. However, it also reduces the incidence of unwanted pregnancy, particularly where none of the parents are ready for a child (Prescott, 2011). The arguments in support and against the legalization of access to morning after pills without prescriptions have been a thorny issue across the world for decades. However, the use of morning after pills, even after legalization of non-prescriptive pills, has been hampered by poor education in its use and ethical issues facing pharmacies with regards to selling to underage girls. Implications of Legalizing non-prescriptive use of the Morning-After Pill While most people have heard about the pill, they do not have all the information about the extent of its purpose. In a survey of 88 patients in a reproductive clinic, in London constructed to observe their knowledge on the morning-after pill, 65% of the women had heard about it, although only 19% were aware of its seventy two-hour limit (Haussman, 2013). While the morning-after pill has the ability to prevent a woman from pregnancy, it will only be efficient is taken after 72 hours orally following contraceptive failure or unprotected sex. In addition, it only works when the woman is not already pregnant. The pill is not an abortion pill and offers no protection against sexually transmitted infections like HIV. It is also not meant for use as a regular method of birth control and should be used for a maximum of four times a month. If a woman is seventeen years or older, she can receive the pill at a local pharmacy if they can present proof age through relevant documents. The pill contains elevated levels of levonorgestrel, which is an analog of progesterone that is found in majority of pills for birth control (Haussman, 2013). After a woman takes the pill, various side effects like period changes, pain in the lower abdomen, nausea, dizziness, headaches and tenderness of the breasts are to be expected. Where it is taken within 72 hours, there is a 95% reduction in probability of pregnancy. Although it was approved in the late 90s, in the US and Canada, the pill’s use can be traced back to the late 60s and early 70s. One of the reasons for this period between discovery and legalization had to do with abhorrence of the fact that teenagers and young women could access the pill so easily (Haussman, 2013). The main focus of the arguments preceding its legalization was concerns and benefits of its use. Finally, most countries in the west, including Canada, came to the conclusion that the use of non-prescriptive morning-after pills was an effective way to reduce the millions of unwanted pregnancies a year prevalent in their countries. One possible downfall of its legalization was that women above the age of 17 could procure the pills for minors, while it was also possible that men would force underage partners to use it. In addition, the presence of the pill over the counter meant that girls became more adventurous and started to engage in unprotected sex regularly since pregnancy was not a worry anymore. Studies conducted globally have shown that the rates of STIs rose dramatically after the morning-after pill was made non-prescriptively available (Haussman, 2013). In the United States, the FDA made known its concerns in 2003 that it was possible for the formation of sex-based cults around morning-after pills (Eldridge, 2010), which was also raised as a pertinent issue in Canada. These cults consist of young women and teenagers, as well as men, who come together to have sex followed by use of the pill after the act. This was just one of a number of arguments as to the implications of legalizing the non-prescriptive use of the pill. Various countries have previously contended that there is a possibility for the pill to become a drug of choice for teen orgies. However, it is also true that the extreme promiscuous actions of young adults and teenagers since the sexual revolution of the 60s cannot be prevented, although the non-prescriptive availability of the pill makes it easier to engage in the act without serious reproductive repercussions (Eldridge, 2010). Therefore, promiscuity among young people will only increase. In addition, even in the absence of the morning-after pill, another product along the way would have had a similar effect because of the increasing tendency for teenagers to become sexually active at a progressively younger age. While the morning-after pill is not the sole contributing factor to increasing rates of unsafe sex and sexually proactive young women, its availability is a critical component. Another implication of legalizing non-prescriptive morning-after pills is the resultant surge in disease transmission, as well as the facilitation of sexual abuse by adult predators on young teenage girls (Eldridge, 2010). However, sexual abuse victims are also highly reliant on the non-prescriptive morning-after pill availability for their own well-being. Although it is a stretch to claim that the pill will increase the number of male sexual predators, it is likely that the predators will be less likely to take advantage of women because the resultant pregnancy can be prevented by use of the pill, which would get rid of evidence as to their act. Another implication of legalizing non-prescriptive morning-after pill use is that, despite the pill being meant for emergency situations, it runs the risk of becoming a regular contraceptive. Although most manufacturers claim it is an emergency pill, a significant number of people are against it because young girls who have not been educated about its use will choose to use it (Eldridge, 2010). In addition, for young girls, the effects of using the pill are catastrophic, including increased ectopic pregnancy risks and severe swings of mood. The implications of increased morning-after pill abuse have led to more pharmacies in North America refusing to fill pill prescriptions, believing that it leads to a destruction of human life after conception, while also posing an increased risk of the same (Eldridge, 2010). While this has some truth in it, it is contradictory to the initial purpose of the pill, which is to prevent a possible pregnancy in the future because of unprotected sex or failure of other contraceptives like condoms. However, it reveals the increasing moral and ethical implications of morning-after pills to different people. Although there are valid reasons as to why legalization of over-the-counter morning-after pills should be rescinded, creators and proponents of the same say that its increased use implies that it works. In addition, the significantly increased use means that the producers of the pill will lobby for its continued legalization, which will result in a never-ending cycle that allows them to gain profits (Eldridge, 2010). Literature Review of Main Points (Framework) Common reasons for the increased use of morning-after pills are the malfunctioning of barrier methods and the lack of any contraceptive method in use at all. Some additional uses include sexually assaulted women to prevent the probability of pregnancy. The Plan B treatment method involves the woman using routine methods of contraception prior to turning to morning - after pills, which consists of two tablets taken orally that, each contains 0.75 mg of levonorgestrel (Ling, 2007). This level is at least ten times, over what is found in various oral birth control pills. However, there has been no single action method identified with regards to plan B. One concept holds that the levonorgestrel impacts on the woman’s ovulation through the delay or suppressing of luteinizing hormone that works to rupture the follicle. This mechanism of action is taken as the predominant one for morning-after pills. Another mode of action is changing the endometrial wall that prevents implantation of fertilized ova (Ling, 2007). However, where implantation has already occurred, the pill will not terminate or abort the existing zygote. Timing is a crucial factor when using emergency contraceptives with high success rates occurring if the pill is taken within the first 72 hours of sexual intercourse, although effectiveness may also extend to five days (Williams, 2007). The effectiveness of the morning-after pill was investigated in a randomized and multi-centered research study, which found that the effectiveness of the pill was heavily dependent on how soon the first dose of the morning-after pill was taken. In addition, if the woman or girl uses the pill within the first 3 days, there is a 4% failure rate, which increases to as much as 10% if the pill’s use is delayed to within five days. Using the morning-after pill portends adverse effects to the woman, including nausea in approximately half of those using it, fatigue, dizziness, and vomiting (Abell, 2009). However, the data on teratogenic effects is limited, especially since most of the studies conducted on the effects on morning-after pills are focused on investigating effects on the woman, rather than on the children she will have later. Some of the contra-indications of using the morning-after pill include suspicion of pregnancy, undiagnosed bleeding of the genitals, and hypersensitivity. Before over-the-counter morning-after pills were legalized, the main debate revolved around advance provision of the pills. This involves making the pill available to females as prescriptions prior to them being involved in sexual intercourse in case there should be a situation where they fail to use normal contraception methods, or these fail (Spitz, 2006). It was found that the provision of advance morning-after pills in advance was utilized at least three times more than the provision of education about how the pills should be used. This runs the risk of poor use, which makes an argument for prior education into how the pills are used prior to their provision to females, especially young women who are more likely to be involved in casual sex. While physicians give advance prescriptions that aid in the prevention of unwanted and unplanned pregnancies, staff in health care institutions should play a more central role in educating girls and young women (Spitz, 2006). Although morning-after pills act to reduce pregnancy risks, they are less effective when compared to consistent use of specific routine methods of contraception like birth control pills. The increased accessibility of morning-after pills and its increase of the risks of promiscuous acts is another issues that is discussed more often. Before the approval of non-prescriptive morning-after pills, doctors were skeptical concerning the provision of the pills because they feared the fact that it could increase more risky sexual behavior (Del, 2012). If this is the case, then non-prescriptive availability of the pill will lead to increased risks for the spread of STIs like HIV and syphilis. Therefore, it is important for patients to be aware that morning-after pills are purely for contraceptive purposes and not for protecting them against STIs. Finally, ethical issues arise with regards to the responsibilities of nursing staff in administering morning-after pills. Kunjappu (2011) addresses an occurrence where a nurse said she would refuse to provide morning after pills to a young woman because she thought it ethically and morally wrong for her to give the pill during her job interview. The author further details how the hospital refused to hire her for the job in the hospital, choosing, instead, to allow another nurse who believed that it was necessary to administer the pill. In this case, the hospital held that that the rights of the patient superseded those of the nurse in offering medical treatment. Conclusion There will always be controversy surrounding the non-prescriptive use of the morning-after pill. As a back up method against unused or failed contraception during or before sexual intercourse, the morning-after pill was recently legalized as an over-the-counter drug. The pill does not interrupt the development of implanted and fertilized eggs, while it is not a method for abortion. The effectiveness of the pill is increased if it is used 72 hours following sex. Side effects are few with the most prevalent being nausea, although teratogenic effects require to be researched on more to present women with more information in making their decision. Ethical issues also arise in use of the pill, including the increased rates of sexual abuse and risky sex, the spread of STIs, and the responsibilities and roles of nurses in providing the pill and their moral and ethical beliefs. References Abell, S. (2009). The morning-after pill. Clinical Pediatrics, 48, 3, 341-2. Del, B. (2012). Conscientious Objection and the Morning-After Pill. Journal of Applied Philosophy, 29, 2, 133-145. Eldridge, L. (2010). In our control: The complete guide to contraceptive choices for women. New York, NY: Seven Stories Press. Haussman, M. (2013). Morning after pill: The battle over emergency contraception. Westport: Praeger. Kunjappu, M. J. (2011). Pioneering studies of the "morning-after" pill. The Yale Journal of Biology and Medicine, 84, 2, 109-11. Ling, J. R. (2007). The morning-after pill: Uncovering the truth. Newcastle Upon Tyne: Christian Institute. Prescott, H. M. (2011). The morning after: A history of emergency contraception in the United States. New Brunswick, N.J: Rutgers University Press. Spitz, K. D. (2006). Sex, Drugs, and Federalisms Role: Regulation of the Morning After Pill on Public College and University Campuses. The Journal of College and University Law, 33, 1, 191-244. Williams, A. (2007). The morning-after pill. Human Reproduction and Genetic Ethics, 13, 1, 8-36. Read More