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Sexual Health (young people)

Emergency contraception (including the 'morning after pill')

 
Emergency contraception is used to reduce the chances getting pregnant after unprotected sex, missing a pill, or a split condom, which leaves women at risk of pregnancy. There are three types of emergency contraception: two types are a tablet, and the third is a non-hormonal coil. The coil is the most effective at preventing pregnancy. 

Tablets are sometimes referred to as 'morning after pills', but actually can be used for a number of days after the unprotected sex, missed pill or split condom. One tablet (levonelle) can be used for up to 3 days after unprotected sex, and is widely available from chemists, GPs, school and college nurses, and sexual health clinics. It is often free from chemists to young people under 18 or 21 (depending on where they live) The other tablet, Ella-One, can be used up to 5 days after unprotected sex, but needs to be prescribed by a doctor or nurse in a clinic. Both are more effective the sooner they are taken after the unprotected sex.
 
The IUD (or non-hormonal coil) can also be used for emergency contraception, and is the most effective way of preventing a pregnancy. Whether this is a suitable method depends on where a women is in her period cycle; a doctor or nurse will be able to advise.
 
Women we interviewed used emergency contraception (or 'EC') when a condom had split or come off, when they forgot to take the pill or it was taken late, or when they'd not used any contraception. 

 

Explains how scared she was of getting pregnant after a condom split. (Actor)

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Age at interview: 19
Sex: Female
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Yeah, when I was using the condom with my current boyfriend it split once and I had to take the morning-after pill it was just before we went travelling. And it was such a nightmare because I was so worried about getting pregnant because I was reading up that it is only like 85% effective so, I don't know, anyway I just got really scared. And then we discussed it, he didn't like to see me so upset and he was a bit worried about it as well so that was that and it was kind of then that we decided that I should go on the pill. So I mean, we did talk about it a lot, it was a joint decision.
 

Thought she might need to take emergency contraception abroad.

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Sex: Male
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G' OK, we did have a little problem in China, condoms broke and we needed, I thought I needed to get the morning after pill and 'cos, I was on antibiotics at the time so I wasn't sure whether the pill worked. So that involved sort of waking my mother up at 6 in the morning or something saying, 'Ahh, you have to help me'. And she talked to the doctor who then, everything was done via my mum. My mum phoned the doctor, the doctor said maybe I didn't really need it.

 

Your mum in the UK?

 

G'Yeah.  

 

So, what happened? She had to send you, there was not...

 

G' No. In the end, because I was on the pill but I was on antibiotics I thought it would reduce the effectiveness of the pill, but the doctor said almost certain that I should be all right so I just had to wait for two weeks and see. But the doctor didn't think it was that big so I phoned my mum, she phoned the doctor, my mum phoned me back. So I did it that way. If I had really needed it I could have gone through my organisation to get it.

 

Indicates that she had oral contraception as a precaution when coming off the Depo Provera...

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Age at interview: 21
Sex: Female
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When I first came off my Depo' recently I took it because I wasn't sure whether I was still in the time, you know they give you a time that they're, that the injection wears off by so just to be sure I wasn't going to be pregnant I went to the clinic, to my doctor and I said 'Could I have the pill please because I've just come off my Depo and I don't want it again so I'd rather take the pill and just you know stop it progressing to that stage.'

Most of the women we talked to knew EC was less reliable in preventing pregnancy than the contraceptive pill or injections. If people are having sex regularly it's convenient as well as more reliable to use a regular method of contraception like the pill, IUD (the coil) or IUS (the hormonal coil), the injection, the implant or condoms.

 
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Thinks that emergency contraception should not be used as a method of contraception but only as a...

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Age at interview: 21
Sex: Female
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I don't think it's good. I would rather that accidents that have happened hadn't. First of all I don't think it's a method of  contraception, I think it's an 'if a contraception fails' and you know, people that use it a lot first of all, I don't know how dangerous it is. 

 

You know, basically it's a very strong pill, I think that's not necessarily good for your body and it's not to be relied on. It's not as effective as using contraception in the first place, basically. But it is really useful if you're worried that something might have happened to the method you were using.  

Women sometimes feel embarrassed about using EC, or worried others will see them as irresponsible but taking EC is a responsible thing to do if they want to prevent an unplanned pregnancy. Younger women that we interviewed didn't always feel that staff treated them as if they were being responsible when they asked for EC, particularly those in rural areas.

 

Gives examples of the kinds of questions health professionals ask and explains the instructions...

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Age at interview: 25
Sex: Female
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To get the emergency contraception? I just went up to the clinic and explained the situation and, you know, they just sort of go through it, they discuss things like if you've been at risk of sexually transmitted diseases, you know, if you've had unprotected sex that kind of thing. And just sort of discuss those sorts of aspects and why you weren't using contraception!  And then yes, in that case they give you two...  Do you want me to tell you about the actual technique?

Yes.

They just give, you have to take 2 pills, hormone pills, 12 hours apart. Take one straight-away and then the second one exactly 12 hours after.
 

Describes how she felt as a teenager when she got a 'lecture' from health workers at her Family...

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Age at interview: 21
Sex: Female
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I don't mind using it but then it's the same as when I was a bit younger and they'd say 'well you know you should have used a condom' and things like that and you think well I'm down here to do something about it so don't give me a lecture.

Who gave you a lecture?

The woman at the Family Planning, 'well you should really use a condom, you shouldn't rely on the mini pill, the a morning after pill' its like, well I know accidents do happen and that's the only thing, that sometimes you feel uncomfortable which is like when' well you feel like they're putting you down or trying to give you a lecture about something.
 

Describes her experience as a teenager when she asked her GP for emergency contraception.

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Age at interview: 18
Sex: Female
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And what was his reaction?

He was quiet, not very comforting, he was quite strict about it and said 'this isn't a method of contraception' blah, blah, blah. He was quite, he made me feel quite bad about myself actually compared to my friend who went to the family planning clinic and they were reassuring to her and kind of helped her more and gave her free condoms and things like that, so I felt that he wasn't very helpful, wasn't very considerate.

He gave you a lecture?

Yeah.

When you went to get the emergency contraceptive from your GP and he told you that it was not another method on contraception, what else did he say to you, can you remember?

I don't know, it was a long time ago so, it was a very young age to be having sex and um you should be using condoms and just things like that, I can't really remember much more than that.
 

Describes the difficulties experienced by teenage girls living in rural areas when trying to...

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Age at interview: 18
Sex: Female
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Most girls I know would go to the chemist, because if you go to the doctors you can get it free can't you, but a lot of the girls round here are quite scared to go and see their doctors so they'll go to the chemist, but when you go to the chemist, like the chemist that we'll get it from would be Boots and the ladies in there aren't the most friendly of people, so they'll shout it out and then you have to be taken into the back room to talk to the Pharmacist, I think, I don't really know who she is, and the way she talks to you makes you feel dirty basically. 

She's really nasty about it, she's like 'oh haven't you ever heard of contraception blah blah blah', and literally has a go at you for it and if you're already worried and a bit upset, and you're having to fork out '20.00 as well which is going to annoy people, you could really do without someone narming in your ear about how irresponsible and childish you are kind of thing, really I think.

Before it was available from pharmacies, it was sometimes hard to find somewhere open to get emergency contraception.

 
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She recalls how unprepared she was for a broken condom and how worried she felt about the thought...

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Age at interview: 24
Sex: Female
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I was a bit pissed off to be honest.                            

Why?

'Cause the condom broke, I wasn't prepared for something like that to happen. And the fact that I had to run around looking for it on a Saturday, and it was a nice day as well.  I should have been in the park or something. It was a lovely Saturday, and I was running around looking for this pill, thinking the worst, thinking, 'Oh my God I could get pregnant' and stuff like that.     
Some women never take EC and some of those we interviewed were put off by stories of friends' who experienced sickness and other side effects. Older EC pills often made women feel sick but newer ones available now rarely do this.

After taking EC, women may get their next period a bit earlier or later than expected. If the next period is not as heavy or as long as usual, then a pregnancy test might be worthwhile.

 

Describes bleeding after she took emergency contraception and the advice she received from her...

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Age at interview: 19
Sex: Female
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Which are the kind of questions that you put through to the helpline?

Well, I had like a side effect in the morning after pill, I took it, and after a couple of days I started bleeding and you know, I was a bit worried like you know, what's going on and everything. 

So like I phoned up the helpline and they told me that the morning after pill had like mucked up my periods and everything, and then I didn't come on for like coming up to two months now. 

So I was like getting really worried now and I was thinking you know, what's going on, so I phoned them back up and they didn't really have any answers. And so I went to the health centre and took a pregnancy test because I didn't know what else to do and it came up negative so, don't really know what to do now.

They advised me not to take my pill until I started my period but like I had two tests and they wouldn't be lying to me and saying I wasn't pregnant, so I decided to take my pill again to see if it restarted my periods.   

That just happened once with the emergency contraception?

Yeah, it just happened the once, but it sort of threw me a little and I was thinking 'what's going on'. I thought you know, it might hurt me if I take it too much and so I thought, right, I've got to be sensible now otherwise it could really harm me. And I don't really know if it's good for you to take it a lot so, I don't really know.   

Last reviewed January 2016.

Last updated January 2016.

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