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With Plan B Pills, Time Is of the Essence

Times Staff Writer

Question: What is Plan B?

Answer: Plan B is the brand name of an emergency contraceptive, sometimes called the “morning-after” pill.

The drug, made by Barr Pharmaceuticals Inc., consists of two pills, each containing a high dose of a synthetic version of the hormone progestin, which is also in regular birth control pills.

The pills are taken 12 hours apart. Although Plan B is referred to as the morning-after pill, it can be taken up to 72 hours after unprotected sex to reduce the risk of pregnancy.

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If taken within that period, Plan B reduces the risk of pregnancy by 89%. That means that seven out of every eight women who would have gotten pregnant will not get pregnant. After the 72-hour window, the pills’ effectiveness decreases by 50% with every 12 hours, so time is of the essence.

Q: How does Plan B work?

A: Preventing pregnancy after unprotected sex can be achieved in several ways. First, the flood of synthetic progestin can delay ovulation so that an egg is not available to be fertilized. Second, fertilization can be hindered by making conditions unfavorable for fusing of the egg and sperm. Additionally, implantation of the fertilized egg into the uterine lining can be prevented.

It is possible that Plan B works in any or all of these ways, but recent studies strongly suggest that prevention of ovulation is the main method by which Plan B prevents pregnancy.

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Q: Is Plan B safe? Are there any side effects?

A: The Food and Drug Administration considers Plan B to be safe. It can be used by women for whom ongoing use of birth control pills is not advised. Side effects include nausea and vomiting, and a woman’s next menstrual period may be slightly altered.

Q: Is Plan B the only kind of emergency contraception?

A: No. The Yuzpe method (named after its inventor, Dr. A. Albert Yuzpe) involves taking large doses of certain brands of birth control pills 12 hours apart.

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This method was first described in 1974, and the FDA declared it safe in 1997. It does not work with all formulations of birth control pills. The Yuzpe method reduces the risk of pregnancy by about 75% if taken within 72 hours of unprotected sex.

In addition, insertion of a copper-releasing intrauterine device after unprotected sex can be used to prevent pregnancy. It also can be left in place for future protection.

Q: Is using Plan B the same as taking the abortion pill?

A: The abortion pill, also known as RU-486, contains the synthetic steroid mifepristone, which causes the termination of an established pregnancy. Plan B will not do this.

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If a fertilized egg has implanted in the womb, Plan B will have no effect. Because Plan B may prevent implantation of a fertilized egg, some people consider it a form of abortion.

Q: Do you need a prescription for Plan B?

A: Currently, the FDA requires a prescription for Plan B. On July 31, the agency announced it would work with Barr Pharmaceuticals on a plan to make the drug available over the counter to women 18 and older. Plan B would remain a prescription drug for minors.

California and several other states allow pharmacists to provide Plan B to patients without a prescription. The pharmacists work in partnership with off-site physicians and receive specialized training in how to correctly dispense Plan B.

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Q: Why is emergency contraception needed?

A: According to figures cited by Planned Parenthood, nearly half of America’s 6 million annual pregnancies are accidental, and half of those are terminated by abortion. Widespread use of emergency contraception like Plan B could potentially prevent an estimated 1.5 million unintended pregnancies and 800,000 abortions each year in the United States.

In 2000, emergency contraception prevented about 51,000 abortions in the United States and was responsible for about a

43% decrease in the number of abortions between 1994 and 2000, according to another study cited by Planned Parenthood.*

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(BEGIN TEXT OF INFOBOX)

How it works

The “morning-after” pill is a type of emergency contraception that contains higher doses of the hormones present in regular birth control pills. Unlike abortion pill RU-486, morning-after pills are not intended to end an established pregnancy.

First dose is taken within 72 hours of unprotected sex. Second dose is taken 12 hours later. Pregnancy may be prevented in the following ways:

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1. The ovary can delay an egg’s release.

2. Fertilization may be prevented in the fallopian tube.

3. A fertilized egg may be blocked from implanting in the uterus.

4. Mucus around the cervix may become thicker and trap sperm from traveling to the fallopian tube.

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*

Sources: Women’s Capital Corp., Associated Press


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