The morning after pill

Medical professionals don't use the term morning after pill. They call it the post-coital pill (PCP) or – in Britain – the emergency contraceptive (EC). the MAP became available for general, rather than exceptional,
use. It became available off-prescription; it was sold over-the-counter by pharmacists; and it was made
available in schools to girls under the legal age of consent to sexual intercourse. Provision of the MAP in
schools violates the government’s own guidelines on the provision of drugs within schools; it violates the
guidelines given by the Law Lords in the ‘Gillick’ ruling; and it violates parents’ hard-won rights to know
and approve the kind of sexual instruction and advice which their children are receiving in school.Despite the fact that no clinical trials have been
conducted with girls under 16, the MAP has been
licensed without an age limit. During 1999, it was
prescribed to girls under the age of 16 on 23,100
occasions in family planning clinics in England alone,
representing 10% of the total prescriptions in that
setting.2
This figure does not include girls who received
treatment from a GP or a hospital accident and
emergency department.Girls as young as 12 can obtain the MAP at the Magic
Roundabout in Kingston-upon-Thames. This selfreferral,
confidential sexual health advice service
targeted at young people aged 12-20 is commended by
the government’s report on Teenage Pregnancy as a
‘promising approach’.5 Similar projects are operating
in other parts of the United Kingdom.Measuring the effectiveness of the MAP is
extremely complex for the simple reason that,
when it is taken, there is no way of ascertaining
whether conception has taken place. Women who
take the MAP do so as a precautionary measure
rather than on the basis of any sure knowledge of
a developing pregnancy.
A World Health Organisation study (Table 1)
which estimated the number of anticipated
pregnancies, taking into account the menstrual
and sexual histories of participating women, and
then comparing them with the actual numbers of
pregnancies occurring after treatment, found that
the progestogen-only pill is more effective than
the combined pill and that the effectiveness of
both pills varies depending on how soon after
intercourse they are taken.For example, a recent study of 240 teenagers who
became pregnant found that 93% had seen a health
professional at least once during the previous year, and
71% had discussed contraception. The researchers
concluded that:
• ‘Most teenagers who become pregnant do access
general practice in the year before pregnancy,
suggesting that potential barriers to care are less than
often supposed.
• ‘Teenagers who become pregnant have higher
consultation rates than their age-matched peers, and
most of the difference is owing to consultation for
contraception.
• ‘Teenagers whose pregnancies end in termination are
more likely to have received emergency
contraception.