Emergency Contraception The Morning After Pill John W' Seeds, MD Department of ObGyn Virginia Common - PowerPoint PPT Presentation

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Emergency Contraception The Morning After Pill John W' Seeds, MD Department of ObGyn Virginia Common

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0.75 mg levonorgestril (5-7xOCP dose) Two doses: 1st within 72 hours of unprotected intercourse; ... The American Academy of Pediatrics. Planned Parenthood ' ... – PowerPoint PPT presentation

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Title: Emergency Contraception The Morning After Pill John W' Seeds, MD Department of ObGyn Virginia Common


1
Emergency ContraceptionThe Morning After
PillJohn W. Seeds, MDDepartment of
Ob/GynVirginia Commonwealth UniversityRichmond,
Virginia
2
Greetings from St. Benedict Catholic Church,
Richmond, Virginia
3
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4
Emergency Contraception
  • Plan B
  • 0.75 mg levonorgestril (5-7xOCP dose)
  • Two doses 1st within 72 hours of unprotected
    intercourse 2nd 12 hours later
  • Reduces pregnancy rate from 8 to 1-2
  • 75-89
  • safe
  • effective
  • reduces abortions

5
Mechanism of Action
  • ?
  • May inhibit ovulation (if taken before)
  • May inhibit egg and sperm transport
  • May inhibit sperm penetration
  • May thicken endometrium
  • May inhibit implantation

6
Over the Counter
  • August 24, 2006
  • The U.S. Food and Drug Administration announced
    that it was approving over the counter sales of
    Plan B to women over 18 years of age.
  • Action supported by
  • Planned Parenthood
  • The American College of Obstetricians and
    Gynecologists
  • The American Academy of Pediatrics

7
Planned Parenthood
  • This is wonderful news for womens health.
  • Long awaited good news.
  • U.S. has highest rate of teen pregnancy among
    developed nations.
  • 2004 teens under 18 had 2880 babies and 1261
    abortions in Virginia
  • CDC says 63 of U.S. high schoolers have had
    intercourse by graduation
  • Expanded access could prevent 1.5 million
    unintended pregnancies and 800,000 abortions a
    year.

8
Planned Parenthood
  • Minimal risks
  • Minimal potential for abuse
  • It will not cause an abortion of a pregnancy
  • It will not harm a continuing pregnancy
  • Should be pre positioned
  • Should be OTC to teenager
  • Assumed compliance
  • Undermined parental relationships

9
Here we go again
  • Theyve lied to us before
  • Overstated deaths from illegal abortion
  • Understated deaths from legal abortion
  • Ignored non lethal consequences of abortion
  • Ignored womens right to complete informed
    consent
  • Ignored parental rights

10
The risks
  • No effective enforcement of under 18 age
    restriction
  • No convincing evidence of safety in case of
    repeated use or overdose
  • Immature people do immature things
  • Another attempt to separate actions from
    consequences will again have undesired
    consequences
  • Pregnancy rates
  • STD rates
  • Abortion rates

11
-According to the World Health Organization, EC
Prevents 95 per cent of pregnancies in the first
24 hours, 85 per cent in the next 24 hours and
58 per cent if taken between 49 and 72 hours
after intercourse.
-It's now just one pill that works best within 24
hours of unprotected sex, but can be taken up to
72 hours after. Available without a prescription.
-Since the government put in place its teenage
pregnancy strategy in 2000, teenage conceptions
have fallen by about 10 per cent - but the plan
was to halve conceptions by 2010. And in the 13
local authorities with the highest rates, 11 have
seen the numbers of teenage pregnancies
increase.
Sunday May 15, 2005The Observer
12
Reduced pregnancies?
  • 2112 randomized controlled trial
  • Pharmacy access no prescription
  • Advanced provision
  • Clinic only access with prescription
  • EC use
  • Pharmacy only 24
  • Advanced provision 37
  • Clinic prescription 21
  • No impact on pregnancy rate

JAMA 2005, 29354-62
13
Advertisements for Plan B include One ad
portraying 13 young men with the caption, So
many men. So many reasons to have back up
contraception. Another pictures a fraternity,
with the words, Delta Delta Thi. 27 upstanding
young men. 34 billion sneaky little sperm.
Another is designed like a poster for
adolescents, describing Damian as A
Renaissance Guy, a Deep Thinker, an Ancient
Soul, a Walking Sperm Factory.
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19
Potential Effect on Public Health Regions that
allow easy access to the EC experience a
significant increase in sexually transmitted
diseases. In the United Kingdom, chlamydia
cases rose from 7,000 in 1999 to 10,000 cases
last year. Gonorrhea cases climbed nearly 50
percent, to nearly 3,000 cases last year, up from
2,000 in 1999. The highest increases were among
16-19 year olds. Contrary to proponents
claims, the number of surgical abortions has not
declined with easy access to EC. In some areas,
the number of abortions increased. In a U.K.
study of users of MAP, four out of the 12 women
interviewed said their choice to have unprotected
sexual intercourse was influenced by the
knowledge that they could obtain the pill from a
pharmacy.
20
Whats in it for PP
  • Whatever increases the risk of unintended
    pregnancy increases the demand for abortion and
    for PP services

21
Whats in it for the teenager?
  • Freedom, but a poor trade off
  • Pregnancy
  • Abortion
  • Broken relationships
  • STDs
  • Infertility
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