Currently in the United States there are 2 emergency contraceptive pills, Plan B (levonorgestrel) and Ella (ulipristal). Plan B is the most widely used emergency contraceptive method and has been available since 1999. Emergency contraception is NOT intended to be a patient’s primary birth control method. It is designed as a back up if a method fails or a patient engages in unprotected intercourse. Plan B is currently available over the counter to patients 17 years of age and older without a prescription. Plan B is kept behind pharmacy counters in the U.S. and patients must show an ID before purchasing the medication. In April a federal judge in New York ordered the U.S. Food and Drug Administration to make Plan B available to people of any age without a prescription. Last week the FDA approved Plan B for patients 15 and older to buy without a prescription. It also approved Plan B to be sold in the retail aisle next to other over-the-counter medications. Many groups including the American College of Obstetricians and Gynecologist and the American Academy of Pediatrics have urged birth control pills to be over the counter due to the high rate of unplanned pregnancies in the United States. The teen pregnancy rate is 68 pregnancies per 1000 teens. 49% of the pregnancies each year in the U.S. are unintended. Plan B is most effective when taken within 3 days of unprotected intercourse, but it is still moderately effective when taken up to 5 days after an unprotected encounter as well. Studies have shown that it may prevent approximately 80% of expected pregnancies. Plan B contains levonorgestrel which is a safe hormone for most women (even with complex medical histories), and it is associated with a low incidence of minor side effects, nausea being the most common. No serious complications have been associated with its use as an emergency contraceptive. Some people have concerns that Plan B causes abortions. This is not the case. For instance, an abortifacient is something that interferes with an established pregnancy. Plan B has no effect on a pregnancy if a patient is already pregnant as Plan B works primarily by preventing ovulation (preventing an egg to be released by the ovary). Finally, the medication is not associated with birth defects. Instead of causing an abortion Plan B can help PREVENT a patient from getting one.
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