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Morning after pill

The morning after pill, also known as emergency contraception, is a pill regimen that a woman can take to prevent pregnancy up to three days after she has had sexual intercourse. It consists of two high-dose birth control pills taken 12 hours apart, reducing the risk of pregnancy by 75% to 89%. The high dose of hormones can cause the user to feel rather sick.

The most popular of these drugs in the United States is available under the brand name Plan B. An earlier product called Preven is lately falling out of use as it is less effective and has more severe side effects. Plan B contains only the hormone progesterone, while Preven, like most other birth control pills, contains progesterone and estrogen.

The morning after pill cannot be recommended as the main means of contraception because of its strong side effects and low reliability. It also does not protect against sexually transmitted diseases. However, it is useful as a back-up when other means of contraception have failed--for example, if one has forgotten to take the Pill or when a condom is torn during sex.

Emergency contraception is not to be confused with RU-486, the so-called "abortion pill", which ends a pregnancy by inducing a chemical abortion of the embryo. From a medical standpoint, the morning-after pill prevents pregnancy in the first place. It has not been determined whether the morning-after pill accomplishes this mainly by preventing ovulation, by preventing the released egg from being fertilized, or by preventing the implantation of the fertilized egg in the uterus. All three mechanisms are probably involved at different stages of the menstrual cycle.

The morning after pill is somewhat controversial: some religious conservatives object to it since it may prevent the implantation of an already fertilized egg, which they consider the moral equivalent of abortion. Others hold that emergency contraception reduces the number of unwanted pregnancies and abortions and view it therefore as beneficial.

Wal-Mart announced in May 1999 that it would not sell morning-after pills in its 2,400 pharmacies; it fills prescriptions for regular birth control pills to be used as emergency contraceptives but does not stock Preven nor Plan B.

In January 2000, France decided to dispense morning after pills in junior and high schools by school nurses without prescription; after strong opposition from the Catholic Church, the decision was overruled by a court in July 2000. The French parliament changed the relevant law in October 2000 and now school nurses are again able to dispense the drugs.

Since early 2001, women of age 16 and higher may obtain the morning-after pill in the United Kingdom without prescription. This was challenged by an anti-abortion group, but the High Court let the rule stand in April 2002. Emergency contraception is available without prescription also in Albania, Belgium, Denmark, Finland, Israel, Morocco, Norway, Portugal, South Africa, and Sweden. The American Medical Association[?] recommended in 2000 that morning after pills be available over the counter without prescription in the U.S.; this proposal is currently (September 2002) under review.

An alternative to the morning-after pill is the intrauterine device which can be used up to 7 days after unprotected intercourse.

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