Emergency Contraception

The question of whether emergency contraception poses a moral dilemma and/or a health risk has been addressed for many years throughout countries in the entire world. Although most moral issues have biased views based on religion, personal beliefs, and family standards, the more important objective question is how are people who choose to use emergency contraceptives putting their own personal health at risk. Today, emergency contraception can be used after a rape or sexual assault, any time unprotected sexual intercourse occurs, or when a birth control method fails. For example, emergency contraception can help to prevent pregnancy after a condom breaks, a diaphragm slips out of place, or birth control pills are not remembered. While there is not just one official definition of emergency contraception, The Whole Truth of Contraception defines it as "a means of using a copper IUD [intrauterine device] or birth control pills to prevent pregnancy after unprotected intercourse" (Winikoff, 1997, p. 214). There are quite a few different forms of emergency contraception, which include, but are not limited to, intrauterine devices, abortion, and oral contraceptive pills, probably the most prevalent method. Many health risks are associated with the use of emergency contraceptive devices, and it is important to be aware of these risks before utilizing these methods.

According to Ory (1993), when abortion was illegal in the United States, most women who were desperate to avoid unwanted childbearing relied on non-medical and unskilled surgeons who performed the procedure under unsanitary conditions. Also, some women had reported that they had inserted catheters and sharp instruments or injected corrosive substances into their wombs. Some even consumed toxic liquids, such as ergot. It is highly recommended that abortions be executed as early as possible, since the threats of mortality increase with weeks of gestation (Ory, 1993). However, now the procedure has become safer with the thankfulness of qualified and skilled practitioners.

Ory (1993) described a few different methods of abortion, which include vacuum aspiration. Vacuum aspiration was developed in China and introduced in the United States in the late 1960's. It involves using suction to remove the uterine contents and appears not to have any negative effects on a woman's future reproductive health, but complications after this type of abortion, or any other type, can lead to infertility. This is because injuries to the cervix that may arise during an abortion can increase the possibility of acquiring cervical problems during a future pregnancy (Ory, 1993). In The Whole Truth About Contraception, Winikoff and Wymelenberg (1997) thoroughly described the complications caused by surgical abortions. Excessive bleeding is the most common complication after an abortion is carried out because either an instrument has injured the walls of the uterus or the vagina, or the cervix has been torn. This profuse bleeding occurs when the uterus is not completely free of pregnancy tissue, or when it does not tighten up afterwards. To prevent this severe bleeding and to allow the uterus to contract, which closes the blood vessels, a local anesthesia is used, rather than a general one, which is associated with greater blood loss (Winikoff & Wymelenberg, 1997). Infections may also occur in the uterus or fallopian tubes, which are signaled by cramps, fever, a smelly vaginal discharge, pain that gets worse even weeks after the abortion was completed, and pelvic discomfort (Winikoff & Wymelenberg, 1997, p. 249).

Intrauterine devices are also a popular form of emergency contraception. The peer-reviewed website, The Emergency Contraception Website (2002), with the article called "Copper-T IUD as Emergency Contraception" stated that the copper-T intrauterine device, also known at IUD, can be inserted up to five days after unprotected intercourse to prevent pregnancy. It can be left in place to provide continuous efficient contraception for up to ten years. The Emergency Contraception Website (2002) also illustrated that the insertion of a copper-T IUD is much more effective than using mini-pills because it reduces the risk of pregnancy following unprotected intercourse by more than 99%. However, IUDs are not ideal for all women, especially women at risk of sexually transmitted infections. Insertion of the IUD can lead to pelvic infection, which can cause infertility if untreated. Nevertheless, the risk of pelvic infection from insertion of an IUD is very slim among women who are not at risk of sexually transmitted infections ("Copper" 2002). In The Whole Truth About Contraceptives, Winikoff & Wymelenberg (1997) described that with the use of intrauterine devices feelings of discomfort and pain may arise, including cramping, as well as abnormal bleeding. In addition, since it "is inserted into the uterus via the vagina and cervical canal, bacteria from those areas can be introduced into the usually sterile uterus, resulting in pelvic inflammatory disease" (Winikoff & Wymelenberg, 1997, p. 149).

The two methods of using combined pills of