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Love and Sex 2007: When the Condom Breaks

February 7, 2007, 12:00 am
By
Emergency contraception can help when accidents happen.


Valentine's Day marks the beginning of the mating season for Homo sapiens, and throughout the spring, males and females of the species participate in elaborate courtship rituals, often involving the sharing of foodstuffs followed by gathering in a large, darkened room to view humorous re-enactments of other couples' courting rituals known as "romantic comedies." Occasionally, dinner and a movie leads to sex. (Woo hoo!) But what many of these young couples are doing is merely practicing for reproduction. Despite their best efforts to avoid procreating, accidents do happen.

So what do you do? Roll over and forget about it? Or move on to Plan B. Now that emergency contraception is available behind the counter at pharmacies, you could just reach into your ***image1***medicine cabinet and take two pills that would reduce your chances of getting pregnant by 89 percent.

Since the 1960s, doctors have known that taking the right combination of certain birth control pills soon after unprotected sex can prevent pregnancy. One of the hormones in the pills, a form of progestin, can delay or prevent ovulation, keep sperm from fertilizing eggs or prevent a fertilized egg from implanting in the lining of the uterus. For decades, doctors have advised women, especially sexual assault survivors, to take this combination of birth control pills as a form of emergency contraception. (Emergency contraception is not to be confused with RU-486, the abortion pill. That's an entirely different subject.)

Rather than take up to 10 birth control pills for emergency contraception, doctors wanted just two pills that contained only the hormone needed for emergency contraception. And in 1999, the Food and Drug Administration approved Plan B, a concentrated and isolated form of progestin. Although there are still approximately a dozen brands of birth control pills that can be used for emergency contraception, Plan B is more effective, with fewer side effects.

After a long and much-publicized fight, the FDA approved Plan B for over-the-counter sales last year. "The problem," Dr. Eve Espey, associate professor of obstetrics and gynecology at UNM Health Sciences Center, says, "is that it's not really over the counter, where you could see it hanging next to the condoms. It's behind the counter. And you have to be 18." Dale Tinker, executive director of the New Mexico Pharmacists Association, isn't happy about the FDA's decision either. "It seems pretty ridiculous to me," he says. "The Pharmacists Association had encouraged them to make it available to women under 18." But the good news is that in New Mexico, about 15 percent of pharmacists are trained to write prescriptions for Plan B, so women under 18 can still get emergency contraception from many pharmacies by filling out some paperwork and paying an extra fee.

Tinker believes that having Plan B available over the counter will contribute greatly to reducing unintended pregnancies. Most unprotected sex happens on the weekend, he explains, when most doctors' offices are closed. And Plan B can be effective up to five days after unprotected sex, but it is more effective the sooner it's taken. "So when the condom breaks and it's midnight," Tinker says, "the pharmacy is there." He suggests that people buy Plan B and keep it on hand, "sort of like in a first-aid kit." That's an idea that Planned Parenthood's Dr. Koster agrees with, but she has a different analogy. "It's like having a fire extinguisher in your kitchen in case a fire breaks out," she says. "You hope you never need it, but you want it there just in case."



The ABCs of Plan B


In a situation like this:

•    Unprotected vaginal intercourse
•    Condom broke or came off
•    Three or more hours late taking progesterone-only pill (mini pill)
•    Missed two or more birth control pills during weeks one, two or three of the 21-day or 28-day pill pack
•    Two or more days late starting new pill pack, vaginal ring or patch
•    NuvaRing out three hours or longer (weeks one, two or three)
•    Patch (Ortho Evra) off 24 hours or longer (weeks one, two or three)
•    Diaphragm slipped out of place
•    Depo-Provera injection was more than 13 weeks ago
•    On antibiotics (in the previous seven days) during your current cycle of pills, patch or ring


Do this:

Call your doctor. If you have unprotected sex during the week, when your doctor's office is open, call immediately. You may be able to get a same-day appointment, and if you have health insurance, the prescription may be covered. If your doctor is not available, try your health care provider's urgent care facility.

Go your school's health center. Santa Fe High (467-2439) and Capital High (467-1081) have health centers that dispense emergency contraception. So do the College of Santa Fe (473-6574) and St. John's College (984-6418).

Go to the pharmacy. Call your pharmacy and ask if they stock Plan B. If you're 18 or older, you can buy it without a prescription at the pharmacy counter for around $40. If your pharmacy doesn't stock it, try Fraser Pharmacy (465 St. Michael's Drive, 982-5524), Sav-On Drugs (511 Cordova Road, 983-6301) or your closest Walgreens or Wal-Mart. If you're under 18, some pharmacists, like at Fraser Pharmacy, can prescribe Plan B for you, but you'll have to pay an additional consulting fee, usually approximately $20.

Call Planned Parenthood (514 Oñate Place, 982-3684). After a brief consultation, they can dispense Plan B. Pick up a handful of free condoms on the way out.

Santa Fe County Public Health Office (605 Letrado St., 827-3560) provides emergency contraception and other services to Medicaid clients and the uninsured.

Santa Fe Indian Hospital (1700 Cerrillos Road, 946-9283) provides emergency contraception to Indian Health Services clients.

Call 888-NOT-2-LATE (888-668-2528) if you live outside Santa Fe. This hotline will give you a list of the five nearest hospitals, health centers, doctors, nurses or pharmacists who are licensed to provide emergency contraception.

 

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