How Well do You Know the Pill

Since time immemorial women have been prisoners of their fertility. With the advent of ‘the pill’ fifty years ago, women were set free from the tyranny of unwanted pregnancies. For the last fifty years the pill has helped women to seek education, plan family, space children and carve out careers. Beyond preventing pregnancies the pill has been helping women treat acne and skip periods. To modern women it would be hard to imagine that the US officials were not initially comfortable announcing the approval of the world’s first oral contraceptive. “… Our own ideas of morality had nothing to do with the case,” said John Harvey of the Food and Drug Administration in 1960.
For the record the pill comes in three variants—oral contraceptive pill, emergency contraceptive pill and abortion pill. The contraceptives have been around since the ’60s itself soon after debuting in the west, the abortion pills arrived in 2002, 15 years after their launch in Europe and China. The morning after or the emergency pill appeared at the bedside only three years ago.

In the last decade the pill has really worked wonders. Maternal mortality went down from 6-8 percent in 2008 from 16-18 percent in 2002; abortions dropped to 60,600 in 2009 from 669,298 in 2004. Everybody is not happy though. Dr Kaushiki Dwivedee, senior consultant Gynaecology with Max Hospitals says, “The emergency pill has given wings to all especially the teenage girls who are misusing pills to experience transitory happiness and in the process putting their health at stake too. I’ve come across many such instances where girls have used oral contraceptive pills three to four times in a month.” Says Dr Dwivedee, “As the name suggests emergency pills should be taken in cases of emergency arising out of ruptured condoms, missed oral contraceptive pill or one off casual sex.” “By no means, the pill should be taken as a substitute for regular contraceptives,” warns she.
The pill is by and large successful in preventing pregnancy if taken within 72 hours of unprotected intercourse. The emergency pill contains high doses of oral contraceptives and it prevents intra-uterine pregnancy. However, if failure occurs with the pill the pregnancy is likely to be ectopic pregnancy, where the fertilized egg gets implanted in the fallopian tubes, instead of uterus. Ectopic pregnancy is a health hazard.
 

What’s in your oral contraceptive pill?
The pills that most women are familiar with are called combination pills. It releases two different synthetic hormones—progestin and estrogen—into your body. Together, the artificial hormones work by preventing you from ovulating—releasing a mature egg cell from your ovaries. They have some other effects, as well, including thickening the mucous around your cervix, which makes it more difficult for sperm to actually get inside your uterus.
Who should not use it
If you smoke you should stay off pills. Women who get migraines need to avoid the pills too.

The mini pill
Unlike the combination pill the mini pill contains only small amounts of one hormone—progestin. It works by reducing and thickening the cervical mucus to prevent the sperm from reaching the egg. It also changes the jelly-like mucus at the entrance of the cervix, making it difficult for sperm to penetrate.
In order for mini pill to be effective you need to take it precisely the same time every day.

The abortion pill
Abortion pill is safe for foetus less than 7 weeks. If the foetus is older than seven weeks, surgical abortion is only option available.” The use of abortion pills is legal in our country and they should be used under gynae’s supervision. Abortion pills work by dilating the cervix to expel the foetus. They might cause excessive bleeding and cramping—reasons which could let your gynae decide for surgical termination of pregnancy,” says Dr Dwivedee

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