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Fact Sheet
Published by the Katharine Dexter McCormick Library Planned Parenthood Federation of America 434 West 33rd Street, New York, NY 10001 The Difference Between the Morning-After Pill and the
Abortion Pill

There has been considerable public confusion about the difference between the morning-after pill and the abortion pill
because of misinformation disseminated by anti-choice groups. The morning-after pill, also known as emergency
contraception, helps prevent pregnancy; the abortion pill, also known as medication abortion, terminates pregnancy.
According to the general medical definitions of pregnancy that have been endorsed by many organizations — including
the American College of Obstetricians and Gynecologists and the United States Department of Health and Human
Services — pregnancy begins when a pre-embryo completes implantation into the lining of the uterus (ACOG, 1998;
DHHS, 1978; Hughes, 1972; “Make the Distinction …, “ 2001). Hormonal methods of contraception, including the
morning-after pill, prevent pregnancy by inhibiting ovulation and fertilization (ACOG, 1998). The abortion pill terminates a
pregnancy without using instruments. By helping women terminate unwanted pregnancies up to 63 days after their last
menstruation, the abortion pill is a safe and effective option.
THE MORNING-AFTER PILL
THE ABORTION PILL
What is the morning after pill?
What is the abortion pill?
Also known as emergency contraception, the Also known as medication abortion, the abortion pill morning-after pill contains medication that reduces contains medication called mifepristone to induce the risk of pregnancy if started within 120 hours (five abortion. Mifepristone (Mifeprex®) can be taken days) of unprotected intercourse. Two brands — under supervision up to 63 days after the first day of Next Choice® and Plan B One Step® — contain the the last menstrual period. It is used in conjunction hormone progestin and are currently available over with misoprostol, which is taken later to complete the the counter to individuals who are 17 or older. They abortion (Creinin & Aubény, 1999; Middleton et al., are also available by prescription, as is ella®, which contain ulipristal acetate (UPA), and certain brands of oral contraception taken in increased doses for Pharmaceuticals, 2006; Glasier, 2010; RHTP, 2009; Rodrigues et al., 2001; Van Look & Stewart, 1998).
THE MORNING-AFTER PILL
THE ABORTION PILL
How does the morning-after pill work?
How does the abortion pill work?
In its approval of the morning after pill, the U.S. Mifepristone ends pregnancy by blocking the Food and Drug Administration (FDA) delcared, hormones necessary for maintaining a pregnancy. “Emergency contraceptives act by delaying or Misoprostol causes the uterus to contract and empty inhibiting ovulation and/or altering tubal transport of sperm and/or ova (thereby inhibiting implantation)” (FDA, 1997). More recently, studies suggested that progestin-only morning-after pills work only by preventing ovulation or fertilization, and have no effect on implantation (Croxatto et al., 2003; Novikova et al., 2007). In 2008, a consortium of authorities declared that progestin-only emergency contraception does not interfere with implantation (ICEC-FIGO, 2008). UPA works only by preventing How effective is the morning-after pill?
How effective is the abortion pill?
The morning-after pill is very effective at reducing The abortion pill is highly effective at ending very the risk of pregnancy. Studies have shown that it early pregnancies. Complete abortion will occur in reduces the risk of pregnancy when taken up to 120 96–97 percent of women who choose mifepristone. hours after unprotected intercourse. With the In the small percentage of cases that medication exception of UPA, the sooner the dosing begins, the abortion fails, other abortion procedures are required more effective the treatment. When taken within 72 to end the pregnancies (ACOG, 2001; Schaff et al., hours of unprotected intercourse, morning-after pills that contain both estrogen and progestin reduce the risk of pregnancy by 75 percent. Within that same time, progestin-only regimens, such as Plan B One Step and Next Choice, reduce the risk of pregnancy by 89 percent. When initiated within 24 hours of unprotected intercourse, progestin-only morning- after pill reduced the risk of pregnancy by 95 percent (Ellertson et al., 2003; Rodrigues et al., 2001; TFPMFR, 1998; Van Look & Stewart, 1998). The effectiveness of UPA, however, does not diminish over the course of the five days following unprotected intercourse (Fine et al., 2010; Glasier et How safe is the morning-after pill?
How safe is the abortion pill?
The morning-after pill is safe for nearly all women — The abortion pill is safe for most women — millions millions of women around the world have used it of women around the world have used it safely. safely (Guillebaud, 1998; Van Look & Stewart, There are risks associated with all medical procedures, including abortion. And, in extremely rare cases, death is possible from serious complications of the abortion pill, but it remains safer than carrying a pregnancy to term (ARHP, 2008). THE MORNING-AFTER PILL
THE ABORTION PILL
Does the morning-after pill cause an abortion?
Can the medicines used in the abortion pill also
The morning-after pill will not induce an abortion in a be used for emergency contraception?
woman who is already pregnant, nor will it affect the Although some studies show that mifepristone could developing pre-embryo or embryo (Van Look & be used in very low doses to reduce the risk of Stewart, 1998). Emergency contraception prevents pregnancy as a method of emergency contraception pregnancy and helps a woman prevent the need for within five days of unprotected intercourse, it is not approved for use as emergency contraception in the United States at this time (Ho et al., 2002: TFPMFR, Why might a woman choose the morning-after
Why might a woman choose the abortion pill?
Women might choose the abortion pill as a way to Women may choose emergency contraception as a end pregnancy because it is a noninvasive way to prevent pregnancy after unprotected procedure and does not require anesthesia. It is intercourse — in cases of unanticipated sexual free from the risk of injury to the cervix or uterus and activity, contraceptive failure, or sexual assault. the possible complications caused by the use of Nearly half of America’s 6.7 million annual anesthesia used for other abortion procedures pregnancies are unintended (Finer & Zolna, 2011). (Aguillaume & Tyrer, 1995). Women who chose medication abortion also reported that they felt it was a more “natural” way to end a pregnancy Does the morning-after pill have side effects?
Does the abortion pill have side effects?
Side effects are far less common using progestin- The most common side effects following medication only and UPA pills than using combined hormone abortion are similar to those of a miscarriage — pills. The most common side effects include nausea abdominal pain, bleeding, changes in body and vomiting. Abdominal pain, breast tenderness, temperature, dizziness, fatigue, and gastrointestinal dizziness, fatigue, headaches, and irregular bleeding distress (ACOG, 2005; Creinin & Aubény, 1999; may also occur (Van Look & Stewart, 1998; OPR, 2011; TFPMFR, 1998; Trussell & Schwarz, 2011). How long does the process of using the
How long does the process of the abortion pill
morning-after pill take?
Combined hormone pills are taken in two doses, 12 It begins immediately after taking the mifepristone. hours apart. Progestin-only pills can be taken in one Some women may begin spotting before taking the dose. UPA is taken in one dose. Side effects misoprostol, the second medication. For most, the associated with emergency contraception pills bleeding and cramping associated with medication generally subside within 48 hours. They affect the abortion begin after taking it. More than 50 percent timing of the menstrual cycle in 10–15 percent of of women who use mifepristone abort within four or women. Changes in the menstrual cycle are seen five hours after taking the misoprostol. Heavy with combined hormone, progestin-only, and UPA bleeding may continue for about 13 days. Spotting pills. If the next menstrual cycle is more than one can last for a few weeks. About 92 percent of week late, a woman should visit her clinician for a mifepristone abortions are completed within a week pregnancy test (Fine et al., 2010; Van Look & (ACOG, 2001; el-Refaey et al., 1995; Newhall & Stewart, 1998; von Hertzen et al., 2002). Winikoff, 2000; Peyron et al., 1993; Wiebe et al., THE MORNING-AFTER PILL
THE ABORTION PILL
Are women who have used the morning-after pill
Are women who have used the abortion pill
satisfied with it?
satisfied with the method?
An overwhelming majority of morning-after pill users An overwhelming majority of women who choose are satisfied with it. One study found that 97 percent medication abortion were satisfied with it. A recent of users would recommend it to friends and family study found that 97 percent of women who had a (Harvey et al., 1999). Another study found that 92 medication abortion would recommend it to a friend. Additionally, 91 percent of the women reported that contraception would use it again in the case of a they would choose medication abortion again if they contraceptive emergency (Breitbart et al., 1998). had to have another abortion (Hollander, 2000). Where can I get the morning-after pill?
Where can I get the abortion pill?
Plan B One Step and Next Choice are currently Contact your nearest Planned Parenthood health available over the counter to women and men who are 17 and older. They and other forms of www.plannedparenthood.org, another women’s emergency contraception, including UPA are also health care center, or your private clinician. Planned available by prescription for all women. If you need Parenthood health centers that do not provide a prescription for emergency contraception, you can medication abortion can refer you to a provider who contact your nearest Planned Parenthood health How much does the morning-after pill cost?
How much does the abortion pill cost?
Nationwide, the price of EC ranges from $10–$70 Nationwide, the price of medication abortion ranges (PPFA, 2012b). Costs vary from community to between $300 and $800. This includes two or three community, based on regional and local expenses. office visits, testing, and exams (PPFA, 2012a). Contact your nearest Planned Parenthood health Costs vary from community to community, based on www.plannedparenthood.org, another women’s health care center, or your private clinician. Cited References
ACOG — American College of Obstetricians and Gynecologists. Breitbart, Vicki, et al. (1998). “The Impact of Patient Experience (1998, July). Statement on Contraceptive Methods. on Practice: The Acceptability of Emergency Contraceptive _____. (2001, April). “Medical Management of Abortion.” ACOG Pills in Inner City Clinics.” Journal of the American Medical Women’s Association, 53(5 Supplement 2), 255–58. _____. (2005, October). “Medical Management of Abortion.” Creinin, Mitchell & Elizabeth Aubény. (1999). “Medical Abortion ACOG Practice Bulletin, 67, 1–12. in Early Pregnancy.” In Maureen Paul, et al., Eds. A Aguillaume, Claude & Louise Tyrer. (1995). “Current Status and Clinician’s Guide to Medical and Surgical Abortion. New Future Projections on Use of RU-486.” Contemporary Croxatto, Horatio B., et al. (2003). “Mechanisms of Action of ARHP — Association of Reproductive Health professionals. Emergency Contraception.” Steroids, 68, 1095–98. (2008, April). What You Need to Know — Mifepristone DHHS — U.S. Department of Health and Human Services. (1978). Code of Federal Regulations. 45CFR46.203. http://www.arhp.org/upload/Docs/mifepristonefactsheet.pdf, Ellertson, Charlotte, et al. (2003). “Extending the Time Limit for Starting the Yuzpe Regimen of Emergency Contraception Barr Pharmaceuticals, Inc. (2006, August 24). FDA Grants OTC to 120 hours.” Obstetrics and Gynecology, 101, 1168–71. Status to Barr’s Plan B® Emergency Contraceptive: Historic El-Refaey, H., et al. (1995). “Induction of Abortion with Dual Status Decision Provides OTC Access to Those 18 Mifepristone (RU 486) and Oral or Vaginal Misoprostol.” Years of Age and Older; Remains Prescription for Women New England Journal of Medicine. 332(15), 983–7. 17 and Younger. [Online]. http://phx.corporate- FDA — U.S. Food and Drug Administration. (1997). “Prescription ir.net/phoenix.zhtml?c=irol-newsArticle&ID=899120. Drug Products; Certain Combined Oral Contraceptives for Use as Postcoital Emergency Contraception.” Federal Register, 62(37), 8609–12. Fine, Paul T. et al. (2010). “Ulipristal Acetate Taken 48–120 PPFA — Planned Parenthood Federation of America. (2012a). Hours after Intercourse for Emergency Contraception.” “The Abortion Pill (Medication Abortion).” [Online]. Obstetrics and Gynecology, 115(2), 1–7. Finer, Lawrence B. & Mia R. Zolna. (2011). “Unintended topics/abortion/abortion-pill-medication-abortion- pregnancy in the United States: incidence and disparities, 2006.” Contraception, 84(5), 478–485. _____. (2012b). “Emergency Contraception (Morning After Pill).” Glasier, Anne F. et al. (2010). “Ulipristal acetate versus [Online]. http://plannedparenthood.org/health- levonorgestrel for emergency contraception: a topics/emergency-contraception-morning-after-pill- randomized non-inferiority trial and meta-analysis.” The RHTP — Reproductive Health Technologies Project. (2009). Guillebaud, John. (1998). “Commentary: Time for Emergency “FDA Approved Emergency Contraceptive Products Contraception with Levonorgestrel Alone.” The Lancet, Currently on the U.S. Market.” [Online]. http://www.rhtp.org/contraception/emergency/document Harvey, S. Marie, et al. (1999). “Women’s Experience and s/FDAApprovedEmergencyContraceptiveChartDecemb Satisfaction with Emergency Contraception.” Family er2011-PRINTABLE_000.pdf, accessed January 10, Planning Perspectives, 31(5), 237–40 & 260. Ho, Park Chung, et al. (2002). “Mifepristone: Contraceptive and Rodrigues, Isabel, et al. (2001). Effectiveness of Emergency Non-Contraceptive Uses.” Current Opinions in Contraceptive Pills Between 72 and 120 Hours After Obstetrics and Gynecology, 14(3), 325–30. Unprotected Sexual Intercourse.” American Journal of Hollander, Dore. (2000). “Most Abortion Patients View Their Obstetrics and Gynecology, 184(4), 416. Experience Favorably, But Medical Abortion Gets a Schaff, Eric, et al. (2000). “Low-Dose Mifepristone Followed by Higher Rating Than Surgical.” Family Planning Vaginal Misoprostol at 48 Hours for Abortion up to 63 Days.” Contraception, 61(1), 41–6. Hughes, Edward, Ed. (1972). Obstetric-Gynecologic Schaff, Eric, et al. (2001). “Randomized Trial of Oral Versus Terminology. Philadelphia, PA: F. A. Davis Company. Vaginal Misoprostol at One Day after Mifepristone for ICEC-FIGO — International Consortium for Emergency Early Medical Abortion.” Contraception, 64, 81–5. Contraception – International Federation of Gynecology Stewart, Felicia H., et al. (2005). “Abortion.” Pp. 673–700 in & Obstetrics. (2008-October). “How do levonorgestrel- Robert A. Hatcher, et al., Eds., Contraceptive only emergency contraceptive pills (LNG ECPs) prevent Technology — 18th Revised Edition. New York: Ardent http://www.cecinfo.org/PDF/ICEC_MOA_10_14.pdf, TFPMFR — Task Force on Postovulatory Methods of Fertility Regulation. (1998). “Randomised Controlled Trial of “Make the Distinction: EC Prevents Pregnancy.” (2001). Levonorgestrel Versus the Yuzpe Regimen of Contraceptive Technology Update, 22(1),4. Combined Oral Contraceptives for Emergency Middleton, Tamer, et al., (2005). “Randomized Trial of Contraception.” The Lancet, 352(9126), 428–33. Mifepristone and Buccal or Vaginal Misoprostol for _____. (1999). “Comparison of Three Single Doses of Abortion Through 56 Days of Last Menstrual Period.” Mifepristone as Emergency Contraception: A Randomised Trial.” The Lancet, 353(9154), 697–702. Newhall, Elizabeth Pirruccello & Beverly Winikoff, (2000). Trussell, James, and Eleanor Bimla Schwarz. (2011). “Abortion with Mifepristone and Misoprostol: "Emergency Contraception." Pp. 113–145 in Robert A. Regimens, Efficacy, Acceptability and Future Hatcher et al., eds., Contraceptive Technology — 20th Directions.” American Journal of Obstetrics and Revised Edition. New York: Ardent Media, Inc. Van Look, Paul & Felicia Stewart. (1998). “Emergency Novikova, Natalia, et al. (2007). “Effectiveness of levonorgestrel Contraception.” In Robert A. Hatcher et al., Eds, emergency contraception given before or after ovulation Contraceptive Technology — 17th Revised Edition. — a pilot study.” Contraception, 75, 112–118. OPR — Office of Population Research, Princeton University. von Hertzen, Helena, et al. (2002). “Low Dose Mifepristone and (2011, February 22, accessed April 21, 2011). Two Regimens of Levonorgestrel for Emergency “Answers to Frequently Asked Questions About… Contraception: A WHO Multicentre Randomised Trial.” Types of Emergency Contraception.” [Online]. http://ec.princeton.edu/questions/dose.html, Wiebe, Ellen, et al. (2002). “Comparison of Abortions Induced by http://ec.princeton.edu/questions/eceffect.html, and Methotrexate or Mifepristone Followed by Misoprostol.” http://ec.princeton.edu/questions/ecsideeffects. Obstetrics and Gynecology, 99(5), 813–9. Peyron, R., et al. (1993). “Early Termination of Pregnancy with Winikoff, Beverly. (1995). “Acceptability of Medical Abortion in Mifepristone (RU 486) and Orally Active Prostaglandin Early Pregnancy.” Family Planning Perspectives, Misoprostol.” New England Journal of Medicine, Lead Author — Jennifer Johnson, MPH Revised by — Jon Knowles 2012 Planned Parenthood Federation of America. All rights reserved. Planned Parenthood®, PPFA®, and the
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