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  • Title: Matters of conscience: the morning after, the night before.
    Author: Bardsley B.
    Journal: Nurs Mirror; 1983 May 25; 156(21):12-3. PubMed ID: 6552614.
    Abstract:
    The morning after pill which contains low doses of estrogen combined with progestogen (100 mcg ethinylestradiol and 500 mcg levongestrel, Ovran Eugynon), is favored by the Pregnancy Advisory Service (PAS), the British Pregnancy Advisory Service (BPAS), Brook Advisory centers, some family planning clinics, and a few enlightened general practitioners. The pills are prescribed within 72 hours of unprotected intercourse. 2 pills are taken immediately and 2 pills are taken 12 hours later. The pills act in 3 possible ways. An alternative postcoital contraceptive method is IUD insertion. Like the hormones, IUDs prevent implantation. An IUD can be inserted up to 5 days after unprotected intercourse. Leading medical authorities consider this 5-day period to be well within the time limit before implantation is completed, so it has the benefit of not interfering with an established pregnancy. Both the pill and the IUD methods of postcoital contraception appear to be very effective. It is inadvisable to use these pills more than 3 or 4 times a year. Currently, there is no well documented evidence that an IUD fitted postcoitally has failed. Women remain wary of the side effects and risks involved in postcoital contraception. Because each woman is screened by a physician before prescription of the postcoital pill, contraindications, such as the risk of thrombosis, should be ruled out. None of the disadvantages of prolonged use occur since the pill is only taken for 2 days. IUDs have the same problems that are associated with its normal use. If the woman finds her IUD comfortable, it does have the additional advantage of being an ongoing contraceptive method. Nurses play an important role in providing counseling and care to women who use postcoital contraception. When given complete information, women respond favorably to postcoital contraception. The experience of a nurse, Joanne, shows that there is a demand for postcoital contraception and that nurses are capable of dealing with it. Negative or uninformed attitudes of doctors inevitably are conveyed to nurses. Jean Spray, a health education officer and former family planning nurse, wants to see this changed so that nurses are more involved in the clinical and the nonclinical aspects of contraceptive work.
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