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Morning After Pill – Abortion, or Prevention of Pregnancy?

By Isaac Ben-Or, M.D., Attending Physician at 75th St. & 126th St. Medical, Ocean Pines Medical & Doctors Weight Control & Wellness centers, Ocean City, MD.

The answer is simple, it is a contraception method. It is not an abortion. Many physicians, including myself, who do not perform abortions, prescribe the combination of birth control pills for the prevention of a pregnancy after a non-protected sex

What is the "morning after pill?" It is a regular birth control pill given as a single or a double dose twice a day for one day. It has to be taken immediately after the sexual contact, up to 72 hours after. After that it will not work.

This combination will prevent about 90% of potential pregnancy. The prevention rate is better as it is closer to the time of the sexual contact.

Understanding the biology of the human pregnancy will clarify this controversial issue:

In order to a pregnancy to occur, a non-protected sexual intercourse has to happen between a healthy and normal (sexually) male and a female, at the appropriate time. A human female can conceive only in a narrow time period that occurs just prior to her mid cycle, where ovulation takes place. How many pregnancies will result in from such an act? Many would think that pregnancy is inevitable, but only 6 women out of 100 will become pregnant.

The sperm has to make its way through the opening of the womb (the cervix), through the cavity of the womb (uterus) and then into the fallopian tube. There it will wait for the egg to arrive (from the ovary). This wait may extend over 24 hours.

The genetic material (DNA) of the sperm penetrates the wall of the egg and combines with the DNA of the egg. The two DNA materials combine with each other to form a new set of genes which is made from the male and female ones but it is not identical to either. This entity is called now an embryo or conceptus. This process takes place in the fallopian tube (and not in womb), and it is called conception. But it is not a pregnancy yet. The majority of the embryos will vanish and their remains will be expelled in the next menstrual bleeding.

To those embryos that will result in a pregnancy, it takes 7 days to move from the fallopian tube to the womb and to be implanted into the wall of the uterus where pregnancy begins. If the embryo cannot dig itself into the wall of the womb, pregnancy does not occur. Since it will be deprived of blood supply, which provides nutrients that are essentials for developing and growing. Once this process began, the embryo becomes a fetus.

As you recall the "morning after pill" is effective in the first 3 days following the sexual contact, long time before the pregnancy occurs. Also to note is that even without this treatment, the majority of women will not become pregnant.

Since the treatment is not 100% effective, and some pregnancies will develop inspite of it, can this harm the pregnancy? Most likely not, since the pills contain hormones that are similar to the natural ones in the mother system. These hormones exist in a high concentration in order to maintain a normal pregnancy.

Babies of women that became pregnant while using birth control pills, were as normal as any other babies, whose mothers did not use ones.

The morning after pill is a good addition to the contraception options. Again, it is not an abortion, but it can prevent an abortion, which is not risk free.

I would recommend to all of you to have your physicians provide you with a prescription for this treatment, so it will be available when needed. It will prevent the anxiety and the emergent visit to your health care provider.

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