Missed pill, cracked condom, a diaphragm that has moved … there are plenty of reasons to get pregnant. The morning-after pill, abortion … The different methods of terminating an unwanted pregnancy.
Women do not yet have the reflex to think about it, but there are different emergency contraceptives, allowing to react a few days after unprotected sex. Once their deadlines have passed, there remains the voluntary termination of pregnancy (IVG), medication or aspiration.
The morning after pill (hormonal emergency contraception)
Within a few days of unprotected or poorly protected intercourse, it is possible to take a morning-after pill. Two contraceptives of this type exist, both sold over the counter in pharmacies, without a prescription.
- The first is a high-dose progestogen based on levonorgestrel (Norlevo), to be taken no more than three days (72 h) after intercourse. .
- The second contains the active ingredient ulipristal acetate (EllaOne), to be taken maximum within five days (120 h) after sexual intercourse. This is why it is also called the day after pill.
Hormonal emergency contraception comes in the form of a single tablet. It is 95% effective when taken within 24 hours of unprotected intercourse, and 58% effective when taken 48 to 72 hours later. It can be taken at any time during the cycle.
Emergency contraception can be delivered free of charge to minors, anonymously, in pharmacies, family planning and school infirmaries (colleges and high schools). Refusal to dispense by a pharmacist is illegal
It is safe and has no serious side effects. However, contraindications exist. If menstruation does not occur within five to seven days of the expected date, a pregnancy test should be done.
Emergency contraception by IUD (intrauterine device or IUD)
After unprotected intercourse, placing an intrauterine device with copper is an extremely effective method (less than 0.2% of pregnancy, or 2 pregnancies per 1000 users, regardless of the time of the cycle).
The insertion of a copper IUD makes the uterus unfit for implantation of the ovum. Between the time of intercourse and the implantation of an egg, at least five days pass.
In the event of poorly or unprotected intercourse, it is therefore possible to have an IUD up to five days after the date of the risky intercourse . The copper IUD is considered the most effective method of emergency contraception.
Voluntary termination of pregnancy: the drug technique
Medicated abortion (voluntary termination of pregnancy) is reserved for women whose pregnancy is less than five weeks (seven weeks after the start of the last period). It takes place in three stages.
- First step: mifepristone tablets (RU 486, Mifegyne) are delivered to block pregnancy.
- Second stage, 36 to 48 hours later: another type of medication, misoprostol (two available: Gymiso and MisoOne; Cytotec long used in this indication but outside of its marketing authorization, has been withdrawn from the market in March 2018 ) is prescribed, to cause the expulsion of the egg. A few hours later, bleeding, uterine contractions, occur.
- Third stage ten days after expulsion: the doctor or midwife checks that the pregnancy has been terminated. A contraceptive pill will then be administered for one month, the day after the abortion, and a gynecological examination in the following month will be scheduled.
Voluntary termination of pregnancy: the suction technique
Aspiration abortion is performed in France before the end of the twelfth week of pregnancy. That is to say before the end of the fourteenth week of amenorrhea (absence of menstruation).
The operation takes place in the hospital under general anesthesia or local anesthesia. In the first case, the woman only stays in the hospital for three hours. In the second case, wait four to six hours after waking up.
The procedure consists in removing the egg and the internal uterine lining by means of a cannula introduced into the cervix previously dilated and connected to a suction system. Once performed, this aspiration abortion must be carefully monitored. A follow-up visit generally takes place within 14 to 21 days following an abortion.
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