You may not feel comfortable hearing that "morning-after Philippines" is a popular search keyword. But emergency contraception comes in handy not only for women who have had unprotected sex but also for those who are using birth control methods that failed, such as when a condom rips or slips during intercourse, missing two or more birth control pills within a menstrual cycle, or when a woman is forced to engage in sex.

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Unfortunately, the Philippines is one of 22 countries around the globe that is actively opposed to emergency contraception. While the Responsible Parenthood and Reproductive Health Act of 2012 gives women more access to more birth control, it does not include emergency contraception such as the morning-after pill. 

How emergency contraception works

Emergency contraception does NOT cause abortion. Medical institutions and the U.S. Food and Drug Administration (FDA) state emergency contraception does not terminate a pregnancy. What it does is help reduce the chances of conception.

Here's how it works, as described in BirthControl.com: A woman doesn't automatically get pregnant right after having sex. After intercourse, sperm lingers in the woman's reproductive system for up to six days waiting for an egg to fertilize. This is why the timing of emergency contraception is crucial — it must be taken within three to five days after sex. Emergency contraception will delay ovulation or stop the ovaries from releasing an egg and block the sperm from meeting the egg.

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Types of emergency contraception

According to Planned Parenthood, a non-profit organization that delivers vital reproductive health care, sex education, and information to millions of women, men, and young people worldwide, there are three types of emergency contraception:

Copper IUD

Also known as a non-hormonal IUD, a copper IUD is a small T-shaped device that's inserted inside the uterus. The coiled copper wire produces an inflammatory reaction that is toxic to sperm and eggs, preventing pregnancy for the long-term.

As a form of emergency contraception, copper IUDs should be inserted in the woman's uterus within five days after engaging in unprotected sex. You need a doctor's prescription and a medical professional to implant it in your uterus. 

The good news: It's the most effective form of emergency contraception. Copper IUDs are also much cheaper than its hormonal counterparts. Some of our local health centers also offer it for free.

Emergency contraceptive pills (ECP)

Emergency contraceptive pills (ECP), more commonly known as the morning-after pill, should be taken within three to five days after having unsafe sex. It's the go-to solution for many women because it's more accessible and cheaper compared to getting a copper IUD.

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ECPs offer up to 89-percent effectiveness when taken within three days after unprotected sex, though studies have shown they may not work as well on women with high body mass index (BMI). As the name implies, ECPs should only be used for emergencies. Consult your doctor for a birth control method that suits your long-term needs.

There are two kinds of ECP, depending on its active ingredients. One is a pill with ulipristal acetate, and the other is a pill with levonorgestrel. Both types are NOT available in the Philippines. You may purchase it outside the country but for a hefty price.

A pill with ulipristal acetate

This is only available in the U.S. (under the brand name "ella") and in Europe (under the brand name "ellaOne") and by prescription only. It's considered a stronger and more effective kind of ECP compared to morning-after pills that contain levonorgestrel. It can be taken within five days after having unsafe sex. It's as effective when you take it on Day 1 or Day 5 after engaging in unprotected sex.

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A pill with levonorgestrel

This type of ECP includes brands names "Plan B One-Step," "My Choice," "My Way," "Aftera," to name a few, and may or may not need a prescription depending on the woman's age and location. It should be taken within three to five days after having unsafe sex. The sooner you take them after sex, the better the chances that they will work.

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The Yuzpe Method

ECPs are not available here in the Philippines, but there is an alternative. Some contraceptive pills available in the country contains levonorgestrel, the same active ingredient found in the morning-after pill. It's a synthetic form of the hormone progesterone, so it's used in progestin-only pills (mini-pill), as well as in combination pills or those that contain both progestin and estrogen.

As a substitute for the morning-after pill, a woman who has had unsafe sex can take a potent dose of contraceptive pills, following what the World Health Organization (WHO) calls the Yuzpe method. By taking certain regular contraceptive pills in a specific order and dosage, daily birth control pills may prevent an unplanned pregnancy before it starts.

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Contraceptive pills that work with the Yuzpe method must have the active ingredients ethinylestradiol (100 μ) with levonorgestrel (0.5 mg) or high-dose levonorgestrel (0.75 mg). Take the first dose within 72 hours of unprotected sex and then 12 hours after the first dose. The sooner you take the first dose, the better chances it has of preventing conception and fertilization.

Among the contraceptive brands that work with the Yuzpe method are Nordette, Trust Pills, Lady, Charlize, Seif, Femenal, and Nordiol, among others. These brands contain either levonorgestrel or levonorgestrel and ethinylestradiol in different doses. With the Yuzpe method, you can be taking four to five pills at one time. This is why a consultation with a doctor is still a must before ingesting improvised ECPs.

Who can use emergency contraception

Unlike hormonal birth control methods, most women can use emergency contraception. However, as with any medication, there are contraindications such as BMI, family and medical history, as well as if you're breastfeeding. Planned Parenthood actually devised a quiz to check what type of emergency contraception suits you. Again, it is best to consult your doctor about it.

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Typically, IUDs aren't recommended for women who have allergies to the copper or other components of copper IUD, have uterine abnormalities, pelvic inflammatory disease, unexplained vaginal bleeding, uterine or cervical cancer. Such conditions may interfere with the placement and retention of IUD. Some women expel the IUDs without knowing it.

ECPs, on the other hand, deals with hormones and a high dose at that, so expect some side effects such as dizziness, fatigue, breast tenderness, headaches, stomach aches, weight gain, or weight loss. You may also get your menstrual period earlier, and it may be more substantial than your usual blood flow.

If you vomit after taking ECP, immediately consult your doctor. You might be ordered to retake the pills or try a different kind of emergency contraception. Seek your doctor advise ASAP, too, if you bleed more profusely than your typical heavy menstrual flow.

This story originally appeared on Smartparenting.com.ph.

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* Minor edits have been made by the Femalenetwork.com editors.

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