Academic literature on the topic 'Morning after pill'

In Chile, the Criminal Code bans all forms of abortion. Furthermore, the Constitution—drafted and enacted by the Military Junta led by General Augusto Pinochet—was inspired by a conservative version of Catholic natural law championed by prominent Chilean constitutional law scholars. This Article traces the emergence, development, and ultimately the defeat of a persistent legal mobilization driven by natural law-inspired litigants, politicians, and scholars against levonorgestrel-based emergency contraception, also known as the morning-after pill. In their decade-long efforts at legal mobilization, these natural law litigants used every tool of the Chilean legal system to challenge the legality and the constitutionality of the morning-after pill. This case of legal mobilization demonstrates both the strengths and the weaknesses of conservative political and religious networks in Latin America, and it demonstrates both the potential and limitations of litigation-led policymaking in civil law countries.

Section 58 of the Offences against the Person Act 1861 prohibits the use of means with intent to procure ‘miscarriage’. In Smeaton Munby J held that the administration of the ‘morning after’ pill with intent to prevent the implantation in the uterus of any embryo conceived as a result of sexual intercourse does not contravene s 58. This article respectfully questions the learned judge's decision.'[Albortion techniques have changed since we legislated in 1967 ... Nowadays they can be carried out by injection or what is euphemistically called the morning after pill, which is an early abortifacient. There have always been legal doubts about whether the morning after pill can be prescribed within the present abortion law ... [Tlhe drug ... works in the early period of pregnancy.'

The number of unwanted pregnancies has not decreased in recent years and this should be addressed. Emergency contraception may be effective when used correctly having the advantage that it can be used after an episode of unprotected sexual intercourse (when regular contraception has failed or was not used). In this research project I set out to explore some of the major reasons why there are still many unwanted pregnancies in Australia. I decided to focus on the use and non-use of emergency contraception, e.g. emergency contraception pill (ECP) “method failures” are not well understood because the actual mechanisms of action are still unclear. There is evidence ECP can effectively interfere with follicle growth and ovulation. It is much less clear is whether ECP is able to interfere with fertilization and implantation, in a way, which may make it acceptable to those who have strong religious beliefs in fertilization being the start of new life. Emergency contraception has the potential to prevent many unwanted pregnancies when unprotected intercourse has occurred. It has relatively high efficacy in many studies, but true method failures are not well understood. By contrast, many unwanted pregnancies occur for “social reasons” where emergency contraception has not been used. I set out to study changes in knowledge and usage of emergency contraception in these groups of Australian women seeking termination of pregnancy: 1. Before a dedicated emergency contraception pill (ECP) pack (Postinor) became available in Australia 2. One year after dedicated ECP became available on prescription 3. One year after the ECP pack became available “over the counter” without prescription. Ninety-nine women were recruited during their presentation with a request for ECP at the six Family Planning Clinics in Australia. All women took LNG 1.5mg in a single dose during the clinic consultation. A blood sample was taken immediately prior to ingestion of the ECP for estimation of serum LH, oestradiol and progesterone levels to calculate the day of the menstrual cycle. Based on these endocrine data we estimated the timing of ovulation to within a ±24-hour period with an accuracy of around 80%. Women were followed up 4-6 weeks later to ascertain pregnancy status. The effectiveness of ECP when taken before and after ovulation was determined. Three women in this study became pregnant despite taking the ECP (pregnancy rate 3%). All three women who became pregnant had unprotected intercourse between day -1 and 0 and took the ECP on day +2, based on endocrine data. Day zero was taken as ovulation day. Among seventeen women who had intercourse in the fertile period of the cycle and took the ECP after ovulation occurred (on day +1 to +2) we could have expected 3 or 4 pregnancies, based on Wilcox et al data. Three pregnancies were observed. Among 34 women who had intercourse on days –5 to –2 of the fertile period, and took ECP before or around ovulation, four pregnancies could have been expected, but none were observed. The major discrepancies between women’s self-report of stage of the cycle and the dating calculation based on endocrine data were observed in this study. These data are supportive of the concept that the LNG ECP has little or no effect on post-ovulation events, but is highly effective before ovulation. Our interpretation of the data in terms of timing of treatment relative to ovulation may explain why EC with LNG works sometimes and fails at other times. A larger study is needed to prove this hypothesis. To investigate other reasons for such a high rate of unwanted pregnancy, which probably has a larger impact we looked into womens knowledge of and attitude towards ECP. Seven hundred and eighteen women participated in this study by answering a questionnaire consisting of 15 questions on their demographic and reproductive characteristics as well as the knowledge about the ECP, e.g. 208 women were enrolled before the ECP was marketed in Australia in 2001, 308 after it was marketed and 202 after it became available over the counter (Group 1, 2, and 3, respectively). We found that the participants who have heard about ECP were significantly younger (p<0.005). The mean age of women who have never heard about of ECP was 29.8 years compared to 26.3 years in women who have heard about ECP. More women were aware about the ECP after it became available over the counter. Women in group 2 had higher educational level in comparison to women in group 2 and 3 (p<0.005). There was significant trend in increased use of ECP in women of higher educational level (p<0.005). The use of ECP did not increase significantly with improved availability and access to the ECP amongst women presenting for termination of pregnancy. Wider availability of he ECP pack in Australia and an easier access to it has increased women’s awareness about the ECP. However, the use of ECP has not increased. This study provides better understanding of mechanism of action of LNG ECP and an explanation to the method failure. It also reveals poor knowledge about ECP despite its wider availability and accessibility. Improving these is a worldwide challenge for family planners and all health professionals.

Master of Medicine
The number of unwanted pregnancies has not decreased in recent years and this should be addressed. Emergency contraception may be effective when used correctly having the advantage that it can be used after an episode of unprotected sexual intercourse (when regular contraception has failed or was not used). In this research project I set out to explore some of the major reasons why there are still many unwanted pregnancies in Australia. I decided to focus on the use and non-use of emergency contraception, e.g. emergency contraception pill (ECP) “method failures” are not well understood because the actual mechanisms of action are still unclear. There is evidence ECP can effectively interfere with follicle growth and ovulation. It is much less clear is whether ECP is able to interfere with fertilization and implantation, in a way, which may make it acceptable to those who have strong religious beliefs in fertilization being the start of new life. Emergency contraception has the potential to prevent many unwanted pregnancies when unprotected intercourse has occurred. It has relatively high efficacy in many studies, but true method failures are not well understood. By contrast, many unwanted pregnancies occur for “social reasons” where emergency contraception has not been used. I set out to study changes in knowledge and usage of emergency contraception in these groups of Australian women seeking termination of pregnancy: 1. Before a dedicated emergency contraception pill (ECP) pack (Postinor) became available in Australia 2. One year after dedicated ECP became available on prescription 3. One year after the ECP pack became available “over the counter” without prescription. Ninety-nine women were recruited during their presentation with a request for ECP at the six Family Planning Clinics in Australia. All women took LNG 1.5mg in a single dose during the clinic consultation. A blood sample was taken immediately prior to ingestion of the ECP for estimation of serum LH, oestradiol and progesterone levels to calculate the day of the menstrual cycle. Based on these endocrine data we estimated the timing of ovulation to within a ±24-hour period with an accuracy of around 80%. Women were followed up 4-6 weeks later to ascertain pregnancy status. The effectiveness of ECP when taken before and after ovulation was determined. Three women in this study became pregnant despite taking the ECP (pregnancy rate 3%). All three women who became pregnant had unprotected intercourse between day -1 and 0 and took the ECP on day +2, based on endocrine data. Day zero was taken as ovulation day. Among seventeen women who had intercourse in the fertile period of the cycle and took the ECP after ovulation occurred (on day +1 to +2) we could have expected 3 or 4 pregnancies, based on Wilcox et al data. Three pregnancies were observed. Among 34 women who had intercourse on days –5 to –2 of the fertile period, and took ECP before or around ovulation, four pregnancies could have been expected, but none were observed. The major discrepancies between women’s self-report of stage of the cycle and the dating calculation based on endocrine data were observed in this study. These data are supportive of the concept that the LNG ECP has little or no effect on post-ovulation events, but is highly effective before ovulation. Our interpretation of the data in terms of timing of treatment relative to ovulation may explain why EC with LNG works sometimes and fails at other times. A larger study is needed to prove this hypothesis. To investigate other reasons for such a high rate of unwanted pregnancy, which probably has a larger impact we looked into womens knowledge of and attitude towards ECP. Seven hundred and eighteen women participated in this study by answering a questionnaire consisting of 15 questions on their demographic and reproductive characteristics as well as the knowledge about the ECP, e.g. 208 women were enrolled before the ECP was marketed in Australia in 2001, 308 after it was marketed and 202 after it became available over the counter (Group 1, 2, and 3, respectively). We found that the participants who have heard about ECP were significantly younger (p<0.005). The mean age of women who have never heard about of ECP was 29.8 years compared to 26.3 years in women who have heard about ECP. More women were aware about the ECP after it became available over the counter. Women in group 2 had higher educational level in comparison to women in group 2 and 3 (p<0.005). There was significant trend in increased use of ECP in women of higher educational level (p<0.005). The use of ECP did not increase significantly with improved availability and access to the ECP amongst women presenting for termination of pregnancy. Wider availability of he ECP pack in Australia and an easier access to it has increased women’s awareness about the ECP. However, the use of ECP has not increased. This study provides better understanding of mechanism of action of LNG ECP and an explanation to the method failure. It also reveals poor knowledge about ECP despite its wider availability and accessibility. Improving these is a worldwide challenge for family planners and all health professionals.

This article analyzes the judicial behavior and the importance of judges in policy making in Peru regarding the case of the magistrates of the Constitutional Tribunal and its decisions regarding the morning after pill. We will focus our research on the shift in orientation of two veredicts issued by this judicial institution; one in favor of its state sponsored distribution (2006) and one against it (2009). In order to analyze the circumstances that led to this two different outcomes, we state that the morning after pill, a case of consciousness, made the judges decide based on their strategic alliances inside the tribunal or their own personal trajectories. In order to solve these dilemmas, the analysis of the kind of judges in the tribunal was crucial to understand the relationship between the elected judges and the interests of political parties in parliament. We believe that the shift in orientation of the veredicts lies in the fact that, for cases of consciousness, the Tribunal uses its sitting judges.
Este artículo analiza el comportamiento judicial y la creciente importancia de los jueces en la hechura de las políticas públicas en el Perú a partir del caso de los magistrados del Tribunal Constitucional y sus decisiones frente a la píldora del día siguiente. Nos enfocaremos en el cambio de orientación de dos sentencias emitidas por la máxima institución judicial ante la misma política; por un lado, a favor de su distribución desde el Estado (2006) y, por el otro, en contra (2009). Para analizar los factores que llevaron a este resultado sostenemos que la píldora del día siguiente, al ser un caso de conciencia, les planteó a los jueces la disyuntiva de decidir a partir de un comportamiento estratégico, de acuerdo con las tendencias dominantes al interior del tribunal o haciendo prevalecer sus trayectorias personales. Para resolver estos dilemas, el tipo de jueces que componía el tribunal resultó crucial por lo que exploraremos cómo se configuraron estas composiciones a partir de las bancadas parlamentarias y qué tipo de jueces resultaron electos (de trayectorias públicas u opacas). Sostenemos que el cambio se explicaría porque, para los casos de conciencia, el Tribunal Constitucional utiliza a sus jueces de turno y las reglas así lo permiten.