The Chemistry of Emergency Contraceptives(ECs): Effectiveness and Safety in Preventing Pregnancy After Rape in Nigeria

In the intricate tapestry of human biology and chemistry, the role of emergency contraceptives (ECs) emerges as a crucial topic, particularly in scenarios of sexual assault. In Nigeria, where societal and legal barriers often complicate access to reproductive health services, understanding the chemistry, effectiveness, and safety of emergency contraceptives can make a significant difference.

Chemistry Behind Emergency Contraceptives

Emergency contraceptives are designed to prevent pregnancy after unprotected sex or contraceptive failure. They are not meant to be used as a regular form of birth control but serve as a critical option in emergency situations. Emergency contraceptives primarily work through hormonal mechanisms. They can be classified into two main categories: hormonal pills and copper intrauterine devices (IUDs). Here’s a closer look at their chemical workings:

1. Hormonal Pills:

Levonorgestrel (LNG):  This is a progestin-only pill, often known as the “morning-after pill.” LNG inhibits or delays ovulation—the release of an egg from the ovary. It may also thicken the cervical mucus, making it harder for sperm to enter the uterus.

Ulipristal Acetate (UPA):  This is a newer type of emergency contraceptive pill that works by altering the function of the progesterone receptor. It effectively delays ovulation even when taken closer to the time of ovulation compared to LNG.

2. Copper IUDs:

The copper IUD releases copper ions into the uterus, which are toxic to sperm and prevent fertilization. Additionally, it induces an inflammatory reaction in the uterine lining that makes it inhospitable to a fertilized egg.

Effectiveness in Preventing Pregnancy

The effectiveness of emergency contraceptives can vary based on several factors, including the type of EC used, timing of administration, and the individual’s cycle.

 Hormonal Pills:

Levonorgestrel:  Effective up to 72 hours after unprotected sex, with the highest efficacy when taken within 24 hours.

Ulipristal Acetate:  Can be effective up to 120 hours (5 days) after unprotected sex, and it remains effective throughout this window.

Copper IUDs:

They are the most effective form of emergency contraception, capable of preventing pregnancy if inserted within 5 days after unprotected sex.

Safety and Risk Considerations

Emergency contraceptives are generally safe but can have side effects. Their side effects are typically mild and include nausea, fatigue, and changes in menstrual bleeding patterns. It is important to note that ECs do not protect against sexually transmitted infections (STIs) or future pregnancies if additional unprotected intercourse occurs.  However, understanding their side effect is crucial:

Hormonal Pills: Side effects like nausea or headaches are relatively common but generally do not lead to serious health issues. Severe side effects are rare and often associated with existing health conditions

Copper IUDs: Side effects might include cramping and heavier menstrual bleeding. However, serious complications are rare.

Challenges and Considerations in Nigeria

Access to emergency contraceptives in Nigeria can be challenging due to cultural stigmas, legal restrictions, and limited availability in healthcare facilities.  Rape survivors face additional hurdles in accessing timely and appropriate care. Here are some considerations:

• Many survivors may not have immediate access to ECs due to lack of availability in local    pharmacies or healthcare centers, or due to the high cost.
• Stigma surrounding rape and contraceptive use may deter individuals from seeking help. Education and awareness are crucial in overcoming these barriers.
• Ensuring that emergency contraceptives are integrated into healthcare services and that healthcare professionals are trained to handle such cases sensitively is vital.