Hidden Dangers Of Misusing “Morning-after” Pills

Have you ever asked yourself on how many times women and young girls are advised to use the Emergency Contraceptive Pill (ECP) or popularly known as the morning after pill?

If not, it is only twice a year as frequent uses can easily cause an ectopic pregnancy, cancer, infertility and an array of complications according to medical experts.

The ECP is a way to prevent pregnancy after unprotected sẹx.

The pills can be taken up to 120 hours (5 days) after having unprotected səx .

Emergency contraceptive pills prevent pregnancy by preventing or delaying ovulation and they do not induce an abortion.

A random survey by Your Health shows that, 15 women use the morning after pill twice or once a month.

Among them, girls at university level go up to three to four times a month.

Amina Said*,19, a second year student at the University of Dar es Salaam is among the many girls who frequently use of morning after pill.

Sadly, she is also one of the many who are not aware of the health dangers she is likely to get because of that.

For people like Amina, who are totally blind about the health dangers that come with frequent use of the morning after pill, Dr Living Colman, a Gynaecologist at Muhimbili National Hospital says it can also result to new cases of HIV/AIDS infections.

Adding to that he says, women who frequently use of the morning after pill are increasing their risk of contracting HIV/AIDS as they tend to have unprotected səx frequently with the intention to use the emergency contraceptive pill.

This goes beyond just HIV/AIDS as they are also at risk of contracting other səxual transmitted diseases which come along with unprotected səx.

Being informed on the dangers she is likely to face with the frequent use of the pill, Amina says, the pill is an easy way to many girls as it is cheap and easily accessed.

It keeps away women from the distress of unwanted pregnancies unlike buying a condoms at the pharmacy.

“I have always known of how unprotected səx can negatively affect one and its ability to spread HIV but majority of us take things for granted, something which will cost us in the future. I am now worried about my health due to the countless times I have had səx with my boyfriend,” says Amina.

She says, majority of her agemates shun away from buying c0nd_oms at the counter out of the fear of societal prejudice.

If you want to buy a c0ndo_m at the counter, everyone from the seller to other clients in the pharmacy will look at you surprised and judge you as a prostitute.

Marina Ismail*,37, is a married woman with two children and also a banker.

She completely agrees with Amina that people react differently when you are buying a c0nd_om as opposed to purchasing an emergency contraceptive pill.

She calls for more awareness and understanding on the importance of having protected səx that will encourage behavioural change and see condoms as any other method of contraceptive method.

Marina falls under the group of 25 women in the random survey by Your Health. She says, she uses it almost every month. And it has her failed on two different occasions.

She says, she had to go through different ways to initiate a home ab0rti_on and one of the incidents was not successful.

She ended up going to the hospital and said she had a miscarriage for her to be treated with post ab0rt_ion care (PAC), a treatment and counselling for women who have endured abortions and miscarriages.

“We all understand our law does not allow ab0rtio<n. How would I have gotten the service without lying? If we had friendly environment for people to access c0ndo_ms it would have been much better to use condoms instead of the pill,” says Marina.

Responding to why Marina had one failed case even after using the pill Dr Colman says, according to the World Health Organization (WHO) recommendations shows that the ECP are very effective if used as within recommended hours.

The proven effects are hormonal imbalance, irregular periods and a change in the ovulation cycle.

It is also recommend to reach out to medical experts before taking any hormonal contraceptive, even the ones purchase the over the counter.

Minister for Health, Ummy Mwalimu was quoted saying: “The morning after pill should be made available for users but it should go along with the right information to the users to avoid more damage in future.”

She said, the misuse of ECPs can result to cancer and infertility for women.

She called upon health experts to continue educating the society on the right ways to use the pills.

Available information from the WHO shows that the side effects of using the ECPs are similar to those of oral contraceptive pills.

Things like nausea and vomiting, slight irregular vaginal bleeding, and fatigue are to be expected.

The website shows, the side effects are not uncommon, are mild, and will normally resolve without further medications.

If vomiting occurs within 2 hours of taking a dose, the dose should be repeated.

WHO recommends that all women and girls at risk of an unintended pregnancy have the right to access emergency contraception and these methods should be routinely included within all national family planning programmes.

Moreover, emergency contraception should be integrated into health care services for populations most at risk of exposure to unprotected səx, including post-səxual assault care and services for women and girls living in emergency and humanitarian settings.

With the recommendations above, Juma Ismail a Pharmacist at Nyumbani Pharmacy says, ECPs are available in almost every pharmacy.

The most challenging part is women misusing them.

“As much as WHO recommends its availability, there is a need to invest in avenues to avail more information that helps women understand its implications, guiding their decisions. In a day I sell it to u to about ten women, says Juma.

“Majority of buyers are university students and some buy in bulk. For the majority of those who buy in bulk, the reason is that they use it as a form of family planning as it is easy to buy and easy to use. You can imagine years later what the effect will be,” says Juma.

According to a study titled: ‘Use of non-emergency contraceptive pills and concoctions as emergency contraception among Nigerian University students’ published at www.ncbi.nlm.nih.gov; too much of postinor-2 will weaken the wall of the womb and damage the uterus. This will cause miscarriages in the future.

This relates to Esther Shirima*,40, a married woman and mother of two who works as an accountant in a law firm in Dar es Salaam.

Five years ago she had a miscarriage. She now thinks could be the effect of misusing the ECPs.

She shares that over the years, ECPs have been her go-to means to avoid falling pregnant. She has been using these pills since her university years.

She learned about the effects on her consultation session with her gynae after she had gone through a surgery with an ectopic pregnancy.

Adding to that, she says her miscarriage happened when her pregnancy was about 12-weeks-old. She went for post abortion care and all was well until she got an ectopic pregnancy a year later.

“I never had any idea what the implications would be until I went through an ectopic pregnancy. It was very painful in the beginning as I did not know it was an ectopic pregnancy. After several visits to see my gynae, it was found that I had an ectopic and was rushed to surgery to save my life,” adds Esther.

Soon after her recovery she visited her doctor and they had a chat about her medical history going back 25 years. It turned out to be that the frequent use of ECPs could have caused a miscarriage. While she has chosen not to have any other child out of the fear of risking another miscarriage, she since not touched any ECPs.

Rose Mleta, a midwife at Muhimbili National Hospital says they give education to different women but there are myths that surround family planning methods, something that affects their efforts towards an educated community.

She says women go through a lot of challenges in dealing with unwanted pregnancies. The burden of PAC in the country is huge due to the fact that women are not ready to use the proposed family planning methods without knowing they also pose health risks through the misuse of ECPs.

A study conducted by researchers from the Muhimbili University of Health and Allied Sciences (MUHAS) and the Guttmacher Institute in 2021 shows that PAC costs the government Sh10.4 billion per year for treating a woman with post abortion care. The research shows that in order for Tanzania to meet all needs for PAC, the cost would rise to Sh25.7 billion.