When
does a woman get pregnant? Do all the intercourses become creating a
new being? How does emergency oral contraception work? Since August
22nd, 2016, Lima's First Constitutional Court instructed EOC to be
distributed free in all health public stands, after the rule was
suspended since 2009.
The
problem was it actually could be sold in private drugstores, what
generated unequitty in access and that is what court decision tried
to balance.
But,
what is all this process about? Before, I think it's necessary you
understand some concepts and interpretations related to this issue in
case you want to join the discussion, so you also do it under equity
criteria.
Plus,
I include you sources you can go deeper about this concepts (all my
references are in Spanish, but you can find their equivalents in your
language).
1.
Reproductive cycle, ovulation and fertilization
every
month, the female organism gets ready for a pregnancy. This
preparation begins the first day of menstruation due to the ovaries
make hormones such as estrogen and progesterone, mechanism ruled by
the hypotalamus at the brain. Its objective is ova maturation, the
preparation of uterus and the rest of the female sexual organs as
well for a possible pregnancy.
The
week after the menstruation begins, the ovaries will be the
responsible for follicular maturation. As in every menstrual cycle 7
to 8 follicula start to grow, only one grows becoming mature between
cycle's days 12 to 16, moment when ovulation happens. The Fallopian
tube catches the mature ovum what begins its trip to the uterus,
which has been preparing for a possible pregnancy swelling its
endometrial layer (1). Once released, the ovum could b fertilized
when joining to spermatozzoon during next 12 to 48 hours, if not it
will begin to be disintegrated.
Human
fertilization is intern, it happens inside the woman's body in other
words, at Fallopian tubes to be exact.
Fertilization
is probable if spermatozoons (male cells) are stored in the vagina by
the intercourse at days 12 of 16of female menstrual cycle. Then,
helped by the cervical mocus and stored in upper portion of the
vagina, they start to raise to Fallopian tubes, those at the same
time have gathered a mature ovum (female cell) .
For
the fertilization (union of ovum and spermatozoon) to be produced,
it's necessary that sexual contact (intercourse) between a man and a
woman (except when artificial or assisted fertilization techniques
are used) be made in a moment close to the ovulation (1).
It's
actually easy to set that because this harmonious and almost timed
working that female reproductive system does, the women are fertile
every month during their reproductive lifetime, what begins in
menarche (first menstruation) and ends in menopause. Then, her
fertility or reproduction will be depend on mechanisms she and/or her
partner adopts to begin or prevent pregnancies, facts those response
to a biological sequence what occur cyclically in every woman,
sequence that can not be unaware to take preventive measures and let
them to God's fate neither.
2.
Pregnancy
If
spermatozzoon and owvum intercept, they will unite fusing their cores
and formin one only cell, that starting in this point, will trek to
the uterus, while it also begins a mitosis process, multiplying in
number of cells.
3
to 4 days since the ovulation, the fertilized ovum will get the
uterus, when it could last 2 to 3 days more for pinning up the
endometrium, place where the new being will develop (1).
3Emergency
oral contraception (EOC) and its action mechanism
The
emergency oral contraception (EOC) is a method that offers an
alternative to forced sexual relations or rapes, intercourses without
prior contraceptive using, misusing or its failure (4). It's
necessary to remark this method is effective only among 72 hours
after having sex. It must not be used when this deadline is over.
It's
proven the EOC works because unables the ovulation, at the same time
it thickens the cervical mocus making the spermatozzoon not to go its
way inside the uterus (5). So for example, Levonorgestrel emergency
contraception pills prevent the pregnancy unallowing or delaying the
ovulation, and avoid the fertilization due to its action on the
cervical mocus, becoming it much thicky, so decreasing the
spermatozzoon mobility with that, then its ability to join the ovum
(4).
Thus,
we support on updated scientific evidence to affirm that once the
fertilization occured, the EOC doesn't interfere the process of
fertilized ovam implantation and, neither it interferes the embryonic
development of an already implantated ovum (4).
What
it should be taken in mind is the EOC is a good method that allows
preventing non-wanted pregnancies, and the protection of the woman's
life in comsequence.
As
I already explained, it must be paid attention to action mechanism
because the EOC, as unallowing ovulation, won't display an ovum to
fertilize, then there will be not a pregnancy. Also in case, that
sexual relation has been happened after the ovulation, when an ovum
has already been produced, this method thickens the cervical mocus as
a second action mechanism, unallowing spermatozzoon and ovum
encounter. So, it is proven it's not an avortive metod, bringing down
the false theories which many politic authorities, influenced by
their ecclesiastical colleagues, are based because here is not
attempting against the life of a supposed new being, but simply
conditions for the pregnancy to occur get nullified.
4.
Sexual and reproductive rights (SRR) and Peruvian laws onEOC
In
the other hand, each men or women has the whole right to decide on
their sexuality, totally free, unattached by coercion, discrimination
or violence, to decide if having kids or not, the number and spacing
of them, as well as having true information with a scientific basis,
and access to contraceptive methodology. In other words, to have
sexual and reproductive rights (SRR), the same what were mentioned
and recognized in Confference of Population and Development in Cairo,
1994, and 4th World Conference in Beijing, 1995.
Peru's
Constitution doesn't mention explicitically to SRR of people, however
it does recognize several rights inside or related directly to SRR of
every citizen. So we find the right to dignity, free development of
personality, also the right to the life, to physical and mental
integrity, to fre concius, to free information, to personal intimacy
for quoting someones.
Additionally
on July 28th, 2005, the Family Planning technical Rule was aproved,
which objective is to guarantee and standardize the attention
processes on family planning inside the SRR focused from gender,
setting up all person has right to enjoy the highest level of own
health for allowing to enjoy own sexuality, to decide free and
responsible the number and spacing of the kids, to have access with
equity, without any discrimination, sexual orientation neither, to
sexual health and family planning services, to the access to
contraceptive methods for choosing free and volunterly, to have
access to quality services of sexual and reproductive health without
any type of coercion, to health institutions guard those principles
to be committed.
Unfortunately,
the women's SRR in Peru have not been totally recognized, as much as
EOC laws have coming out behind a machismo veil, wwhich even the
eecclesiastical authorities have self-allowed to give messages
opposed to this contraceptive method despite Peru is a secular
country, so the Church sshould not influence when ruling about issues
related to sexual rights of persons.
The
opposers' argument is the defense of a hypothetical being, not
proven, based upon the premise of life defense.
Faith,
science and machismo
despite
Peruvian law fortunately begins to have a much favorable position to
sexual rights, paradoxically it's still perceived there is a big
number of women (not counting the men) who although recognize this
contraceptive method offers a way-out before a non-wanted situation,
they still see it like something attempting against the faith,
prefering to accept what they had to live by God's fate, and that the
woman's mission by tradition andd religion is the calling to give
life despite the conditions it is given.
To
us, who have a panoramic view of what happens, can affirm
cathegorically this situation is just the product of the letargy and
the lack of interest of Peruvian Government about recognizing and
ruling on time in favor of sexual rights of people, much more women's
- that the government, after paying more attention to religiosity,
has come allowing laws those give to the woman a role of almost pure
reproduction.
If
we add disinformation to this, we have the perfect formula to
continue in the chaos that non-wanted pregnancies bring themselves
on. Then, we can elucidate that before such conditions, unfortunately
the EOC is not an option for many of our women as a mean to protect
their life, but it's not an option by own will, by pure ignorance
given by the lack of information instead, because the State (almost
holding hands to the Church and machismo) doesn't offer the
conditions for the ownn woman to be the one who recognizes, empowers
and internalizes she has sexual rights, those have not to struggle to
her faith, making them to respect.
Don't
lose our main focus, and this is the health of each person,
translated in social health, our women's mainly, because a big amount
of non-wanted pregnancies become clandestine abortion in unhealthy
places those attempt against women's physical integrity, psychologic
problems as well.
Let's
have in mind that before rapes or any intimate relation without
condom, the person exposes not only to a non-wanted pregnancy because
EOC doesn't protect from sexually transmited infections nor HIV
neither, due to this is not a method what avoids the contact to body
secretions of the other person.
If
you want to go more in-depth, I suggest go to bibliographic
references I used to write this article. Remember they are in
Spanish, so you can find out the equivalent in your language.
1.
Saludemia. Planificación familiar. Lima: Saludemia; 2016
4.
World Health Organization. Anticoncepción de Emergencia.
España: Organización Mundial de la Salud; 2016.
5.
Centro de la mujer peruana Flora Tristán. Anticoncepción
Oral de Emergencia. Lima: Centro de la mujer peruana Flora Tristán;
2016.
8.
Petrell E. Política de anticoncepción oral de
emergencia: la experiencia peruana. Simposio [Serie en internet].
2013[Citada 2016 octubre 31]; 30 (3):m [aAround 2 screens]. Available
on: http://www.scielosp.org/pdf/rpmesp/v30n3/a19v30n3.pdf
