The Morning-After Pill

The Pill and other birth control devices are available everywhere, but women still get pregnant without wanting to: too many people neglect precautions at precisely the wrong time or use them improperly. Therefore scientists continue to search for an effective next-day antidote to tonight's mistake. An experiment announced last week in the Journal of the American Medical Association gives strong evidence that such a pill is not only feasible, but that a woman can have up to 72 hours after intercourse to correct matters.

Dr. Lucile Kuchera of the University of Michigan Health Service kept records on 1,000 women who had come to her since 1967. All of childbearing age, the women had had sexual intercourse in the couple of days before their visits but did not want to be pregnant. About 70% reported that coitus had taken place at a time in their menstrual cycle when conception was likely. Nearly 90% had used no contraceptive means, or said that the device used had failed to function properly.

Conception Odds. Each woman willing to take the experimental treatment was given 25 mg. of diethylstilbestrol (DES), a synthetic estrogen, twice a day for five days. The hormone substitute has long been used to relieve the symptoms of a variety of women's ailments. Five years ago, researchers at Yale University School of Medicine found that it could also prevent pregnancy, apparently by blocking implantation of the fertilized egg in the uterine wall.

The probability of conception from a single act of unprotected coitus is between one in 25 and one in 50; thus at least 20 pregnancies should have occurred among Dr. Kuchera's 1,000 patients. But not one became pregnant. Nor did any suffer serious side effects from the drug, though some experienced nausea and intermittent vomiting for a few days.

Dr. Kuchera's success has been duplicated elsewhere. Several physicians have used DES to prevent pregnancies in rape victims, and Dr. Takey Crist and Cecil Farrington of the University of North Carolina reported last week that they had used an animal estrogen successfully with 94 patients. But neither Dr. Kuchera nor her colleagues see DES as a panacea for unwanted pregnancies. The drug has been linked to cancer of the vagina in the daughters of women who took it for other purposes (TIME, Aug. 2). The Food and Drug Administration has not approved it for general use as a pregnancy preventive. Until DES is better understood, say the doctors, the morning-after pill should be only a last resort.

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