Many people have the misconception that preventing an unwanted pregnancy is simply about making sure to use a condom during sex, or keeping up with birth control pills to prevent a pregnancy. However, there’s also the option of emergency contraception. As the name implies, it’s something to take only in an “emergency”, when you have reason to believe you’re at risk of getting pregnant. Getting emergency contraception in Singapore isn’t as easy as you think, but it’s worth the trip to the doctor if you really need it.
No matter how careful you are, accidents can happen. Here are some scenarios where you might want to take emergency contraception after sexual intercourse:
- Condom broke during sex
- Condom came off during sex
- You or your partner forgot to use a condom
- Your partner didn’t pull out in time
- You forgot to take your birth control pill
- Intrauterine Device (IUD) slipped out of place
- You have another reason to think your birth control might not have worked
- You were forced into having unprotected sex (This can be by anyone, including a boyfriend or husband)
Types of emergency contraception in Singapore
1. The morning-after pill
As the most widely known and used form of emergency contraception, the morning-after pill is a safe and effective method to prevent pregnancy after unprotected sex. There are two types — levonorgestrel (Postinor), and ulipristal acetate (ellaOne).
How the morning-after pill works
The morning-after pill is proven to be 95 percent effective in preventing a pregnancy when taken within 24 hours after having unprotected sex. It’s 85 percent effective when taken between 25 to 48 hours after, and 58 percent effective when taken 48 hours after. This means that the sooner you take them, the better they work.
The levonorgestrel pill is made of a synthetic version of a hormone called progestin, which is also found in birth control pills. The pill works to prevent or delay ovulation. It also stops your ovaries from releasing an egg by thickening the cervical mucus and/or thinning the uterine lining.
Cervical mucus is produced in the overlying glands in the cervix. The consistency and liquidity of cervical mucus changes when you’re in different stages of your cycle. When it’s thick, it prevents germs and other substances from entering the cervix as it does not allow fluid to pass through. After taking the morning-after pill, the thickened cervical mucus blocks the sperm from entering the uterus by closing the cervix. It can even promote the destruction of sperm in your uterus.
Taking the morning-after pill also thins the uterine lining and keeps a fertilised egg from attaching to the uterus, thereby preventing pregnancy. Note that you may get your period earlier than expected or experience some spotting after taking the morning-after pill.
While the pill is a highly effective way of preventing a pregnancy, remember that it should not be used as your main form of birth control. However, if you have unprotected sex again after taking the pill, you’ll need to take it again.
Do note that you also can’t use two different types of morning-after pills at the same time or within five days of taking the first one. This may cause more harm than good as the ingredients in the pills may counteract each other and not work at all.
If you haven’t gotten your period within three weeks of taking the morning-after pill, take a pregnancy test or go to your doctor for one.
Cons of the morning-after pill
There is no conclusive evidence that the morning-after pill will work once you’ve begun ovulation. Even if the pill is taken very close to your ovulation window, there’s still a chance it may not work and you can still get pregnant. Most women won’t know when exactly they’ll ovulate, so it’s recommended for you to be on top of your regular birth control.
Also note that while this pill is highly effective for most, its effectiveness depends on factors like your weight and type of birth control you’ve been using.
Some possible side effects after taking the pill include nausea, throwing up, breast tenderness, irregular bleeding, dizziness, headaches and more. In the event you throw up within two hours of taking it, go to your doctor to see if you need to take another one.
If you experience symptoms like a swollen face, swollen eyes/tongue/lips, difficulty breathing or itchy skin / rashes all over your body, this could mean that you’re allergic to the medication. You should see your doctor immediately.
Where to get the morning-after pill
While you can get the morning-after pill over the counter in other countries, it’s not that simple in Singapore. Here, you can only get emergency contraception from a clinic or a hospital with an obstetrics and gynaecology department.
Sometimes your neighbourhood clinic may not carry the pill, so call ahead just to be safe. One more thing — you need to be at least 16 years old and only women can get the pill. Also, your partner can’t get it on your behalf.
Cost of the morning-after pill
The morning-after pill can cost almost $40 to $50 a pill. And again, the morning-after pill should only be taken for an emergency.
2. Copper IUD (ParaGard)
Another option for emergency contraception in Singapore is the copper intrauterine device (IUD). A copper IUD is a small T-shaped device with copper wrapped around it. It’s inserted into your uterus to prevent pregnancy.
While there are other types of IUDs available, only the copper IUD can be used as a form of emergency contraception.
How the copper IUD works
The copper IUD works by preventing sperm from fertilising an egg, or preventing implantation of a fertilised embryo. The copper IUD must be put in place within five days after you have unprotected sex for there to be a chance of preventing a pregnancy.
The device is also a form of long-term birth control, as it can stay in your body for three to five years. The copper IUD doesn’t affect your fertility, and can be removed anytime you want if you’re thinking of having children.
The copper IUD is 99.9 percent effective as a form of emergency contraception. However, do note that you can still get pregnant while using an IUD. In the event that you do get pregnant, there’s a high chance that you’ll have an ectopic pregnancy. An ectopic pregnancy occurs when a successfully implanted embryo grows outside the main cavity of the uterus.
Copper IUDs are non-hormonal and are a good option for those who prefer non-hormonal emergency contraception or birth control. They can also be used when you can’t use hormonal birth control for medical reasons.
Cons of the copper IUD
You may experience cramps and light bleeding immediately after inserting the copper IUD. However, they’ll usually subside within a couple of hours.
Other possible side effects include heavier and longer periods, as well as more cramping, all of which can happen especially in the first three to six months after insertion. These side effects are usually tolerable for most women and will most likely get better over time.
In rare occasions, complications such as uterine perforation, infection, and migration or expulsion of your copper IUD can occur. Birth control isn’t supposed to make you feel uncomfortable for a long period of time. If the pain or bleeding bothers you a lot, visit your doctor.
Do note that copper IUDs aren’t suitable for those with some active STDs. Work with your doctor to determine the best type of emergency contraception in Singapore for you.
Where to get a copper IUD inserted
Similar to the morning-after pill, you’ll need to go to a clinic or hospital to get a copper IUD inserted. Book an appointment as soon as possible if you need it as an emergency contraception.
The whole procedure takes about ten minutes, and it may cause some pain and discomfort.
To insert the copper IUD, a speculum is placed into your vagina for the medical professional or doctor to be able to see your cervix.
The vagina is then cleaned with an antiseptic solution, and a special inserter is used to put the IUD in through the opening of your cervix and into your uterus.
Cost of getting a copper IUD inserted
It costs about $150 to $300 to get a copper IUD inserted in Singapore.
Other contraceptive methods available in Singapore
There are three main categories when it comes to contraceptive methods: hormonal methods, non-hormonal methods and permanent methods.
Let’s look at each one in detail.
1. Hormonal methods
Birth control pills
Birth control pills contain the hormones estrogen and progestin. These hormones stop ovulation and thicken the cervical mucus, thereby preventing sperm from reaching the egg.
The pills come in a pack and you’ll need to remember to take one every day at around the same time. If you decide that you want to start having children, you can simply stop taking them.
Such birth control pills can provide other benefits. This includes preventing or reducing acne, making your periods lighter and more regular, and easing menstrual cramps.
One of the major drawbacks of being on such birth control pills is that you can easily forget to take them, which can affect their effectiveness. They also come with side effects such as a risk of blood clots (especially if you smoke), bloating, nausea, headaches, weight gain and mood swings. Some women have even found that it dampens their libido.
Contraceptive patch (Evra)
This is a thin patch that’s worn on certain parts of your body such as your arm, stomach, upper back or buttocks. It works by releasing hormones through your skin to prevent pregnancy, and many women use the patch as an easy and convenient method for birth control.
You’ll need to use the patch for three weeks in a row, then leave it off for a week. Each patch lasts for a week, and it’s important that you change your patch on time so that it’s effective.
The patch can help to regulate your periods with the hormonal boost, making them easier to predict.
However, there can be some side effects such as spotting between periods, nausea and breast tenderness. Some women may also get a rash after using it.
Contraceptive ring (NuvaRing)
This is a small and flexible ring containing hormones that’s inserted into your vagina for birth control.
The ring needs to be worn for three weeks in a row and taken out on the fourth week. The side effects are similar to those that come with the contraceptive patch.
Some women have found that the ring causes increased vaginal discharge or irritation, as well as a dampened libido.
Birth control injection
This is a hormonal injection you get once every three months from your GP or gynaecologist.
A common side effect is irregular bleeding, which can last for the first six to 12 months of getting the shot. According to Planned Parenthood, a lot of women stop getting their period about a year after getting the shot every three months. If you decide to have children, it can take a little while longer to get pregnant after you stop the shots.
Birth control implant
This comes in the form of a soft matchstick-sized rod that’s inserted by a doctor under the skin of your upper arm. The implant can stay in your body for about three to five years, and has an effectiveness rate of 99 percent.
The implant only contains one hormone: progestin. This makes it suitable for some people who can’t use methods that contain estrogen. The side effects are similar to other hormonal methods of birth control, and you may get light bruising or temporary pain on your arm where you got the implant.
Note that only a doctor or a medical professional can safely remove it from your body, and you should not try to remove it on your own.
Similar to the copper IUD, a hormonal IUD is a plastic T-shaped device inserted into your uterus. However, instead of containing copper, it contains hormones that are released in small amounts into your body for as long as six years.
Hormonal IUDs have the same side effects as the other hormonal birth control methods we’ve looked at. It can also lighten your period cramps and make premenstrual syndrome (PMS) better. In very rare cases, the IUD can slip out of place.
Here’s a look at the costs of the various hormonal birth control methods we’ve looked at.
|Contraceptive method||How much does it cost?|
|Birth control pills||$25 to $40 for a month’s supply|
|Contraceptive patch||$36 to $50 per month for three patches|
|Contraceptive ring||About $60 per month (You’ll have to replace it every month)|
|Injection||$150 to $200 per injection, where you get up to four injections per year|
|Implant||$400 to $500 per implant, which lasts you for three to five years|
|Hormonal IUD||$400 to $500, which lasts as long as six years|
Do note that all of these birth control methods require a doctor’s prescription. You can book an appointment for a consultation at a clinic or a hospital.
2. Non-hormonal methods
Many women use this method of birth control if they don’t want to use hormonal methods.
The copper in the IUD is toxic to sperm and prevents it from fertilising an egg. The copper also makes implantation of an embryo difficult.
|Contraceptive method||How much does it cost?|
|Copper IUD||$150 to $300, which lasts you for three to five years|
Typically, you can get a copper IUD at a gynaecologist’s clinic or a hospital.
3. Permanent methods
Sometimes called female sterilisation or “getting your tubes tied”, ligation is a surgical procedure where a woman’s fallopian tubes are closed or blocked. This prevents eggs from traveling to the uterus to be fertilised by sperm.
The surgery is low-risk and is a permanent method of birth control. With that said, all medical procedures pose a degree of risk, and you may experience some pain or discomfort after the procedure.
This is a birth control method for men, and is generally cheaper than ligation.
The procedure is done by cutting or blocking off the tubes that carry sperm. This is so that sperm can’t leave the body and cause a pregnancy. This is permanent and usually can’t be reversed.
A common risk would be an infection, but this is usually treatable with antibiotics.
|Contraceptive method||How much does it cost?|
|Ligation||$1,000 (Public hospital)$10,000 to $14,000 (Private hospital)|
|Vasectomy||$200 (Public hospital)$2,000 to $3,000 (Private hospital)|
Both of these contraceptive methods are available either at a private or public hospital.
If you’d like to get some personal advice on birth control or emergency contraception in Singapore, MyDoc’s partnership with DTAP clinic allows you to consult their doctors via video through the MyDoc app. Register here.