Keep Taking the Pills

by Patsy Collins

Mandy stood by the front door, waving to Kevin long after he'd gone out of sight. She'd only said goodbye to him a week ago, thinking she wouldn't see him for months; this time she really wouldn't. Kevin is in the Navy and going on deployment to the South Atlantic. He, and of course the rest of the crew, had spent the last week on final preparations. They'd been surprised when the Captain had given them some time off. Kevin had raced home to spend a few hours with Mandy. They'd made the most of the few hours they had together.

Now Mandy sighed and went back indoors. She'd miss Kevin, but she had plenty to keep her busy. They'd only recently moved into the house, so she had decorating to do and the garden to sort out. She thought she might try to make a vegetable patch. Work would take up a lot of time too, then there were her evening classes in upholstery and she'd be writing and e-mailing Kevin to let him know how she was getting on and to tell him she missed him.

It wasn't until she took her pill the following morning that it occurred to her there could be a problem. She'd been sick the night Kevin left for the first time. It was nothing serious. Probably caused by eating and drinking a lot too much with family and friends determined to give Kevin a good send off. Her emotional state once he'd left hadn't helped either. She wouldn't be ill today, she'd got over that brief period of feeling sorry for herself, but she had been last week. She remembered Aunty Kath, who's a practice nurse, saying something about being sick if you were on the pill. She checked the pack. Sure enough, that was something that could cause her contraception to fail. She rang Kath.

"Hello love, can't cope without that man of yours?" her aunt had asked.

"Of course I can, it's not that, it's just that I was sick last week."

"Aaw, poor kid, if you're still sick now you need to see your doctor."

"No no, I'm fine. It was just once."

"Well, you're a bit late to look for sympathy."

Mandy laughed. "You'd just have told me not to make a fuss."

"Absolutely, so what's on your mind, Mandy?"

"It's the Pill, being sick can stop it working can't it? I remember you telling me that, when I asked you about taking it."

"That's right, it can. When were you sick?"

"The day after Kevin's good bye party."

"Well that's OK then. If you were sick when he was home, it would be the same as if you'd missed a pill, and I'd advise you to use a condom. In this case, there's no problem, you can just abstain. That should be easy enough as Mr temptation has gone to sea. You'd be OK after your next period anyway, but you've got three months. You'll be fine to welcome him home love."

"That's just it. He came back for a few hours yesterday, and I er, did ..."

"Ah."

"Could I get pregnant?"

"Possibly. I know that you're not ready for that yet. You might want to go down the surgery."

"And do what?"

"Ask for Emergency contraception."

"Isn't it a bit late, you know, afterwards?"

"Not with the morning after pill."

"Oh, yes I've heard of that. Will it work?"

"Yes, it's very effective unless you keep using it. It becomes less so if you make a habit of it, but you won't do that."

"OK, thanks Aunty Kath, I'll ring and make an appointment. Good thing I'm on a late shift today."

"Come round and see me later, if you've got time. We haven't had a chat for a while."

Mandy rang the local health centre and was advised that she could come straight in and her doctor would see her after those who had appointments. Luckily for her, someone hadn't turned up and she got in almost straight away.

"I was lucky to see you so quickly," she remarked to her doctor.

"It's a good thing you were waiting, usually when a patient doesn't bother turning up it wastes my time and just means people who make and keep their appointments have longer to wait."

"I hope that doesn't happen often?"

"It's far too common, but sorry to moan. That's not your problem. Now, what can I do for you?"

Mandy explained her situation. Her doctor confirmed that the emergency contraception pill would be suitable for her.

"It's effective for up to about 72 hours after intercourse, but works better the earlier it's taken."

"What is it, exactly?"

"It's a single dose of a progestogen hormone."

"Is that what's in the normal pill?"

"That's right."

"What will happen when I take it?"

"If you've not ovulated it prevents or postpones ovulation, if you have it will prevent the egg, if it has been fertilised, from settling into your uterus."

"So it will stop me from getting pregnant, rather than causing a really early miscarriage."

"That's right. I suggest you take it with some food, you're much less likely to feel sick that way. There are very few other side effects. It's much like the regular contraceptive pill, you might get a headache, feel dizzy or tired for a while, you probably won't experience any of these though."

"You said I might feel sick, what if I really am, would I need to take another one?"

"Yes, if it was within three hours. You could buy one from a chemist if you needed to today or if you experienced another possible contraceptive failure; but don't rely on that."

"How do you mean?"

"Don't use them as a regular method of contraception, they become less effective if used often. If you have problems with the pill come back and we'll discuss alternative contraception."

Mandy took her prescription to the chemist, she wasn't charged for the pill. She decided to buy some cakes and share them with Kath, rather than going straight home. It would be good to chat to her Aunt and she could get into work just as easily from her house.

"What have you got there?" Kath asked as she opened the door.

"Jam doughnuts and chocolate éclairs. Fair exchange for a cup of tea, I think?"

"Oh, OK. I suppose you can come in," Kath said in mock reluctance.

Kath made tea whilst Mandy swallowed her pill and put the cakes onto a plate. As they ate, Mandy told her what the doctor had said.

"I'd better make sure it doesn't happen again. I don't plan to be sick very often, but if I am, I'll know what to do. Are there other things that could stop the pill working?"

"Really bad diarrhoea would have the same effect as being sick; I hope that's never a problem for you. The usual reason for the pill not working is that people forget to take them. You need to have a particular time to do it and get in a routine."

"I keep mine in the bathroom cabinet, that way I see them when I get my toothpaste. I never miss cleaning my teeth or taking the pill."

"That's a good idea. Another thing that can affect it is taking other medicines. Not all of them, but antibiotics can cause trouble. Your doctor knows you're on the pill, so should mention if she's prescribing something that might interfere with contraception, you should always check though."

"And stop taking the pill?"

"Not unless the doctor says so. You should either not have sex or use something else, probably a condom, whilst you're taking the medication and for a week after."

"My vitamin tablets aren't a problem are they?"

"No, they're fine, but if you take anything else, even herbal stuff or tablets you buy in the chemist then check with the pharmacist."

"OK, I'll remember. I've got to dash or I'll be late for work. What shall I do with this last éclair?"

"You just leave that here."

Kath stood on her doorstep, waving. Mandy waved back until her Aunt was out of sight. She wondered how long it would be before Kath refilled the kettle and demolished the last éclair.