‘Black Mirror’ Confused The Morning After Pill With Birth Control; Don’t Make This Dangerous Mistake

The fact that we don’t know what the future holds for us often makes it easier for us to imagine an alternate “what if”. But this allure towards what technological advancements can create an unrealistic expectation for the future – heck, weren’t we supposed to have flying cars this year, in 2020?  – and thus a distorted perception of our present. ‘Black Mirror’, Netflix’s popular science fiction drama, tends to push the boundaries by taking our deepest, darkest and most twisted fears of what technological advancement can mean for mankind in the future and manifesting that in short, but impactful, episodes. However, an episode from the fourth season of the series, titled ‘Arkangel’, failed to portray a medically advanced future for contraceptives and instead, caused more confusion over the what, where, when, why and how present day contraceptives work.


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The episode follows Marie, the mother of a now 15-year-old Sarah, who installed technology in her daughter’s brain when she was a child that allowed her to view life through her daughter’s eyes. Not only that, but the tech also allowed Marie to replay Sarah’s memories, find her location and monitor her vitals. Now, Marie does turn off the tech when Sarah gets older (and only because a therapist recommended that she did) BUT she turns the monitor back on after she catches Sarah lying to her. When she turns it on, she sees Sarah daughter having sex (how messed up is this?). Days later, Marie receives a notification from the device that Sarah is pregnant. She goes to the pharmacy, buys emergency contraception (EC) for Sarah and grinds it into a smoothie that Sarah then drinks.


Image from Netflix/’Black Mirror’


Then, while in school, Sarah feels sick and vomits before going to the school nurse – this is where it gets messy. The nurse tells Sarah,


“Honey, it was an EC pill that made you sick,”


before leaning in to explain that she’s referring to emergency contraception, “for terminating your pregnancy.” The nurse then goes on to say:


“It will work in spite of the vomiting. You’re not pregnant anymore.”


This scene with the nurse is a gross misrepresentation of what emergency contraceptives do and how abortion pills work. The emergency contraception pill, commonly known as the morning-after pill, and the abortion pill are not the same.



Here’s what you need to know about the morning-after pill, the abortion pill and why they are different.



The Morning After Pill

Plan B, also known as the “morning-after pill,” is medication that you can buy at any pharmacy without a prescription (over-the-counter) that you can take after having unprotected sex. The pill works to prevent pregnancy before it even starts by stopping the release of an egg from the ovaries or prevents the egg from being fertilized by the sperm.


How effective is it?

Plan B has a 95% chance of preventing pregnancy if you take it within 24 hours. The longer you wait to take it the less effective it is. It is taken orally, meaning you swallow it. The longest you can wait to take it is within 72 hours, but this will lower its effectiveness as much as 20%.


Can you take Plan B while on the birth control pill?
It is okay to take Plan B if you are also taking birth control. This does not affect the efficiency of your birth control nor the efficiency of the pill. If you’re taking Plan B because you missed a day with birth control pills, just make sure you continue to take your regular birth control according to schedule as soon as you can.


Are there side effects?

Some women have reported having tender breasts, dizziness or lightheadedness after taking the pill. It can also cause stomach discomfort and headaches. Try not to throw up within two hours of taking the pill or you will have to take another one. Also, don’t be alarmed if your next period comes a little earlier or later than it usually does. While plan B does not stop periods, it can delay them. If your period does not come, it is best to take a pregnancy test.


Can the morning-after pill be used if you’re already pregnant?

The pill does not induce abortion nor does it affect pre-existing pregnancies. It works as prevention, not as a cure.


Where can you buy Plan B?

At your local pharmacies. If it is your first time buying the pill, go to a pharmacist you trust or know will be able to answer your questions. You do not need a prescription for the pill, you do not need to show your IC, but you will need to write down your details (standard procedure here in Malaysia).


Remember: It is not the same as birth control and should not be taken regularly. Plan B will not protect you from getting pregnant if you have unprotected sex after taking it. To protect you against getting pregnant, you need to take it right after you have unprotected sex and use a form of contraception when you have sex.



Abortion pills


How do abortion pills work?

Abortion pills come in twos – the first is mifepristone and the second is misoprostol. Mifepristone blocks progesterone, which is needed for pregnancy and thus, puts a stop to the pregnancy’s growth. Then, either right away or up to 48 hours later, you take misoprostol. This second pill works to “expel the pregnancy from the uterus” by causing you to bleed.


What can I expect after taking abortion pills?

Abortion pills will cause your body to react in a similar way that miscarriages do. Most people will experience cramping and bleeding an hour or so after taking misoprostol (the second pill). While bleeding, large blood clots (up to the size of a lemon) or clumps of tissue will appear, not dissimilar to a really really heavy, crampy period. This can last for several hours and will slow down after the pregnancy tissue comes out. It is okay to take pain medication (like ibuprofen) to deal with the cramping, which can appear on and off for a day or two. However, it is important to avoid aspirin, which will make you bleed more.



Are abortion pills effective?

The effectiveness of the abortion pill depends on how far along you are in your pregnancy when you take the medicine.

  • 8 weeks pregnant or less – 94 to 98% effective.
  • 8-9 weeks pregnant – 94 to 96% effective.
  • 9-10 weeks pregnant – 91 to 93% effective.
  • 10-11 weeks pregnant – 87% effective.


Is the abortion pill safe?

Like all medications, the abortion pill isn’t right for everyone. Serious complications are really rare but can happen. These include:

  • the abortion pills don’t work and the pregnancy doesn’t end
  • some of the pregnancy tissue is left in your uterus
  • blood clots in your uterus
  • bleeding too much or too long
  • infection
  • allergic reaction to one of the medicines

However, it is a common way to have an abortion and, in fact, pregnancy and childbirth can be riskier than most abortions.


Can you buy abortion pills in Malaysia?

Apparently, you can buy abortion pills online in Malaysia. Some pharmacies may prescribe them, but these pills are not regulated by the Ministry of Health for the purpose of abortion itself. The abortion pill available in Malaysia is Misoprostol, listed under the trade name Cytotec. Cytotec is approved by the Ministry of Health to treat gastric ulcers, but not to terminate pregnancies. Another pill called Mifepristone is often paired with Misoprostol to induce abortion, but the former is not approved by the MoH. Hence, it’s actually illegal for you to purchase these pills online for the purpose of abortion. Only doctors may prescribe these pills for medical abortions.



So, think twice before you trust what you see or hear on TV. We are lucky that we have the internet to fact check what we’ve heard and seen. Even then, verify and cross-reference what you’ve read to ensure that the facts are true. It can be the difference between keeping yourself safe and misdiagnosing yourself.





*Cover image credit: BBC Women's Hour on Instagram