Jan 24, 2011

Over-the-counter Morning After Pill is a positive step

Rebecca Murphy – USI Welfare Officer

Last week, Boots announced that they would start providing the Morning After Pill, a form of emergency contraception, over the counter in their stores across the country. Boots are able to do this because the legislation states that pharmacists can provide the pill under a protocol drawn up by a doctor. Boots operate this service under a protocol authorised by their company’s medical director, thus putting them in a position to provide the EC pill to the person seeking it. Boots charge €45 for this service, which still works out cheaper than a visit to a GP and the prescription for the pill.

The Irish Pharmacy Union are currently working on a protocol which would allow up to 1800 of their members to dispense this pill over the counter in their pharmacies and hope that this will occur within the next 6 months, thus easing access to emergency contraception for thousands of women across the country.

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USI wholeheartedly welcomes both these moves. We believe that people are entitled to complete control over their reproductive rights and choices, and the accessibility of the morning after pill over the counter is an essential part of that – this policy has been affirmed at our Annual Congress by members of Students’ Unions all over the country.

The advantages of over the counter Emergency contraception is obvious to anyone who has attempted to access the morning after pill out of hours (such as at weekends or in the evenings). The failure rate of the MAP is between 1% and 3% and it is most effective within 72 hours of unprotected sex, and the quicker the pill is taken the more effective it will be. In cases where unprotected sex has occurred unexpectedly (through a condom split, sexual assault or any other reason) it is imperative that the pill is acquired as soon as possible to ensure maximum protection against pregnancy. As well as time being of the essence in this situation, cost is also of importance especially to students. If one needs to access an out of hours service for medical attention it can cost approximately €60 depending on the service you attend, plus the cost for the pill itself which can be up to €15. While €45 in Boots is still too expensive and a huge mark up on the actual cost of the pill to provide, it still works out cheaper than previous out of hours services.

In countries where the EC pill is available over the counter you do not see an increase in demand – just a change in where people access the service. GPs currently report a spike in MAP presentations on Monday mornings after weekends of partying – but if the unprotected sex occurred on the Friday night, the effectiveness of the pill has been dramatically reduced in the time since then. The woman could be already pregnant and the pill then rendered entirely ineffective. An unplanned pregnancy could have a negative impact on a woman’s life, and the result of delayed access to the morning after pill could be an abortion or a baby being born to a mother unable to provide what is necessary for a child. Therefore, it is imperative that access to emergency contraception be as easy and as affordable as possible whether it’s Sunday at 9am or Wednesday at 6pm – accidents, by their nature, are not planned. Therefore services must be flexible to respond to this fact of life.

While access to emergency contraception and the morning after pill is essential and important the Morning After Pill should not be used as a regular form of contraception for a number of reasons. While it does not stop being effective if you use it more than once it is less effective in the long term than other forms of contraception eg condoms, the contraceptive pill – and is also much more expensive. The morning after pill does not protect against STIs, so if you have had unprotected sex you may want to consider getting an STI test in the near future to confirm that you haven’t contracted a sexually transmitted infection from your partner.

It’s important to note that Emergency Contraception is just like other forms of contraception – it prevents pregnancy, it does not end it.  It does not cause an abortion. It prevents the release of an egg from the ovary for 5-7 days, by which time any sperm from the sexual encounter will have died off. The EC pill does not increase the chances of infertility in later life and there is no evidence that if the MAP fails and the person falls pregnant that it will have harmed the foetus or increase the chance of an ectopic pregnancy (a pregnancy that develops outside the womb).  While some women may feel nauseous after taking the pill and will experience an irregular next period there is no evidence of long term ill-effects from the Morning After Pill.

If you find that you regularly do not use contraception due to alcohol intake then please talk to your welfare officer or to your Student Health team, or another medical professional who can advise you on your alcohol intake. According to drink aware almost half of men (45%) and a quarter of women (26%) agreed that drinking alcohol had contributed to them not using contraception.

With the SHAG packs your union will be handing out over the next few weeks and the cheap/free condoms from your Students’ Union, get into the habit of carrying condoms with you when you go out – whether you’re male or female. Prevention is always better than cure.

The morning after pill is a much misunderstood but essential aspect of a society that values citizens’ reproductive freedoms – access to this must be convenient and must be at a much lower cost than is currently levied. USI urges the stakeholders in this situation – the pharmacies and the lawmakers – to ensure that emergency contraception becomes cheaper and more accessible to those that need it.

Trinity Student Health Centre is still the cheaper option for Trinity students during opening hours – it is €15 euro for the prescription and €15 for the tablet itself.

If you wish to learn more about your contraceptive choices, check out www.thinkcontraception.ie, talk to your Students’ Union welfare officer Steph on [email protected] or contact your Student Health Centre.

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