A new campaign from the British Pregnancy Advisory Service (BPAS) is calling for emergency contraception, commonly known as the morning-after pill, to be sold directly from pharmacy shelves without a mandatory consultation. The campaign highlights the fact that the pill can cost British women up to £30, as much as five times higher than in other European countries, meaning that it could even be cheaper to fly to France and buy it there than to visit a local pharmacy.
A 2003 report published in the Pharmaceutical Journal revealed that the high price –described by BPAS chief executive Ann Furedi as a “sexist surcharge” – was a deliberate attempt to prevent women from taking it too often. As a spokesperson for Levonelle, a manufacturer of the pill, said: “The price has been set, in part, to ensure that EHC [emergency hormonal contraception] is not used as a regular method of contraception.”
BPAS also argues that the mandatory consultation women must go through with a pharmacist may be part of the reason it is so costly in the UK, compared with other countries where such consultations are not required. Given that the medication is considered very safe, even compared with other medications sold off-the-shelf, and that the NHS says it has no serious side effects, it seems likely that this is a means of influencing women’s sexual and reproductive decisions, rather than a requirement for safety reasons.
The comments of one spokesman from the Family Education Trust exemplified this rationale: “With no questions asked about previous medical history or previous use of the drug, there is a very real danger that it could be misused or overused.” The same could be said of countless other off-the-shelf products, but the extra barriers only seem to come into play when a product is associated with female sexuality. And considering the lack of medical dangers associated with the morning-after pill, the “misuse” or “overuse” seems likely to be a moral, rather than medical, judgment.
So the major arguments both for the sky-high cost and the mandatory consultation seem closely tied to the idea that women cannot be trusted to make their own decisions about their bodies and sex lives. Not to mention the terrifying risk that, should the situation change, immoral, promiscuous women might run amok, foregoing other forms of contraception, indulging in countless one-night stands and choosing to pop morning-after pills instead of taking any other precautions.
Talk of ‘misuse’ or ‘overuse’ being referred to here seems likely to be a moral, rather than medical, judgment
Of course it makes sense for a consultation to be available for those who choose it, as with any other product purchased in a pharmacy. Some people might want to ask about the efficacy of the medication within a given timeframe, or seek further information about issues such as sexually transmitted diseases. But this is a decision an individual is capable of making herself – not every person taking emergency contraception needs to be subjected to these interactions, often described as “embarrassing” and “shaming”.
The moralistic overtones of this debate are the same ones that emerge during any discussion relating to women’s reproductive health – as if male lawmakers and commentators feel the need to wrestle women’s autonomy from them because “we know best”.
As a healthcare option for those who wish to avoid unwanted pregnancy, it is hugely important that women should be able to access the morning-after pill as easily and cheaply as possible. But a 2014 study found that women in the UK were nearly twice as unlikely to use emergency contraception because they were “embarrassed to ask for it” than women in other European countries. Nearly a third of all the women surveyed who used emergency contraception said they felt uncomfortable or judged when obtaining it.
That women have to jump through hoops because they aren’t trusted to use it responsibly is reminiscent of the ongoing Victorian-era legislation that means abortion is still technically illegal in mainland Britain. Rather than overturning the 1861 Offences Against the Person Act, the 1967 Abortion Act essentially created a loophole allowing the procedure only after two doctors have agreed that a woman’s mental or physical health would be harmed by continuing with the pregnancy. The law hasn’t been changed since.
Like the idea that a woman’s decision isn’t valid until two doctors have agreed to “let her off” prosecution, the notion that we need a consultation before being allowed to take emergency contraception is outdated and patronising. It’s 2016. Isn’t it time we moved away from the Victorian notion that women can’t be trusted to make their own choices about their health, bodies and sex lives?
The morning-after pill is safe. So why is it so difficult to access?
