Should the pill be more readily available?

By Heather McKay

That last tequila slammer was one of those, definitely seemed a good idea at the time, moments. The reason your stomach lurches is because you drank too much, but it could also be the regret. Regret formed from the jigsawed memories of last night’s shenanigans.

A sip of over-milked coffee and a deep breath act as the stimulus to sheepishly walk into the chemist. Like a dirty harlot you approach the pharmacist, you feel the next time you will be judged like this will be at the Pearly Gates on the Day of Reckoning.

For some women obtaining emergency contraception is an awkward and embarrassing affair. But this may be about to change.

The National Clinical Institute for Excellence (NICE) recently issued draft guidance for public consultation, which recommends emergency contraception should be obtained more easily, including advanced provision. This could mean women would be able to obtain the morning after pill, or Levonelle as it is known, before the ‘accident’ takes place.

The borough of Merton saw 118 per 1000 conceptions in under-18s in 2008, 62% of which led to abortions. Nationally, just under half of all pregnancies lead to an abortion. Could these new recommendations help lower Merton’s abortion and unwanted pregnancy rates?

What do Merton women think about being able to stockpile the morning after pill?

Pharmacy Manager of Boots in Wimbledon, Amee Patel, says she is reticent about young women obtaining the morning after pill in advance.

“In terms of children, maybe I’m quite wary about it because sometimes they don’t always get the right advice they need,” she said.

“It could be taken two ways. It could be taken like a sign ‘I could have unprotected sex but I know I have got the Levonelle, so it is going to protect me’. But that shouldn’t be the case.

“For some people, yes, it is a genuine accident, and that’s alright.

“I’m a bit nervous though about this for people between 13-17 years, the vulnerable children, because they are not fully clued up.”

“To some degree yes, it is good to have them handy. But then I wonder; is that not promoting sex at such a young age?”

She agrees some young people see the morning after pill as a method of contraception.

“It is perceived like that, but it is not supposed to be,” she added.

Women like 23-year-old law student, Emma*, believe the morning after pill does not promote promiscuity.

She said: “I think it is a very worthwhile service. I think obviously it is ideal not to have to use it but it is far, far better to have the option there for when you do need to use it because life, being as it is, there will always be mistakes and accidents and stupid situations.

“I don’t know if it does encourage promiscuity. I think if people want to go out and have sex with strangers then they are going to regardless of whether or not they may get pregnant.

“There’s a certain amount of recklessness involved there anyway, and if you are putting yourself in that situation, unwanted pregnancy is such a small factor of that recklessness.”

Penny Barber, Chief Executive of sexual health charity, Brook, in Birmingham, helped develop NICE’s draft guidance.

She said: “We know emergency contraception is more effective the sooner you use it after sex so it’s crucial young women have it on hand in case they need it.

“Evidence demonstrates that making emergency contraception available in advance does not change the amount of sex young people have.”

She added: “Our aim is to make sure all young men and women use the right contraception for them.”

But Emma thinks advanced provision is only acceptable in certain circumstances.

“I do think it might be dangerous if it leads to a lack of education amongst particularly young girls not knowing the genuine risks about using proper contraception,” she said.

Helen*, a 23-year-old personal assistant from Merton, believes advance provision is not the answer.

“It stops you thinking about why you have to take it and what mistakes you made the night before, as in you should have used some form of protection,” she said.

“Having to go out of the house to get this might stop you from having to take it again. Where as if it’s at home and easy to access, it could become a habit to take, which cannot be good for your body.”

She added: “When people have been out drinking, they get home, no one has condoms so they think ‘oh well I can just get some emergency contraception’, especially students. This must happen all the time.

“It’s an easy way out. Plus it doesn’t protect you from STIs and people probably tend to forget this, as they are mainly worried about not getting pregnant, not about a rash or an itch!”

Ms Patel says she gives out Levonelle approximately 20 times a week. Most of young women she sees are between 13 and 25.

“I think ‘condom split’ is the most common reason why girls come in. We have the odd few that say they haven’t used any form of protection and that’s when we say it is always important to use some sort of protection.”

According to Ms Patel, youngsters in Wimbledon appear quite knowledgeable about contraception and sexual health services available to them.

“I find them very, very much clued up. I think it is all about if a friend has had it. If a friend has had it then they are more clued up,” she said.

The borough of Merton has a broad socio-economic range, so are Ms Patel’s comments the norm, rather than the exception?

It would seem more needs to be done to help young people in deprived areas.

Dr Gillian Leng, NICE Deputy Chief Executive, said: “This draft guidance responds to a real need to improve existing contraceptive services, making it easier for young people, especially the most disadvantaged, to get the right information, advice and treatment at the right time.”

For this reason, the guidance suggests schools, colleges and city centres provide contraception and sexual health services.

Ms Patel suggests: “I think what would really be good is having more pharmacists training and providing these kinds of services.

“As a company, working for Boots, we are open seven days a week and that means we are easily accessible – we have long opening hours. I think that would be more of a benefit than giving the pill out before it is needed.”

[* Names have been changed for confidentiality reasons]