A study published in The European Journal of Contraception & Reproductive Health Care assessed awareness and knowledge of EC among adolescents in Berlin, Germany. The authors conducted a cross-sectional survey among ninth graders in a convenience sample of 13 Berlin schools in which they assessed perceived and actual knowledge on the effectiveness, timeframe, and availability of EC and on pregnancy risk in six scenarios. A total of 1177 students between 13 and 16 years of age participated in the study, and the authors found that 8.7% had never heard of EC, 38.6% knew of its effectiveness, but only 12.7% knew of the timeframe for EC. Of the sources of EC, only gynaecologists were widely known, and attending a school of lower academic standard and being of immigrant background was associated with lower knowledge on the majority of items. The authors conclude that generally, students were aware of the existence of EC, but many lacked the knowledge of when to take it and how to access it. See the citation below for more information:
Awareness and knowledge regarding emergency contraception in Berlin adolescents. Frederik T. von Rosen, Antonella J. von Rosen, Falk Müller-Riemenschneider, and Peter Tinnemann. The European Journal Of Contraception & Reproductive Health Care, Vol. 22, Iss. 1, 2017.
The ASTRA Network has informed us that in mid-February 2017, the Polish Government announced that it accepted a project proposing to restrict access to the only ECP available over the counter (UPA ECP). This project is to be discussed in plenary and voted upon in the next session of the Sejm, possibly as early as March. UPA ECP has been available in Polish pharmacies without a prescription since April 2015. The planned restrictions would greatly impede the lives of women and girls, contribute to the sales of this product from unsafe sources, and cause a rise in the number of unplanned pregnancies and abortions in a country where access to safe and legal abortions is already incredibly difficult. For more information, please read this article.
ASTRA, together with ASTRA Youth, You Act, CHOICE for Youth and Sexuality, and ECEC, sent a letter on December 1, 2016 to the representatives of the European Commission to voice their concern on the current developments in Poland with regards to women and girls’ reproductive health and rights. That letter was resent following the project proposal to restrict access to UPA ECP and is available here.
In February 2017, the European Parliamentary Forum on Population & Development launched the ContraceptionAtlas, a map scoring 45 European countries on access to modern contraception. Included among the examined factors are number of contraceptives available, what sort of information is available online, level of reimbursement, and availability of emergency contraception. According to the atlas, France is number one in access to modern contraception, followed by the United Kingdom and Belgium. For further information on this initiative, please visit here.
In March 2016, pharmaSuisse and IENK (groupe interdisciplinaire d’experts/es en contraception d’urgence) published tools to facilitate EC counseling and provision among health care professionals, such as pharmacists and family planning staff. These tools, including a flow-chart (seen at right), are available in French, German, and Italian and can be accessed through the box on the right-hand side of the page.
According to a report recently published by the Italian Ministry of Health, the abortion rate in Italy dropped by 9,3% in 2015. In April 2015, the Italian Medicines Agency (AIFA) eliminated the mandatory prescription requirement for UPA EC pills for women older than 18, and in October 2015, AIFA eliminated the mandatory prescription requirement for LNG EC pills as well. This news piece (in Italian) suggests at least a partial connection between the decrease in the abortion rate and the greater access to EC pills.
(December 16, 2016) As of December 14, 2016, and for the first time in the history of Malta, dedicated emergency contraceptive pills are available for purchase behind the counter in Maltese pharmacies. UPA EC pills are already on the market, and LNG pills are expected in the coming weeks.
Untill 2016, Malta was the only European Union country that had no dedicated EC pills registered nor available in the local market. In June 2016 the Women’s Rights Foundation filled a judicial protest to request access to emergency contraception. In October 17th, the Malta Medicines Authority announced that the sale of EC pills would be allowed without a prescription, in order to ensure quality, safety and efficacy of the treatment.
Women in Malta now will have emergency contraception accessible to them as in the rest of the European Union, except for Hungary, the only country of the EU that still requieres a prescription for both LNG and UPA EC pills. We will update our Malta country page soon.
The British Pregnancy Advisory Service (bpas) recently launched a campaign in the UK calling for LNG EC to be made available directly on pharmacy shelves at an affordable price. Currently in the UK, women can only obtain EC from behind the pharmacy counter after a consultation with a pharmacist, and LNG EC costs up to £30, which is more than anywhere else in Europe with the exception of Ireland. bpas’s campaign is calling for EC to be reclassified as a General Sales List medication so that it can be placed on pharmacy shelves for women to buy without a consultation. The organization is also calling for all those involved in the pricing of EC to consider how they can provide women with a much more affordable product.
While women in the UK can obtain EC free of charge from GPs and sexual health clinics through the NHS, these are not suitable options for many women. They might not be able to get an appointment in time, and funding cuts mean that sexual health clinics are increasingly restricting services or shutting down altogether. Some pharmacies run local schemes providing EC for free, but they often only serve young women and only those who live in certain areas.
To launch the campaign, bpas created a humorous video highlighting that for some women in the UK it would be cheaper to fly to France to buy EC than purchase it in their local community. Click here to see the video, and for more information on the campaign, please visit http://www.justsaynon.org.uk/.
On October 17th, 2016, the head of the Malta Medicines Authority, Serracino Inglott, announced that the sale of EC pills will be allowed without a prescription. According to an article from Times of Malta:
“The authority has always based its decisions on three things; quality, safety of patients and efficacy. By asking patients to go to doctors to get their hands on the contraceptive, you are compromising efficacy,” [Inglott] said. The authority head also insisted that the parliamentary committee failed to take into consideration that Malta’s pharmacists not only have the necessary skills to be able to give the MAP [morning after pill] but they also rank among Europe’s best pharmacists in patient-centered care.
This decision comes shortly after a Parliament Committee recommended to permit the sale of EC pills only with a prescription and to allow doctors to refuse prescribing EC on the basis of conscious objection.
A study published in September 2016 in the European Journal of Contraception & Reproductive Health Care looks at the characteristics and profiles of 1773 women who presented at an emergency service (ES) for a prescription of EC (mandatory until May 2015) in Italy.
The study found that the mean age of the women was 26.0 years; 78.5% of the women were Italian; 91.5% were unmarried; 55.2% were still studying and 51.9% had high school education; 61.2% reached the ES within 12 hours of unprotected sexual intercourse (USI); and 42.4% had USI during days 9–16 of their menstrual cycle. LNG was prescribed in 81.4% of women and UPA in 17.7%. When looking at why women were requesting EC, the majority (57.9%) requested EC for condom rupture; 49.5% reported previous use of EC; and 41.6% received information on the subject through friends. The vast majority (83.8%) reported prior use of contraception; in 25.4% the reason for not using it was the absence of a relationship. This study highlights the importance of understanding the profile of women requesting EC so that they can better choose the right long-term contraception for them.
To read the full article in English, please click here.
(October 5, 2016) Gideon Richter released a new video that provides a very clear and easy-to-understand explanation of the mechanism of action of EC. This video, which incorporates 3-D animation, can be found here and is available for use in educational programas and trainings.