War in Ukraine: European Parliament calls to ensure access to emergency contraception for women throughout conflict and displacement.

May 2022. On May 5th, the European Parliament adopted a resolution that strongly condemns the use of sexual and gender-based violence as a weapon of war. Members of the European Parliament (MEPs) call on the EU and host and transit countries to guarantee access to sexual and reproductive health and rights services, particularly emergency contraception, post-exposure prophylaxis and abortion care, including for survivors of rape.

The resolution notes the challenges of accessing EC in countries with restrictive policies such as Hungary and Poland.

“T. (…) women require access to the full range of sexual and reproductive health services including contraception, emergency contraception, legal and safe abortion care, antenatal care and skilled assistance during childbirth; (…) access to emergency contraception is severely hampered by barriers in Poland and Hungary, due to prescription requirements; (…) in the case of Poland, Romania and Slovakia there are economic barriers in accessing such fundamental sexual and reproductive health and rights services as they are not covered by public health insurance or subsidy schemes, resulting in significant cost barriers as refugees have to pay the full cost out of pocket or seek help from local civil society organisations to cover the costs for them; (…).”

According to the United Nations High Commissioner for Refugees (UNHCR), since the beginning of the invasion of Ukraine by Russia in February 2022, approximately 5 million refugees have fled from Ukraine to the EU; an estimated 90 % of the refugees are women and children. A further 7,1 million people have been displaced internally within Ukraine.

Read the full resolution here or download it from here.

Over-the-counter provision of EC pills is feasible

March 2022.  A new systematic review of over-the-counter (OTC) provision of emergency contraception pills (ECPs), concludes that it is feasible and acceptable, and that it may increase access to and timely use of effective contraception. Evidence suggests that OTC provision of ECPs do not substantively change reproductive health outcomes. This review expands the evidence supporting ECPs as a self-care intervention.

In Europe, the most prevalent modality of ECPs delivery is pharmacy access (also called “behind-the-counter”): ECPs are bought without a prescription but an interaction with the pharmacy’ staff is required.  This interaction varies significantly from country to country and often within countries too [read more here]. Only in Norway, Sweden and the Netherlands ECPs are available directly on store shelves (OTC). This is review is very valuable for Europe, and we hope this  evidence will be used to drive policy changes on EC access.

Access the full review here. And learn more about UPA and LNG ECPs delivery modality in different European countries here.

An update on access to EC in Europe: New publication by ECEC

February 2022. Since 2012, the European Consortium for Emergency Contraception (ECEC) monitors emergency contraception (EC) availability and accessibility in Europe, and maintains a country-by-country database to generate and disseminate knowledge. This open-access database is regularly updated thanks to the collaboration of partners and local experts to whom we want to express our deepest gratitude.

ECEC now issues An update on access to emergency contraception in Europe. This publication summarizes EC availability in Europe up to December 2021and covers all European countries expect Iceland, Kyrgyzstan, Liechtenstein, Monaco, Montenegro, Republic of Kosovo, San Marino, Turkmenistan and the Vatican City State. The previous edition was published in April 2016.

For more information about a specific country, visit the country-by-country section of our website. Contact us at ecec [at] eeirh [dot] org if you believe that information about your country is inaccurate or outdated. This fact sheet can be found online at the Publications section of our website.

 

 

 

Access to emergency contraception through community pharmacies in Europe: Findings from a participatory survey

January 2021. The European Consortium for Emergency Contraception (ECEC) and the European Youth Network on Sexual and Reproductive Rights (YouAct), launched in 2019 a participatory survey in order to better understand how access to and availability of emergency contraception (EC) pills is through community pharmacies in our region.

We are pleased to introduce the survey report, which focuses on five countries: Andorra, Bosnia and Herzegovina, Malta, Spain and Sweden. You can download the report here.

Our findings suggest that community pharmacies play a very important role in ensuring access to EC pills, with the big majority of pharmacies carrying them (even in countries where they are entitled not to). However, our findings also point at individuals not being systematically offered a choice of postcoital contraception methods in every pharmacy of our sample.

We conclude that access to the highest standard of care in post-coital contraception remains uneven within and among countries in Europe: individuals are likely to have different experiences and outcomes when procuring EC, depending on what European country she/he is in, and also on what pharmacy she/he walks in.

ECEC and YouAct recommend some measures to reduce inequities in access to the highest standard of post-coital contraception care. These include:

  • Reclassifying ECPs so they can be sold in pharmacies and other outlets, without the supervision of a pharmacist.
  • Developing minimum regional and national standards for EC dispensing.
  • Disseminating these standards and making them publicly available, so individuals know what to expect when procuring EC.
  • Conducting non-commercial information campaigns to ensure the ability of all people to access accurate information about all post-coital contraception choices available to them.

Different responsibilities fall on different players. We look forward to starting a conversation to move forward toward a stronger rights-based approach to EC dispensing.

We thank all the organizations, individuals and pharmacy staff that participated in this effort.

Contact us at ecec[at]eeirh[dot]org and join our e-mail list.

 

 

EC for transgender and nonbinary patients

January 2021. The American Society for Emergency Contraception just published EC for Transgender and Nonbinary Patients. This fact sheet is a great resource for all healthcare providers offering care to patients of reproductive age.

Pregnancy is possible for any individual with a uterus and ovary(ies) who has receptive penis-in-vagina sex with partners who produce sperm, regardless of gender identity. Patients who are amenorrheic due to testosterone use may (…)  be at risk for pregnancy. This fact sheet addresses medical and social-emotional aspects of EC for transgender and nonbinary patients.

Download the factsheet from ASEC’s website or from here. We thank the colleagues at ASEC for sharing this valuable work with us.

Switzerland: a qualitative study of young women experiences obtaining EC in pharmacies 

November 2020. Last April, Unisanté published “Remise de la contraception d’urgence en pharmacie : une étude qualitative sur l’expérience des clientes”, the report of a qualitative research exploring the opinions and perceptions of young
women who obtained EC in community pharmacies in Switzerland.

Individual face-to-face interviews were conducted between April and August 2019 with 30 women ages 18 and younger, who had sought EC in pharmacies in the canton of Vaud between 2014 and 2019. Issues asked included: reasons for choosing to go to a pharmacy; advantages and disadvantages; reception at the pharmacy counter; questions asked; judgments; actual in-take of the pill; price; support; contraception and prevention.

In short, the study concludes that community pharmacies are very convenient points for EC delivery. They are highly appreciated because they provide great accessibility, short waiting time, and extended hours. However, the report points at several avenues for improvement, to ensure that no barriers for young women arise in pharmacies:

  • improving the information and knowledge of young women about the procedure for dispensing EC in pharmacies;
  • improving and systematizing the information that is asked during the mandatory counseling; 
  • reducing embarrassment and prevent judgemental attitudes;
  • raising awareness among young men;
  • reconsidering the price of EC;
  • integrating pharmacists in the reflection around the delivery of EC in pharmacies.

The full document can be downloaded here and directly from our website, here

Romania: EC featured in YouTube channel Sexul VS Barza

 

September 2020. The Romanian YouTube channel, SEXUL vs BARZA, run by reproductive justice and sex education advocate Adriana Radu, just released a new chapter focused on emergency contraception, which you can watch here:

Such resources are key to educate the young (and the not so young) generations that are more prone to look for information on contraception on-line. We are grateful for Adriana Radu’s work: Mulțumesc!

Switzerland: new recommendations for EC providers (available in German and French)

September 2020. This past month of July, the Swiss Interdisciplinary Group of Experts on Emergency Contraception (IENK) updated its position paper, originally published in 2014, in order to reflect new recommendations and research findings (as of April 21st, 2020).  The paper is available in French  and German, and also directly from Santé Sexuelle Suisse (IENK‘s member) webiste: https://www.sante-sexuelle.ch.

IENK is a coalition of individuals and organisations aimed at promoting access to EC and ensuring quality counselling. It brings together professionals of different fields (pharmacists, medical staff, sexual health specialists, midwives) that work on EC.

“EC in the COVID-19 era: advance access is more important than ever”

May 2020. The American Society for Emergency Contraception (ASEC) publishes “EC in the COVID-19 era: advance access is more important than ever”. While EC access in the US and most European countries differ (UPA EC pills are still a prescription product in the US) ASEC overall recommendation is still valid in our context: know where you can get EC, and keep it on hand in advance of need.

“EC is an important back-up contraceptive option at any time. This is true more than ever during the COVID-19 pandemic, when access to ongoing contraception may be limited and efforts are underway to limit access to abortion in some states. Purchasing EC in advance of need can help people maintain autonomy and reduce the risk of pregnancy during this crisis.“

You can check the  availability status of different type of EC pills in your country, in our website: https://www.ec-ec.org/emergency-contraception-in-europe/country-by-country-information-2/.

Switching EC to non-prescription status and unwanted pregnancy

January 2020. The paper Switching emergency contraceptives to non-prescription status and unwanted pregnancy among adult and teenage women: A long-term European comparative study was published in the South Eastern European Journal of Public Health and is available as open access.

This study’s assessed abortion/birth rates among adult and teenage women in Europe before and after the switch of EC to non-prescription status. Findings suggest, among others, that the switch contributed to reduce abortion and live birth rates among teenagers.

 Click here to read the paper.