Romania: New EC counseling tool

In Romania, MagnaPharm has translated and adapted the EC Wheel to help strengthen pharmacists’ knowledge on EC methods and counseling. The Wheel was developed in 2016 by ECEC with financial and technical support from the European Society of Contraception and Reproductive Healthcare (ESC). This tool summarizes the UK Faculty of SRH and WHO’s recommendations on the use of LNG, UPA and the Cu-IUD for emergency contraception. With this tool ECEC and partners aim to strengthen evidence-based EC counseling in Europe.

 

 

 

Historic step in the USA: FDA updates language on LNG ECPs mechanism of action

December 2022. In the United States, the Federal Drug Administration (FDA) just approved to change the label of Plan B One-Step (a levonorgestrel 1,5 emergency contraception pill) and its generic versions, in order to remove language suggesting that it prevents implantation of a fertilized egg.

Until now, and despite what scientific evidence and research has clearly shown for the past decade, the leaflet and patient information of this product (and its generics) said that the pill might work by preventing a fertilized egg from implanting in the womb (that is, after fertilization). The new text will state that it works before release of an egg from the ovary.

It must be noted that in Europe, this update on the language about mechanism of action was already proposed by HRA Pharma (manufacturer of Norlevo) and accepted by the European Medicines Agency (EMA), in 2013 (almost 10 years ago). The process to update the label in the USA begun in 2018, and has taken four years to be completed.

Congratulations to reproductive health and rights advocates in the US and to Foundation Consumer Healthcare (makers of Plan B) for this historic and long overdue achievement. The change has critical implications for EC access not only in the United States, but also for many other countries like Peru, where the label of Plan B was still used to restrict access to EC.

Visit FDA’s page “Plan B One-Step (1.5 mg levonorgestrel) Information” for more details.

Honduras: Is EC really available to sexual violence survivors?

December 2022. The Ministry of Health in Honduras recently published a new protocol to provide comprehensive care to survivors of sexual violence (Protocolo de Atención Integral a Víctimas / Sobrevivientes de Violencia Sexual). The protocol includes the provision of  emergency contraception as part of the first line treatment, which is a major step forward. At the operational level, however, it is unclear how this measure will be implemented given that a ban that prevents any sort of emergency contraceptive formulation from being sold, distributed or used, is in place in Honduras since 2009.

The Grupo Estratégico  por la Pastilla de Anticoncepción de Emergencia (a coalition working to make EC pills available again in the country) has expressed concerns: “While the protocol is an advance, making emergency contraception pills available only to survivors of sexual violence, continues to constitute a violation of the human rights of people in Honduras”. Read the full statement here.

Emergency contraception can prevent pregnancy after rape and is safe in all circumstances and for females of all ages. To learn more, read the position papers on EC for rape survivors from the International Association of Forensic Nurses  and the International Consortium for Emergency Contraception.

 

 

Catalonia: complaints about access to EC

December 2022. In Catalonia (Spain), the Observatory of Sexual and Reproductive Rights monitors violations of sexual and reproductive rights (SRR) reported by citizens, in order to influence and transform public SRR policies and services.

According to the Observatory 2022 report, problems with access to emergency contraception (EC) are the second most common complaint received. Problems to access evidence-based EC information and services have been reported in public healthcare centers (primary care, sexual and reproductive health clinics, and hospitals), as well as in pharmacies, and even on the public health information hotline (061).

Cases include:

  • denying to provide any EC method;
  • denying to provide UPA EC pills;
  • advising not to use EC more than 3 times in a year;
  • advising not to use EC after abortion;
  • not receiving information on where to procure EC when a specific service can’t provide it;
  • requesting the assessment of a contraception specialist;
  • denying EC to women under 16.

The Catalan Health Department has recently updated its guidelines for EC provision in public healthcare units (click here to read more). Furthermore, UPA EC is now offered on the public health network too. These are important steps towards offering a more comprehensive EC service. However, as the Observatory report shows, work is still needed to ensure that up-to-date knowledge on EC provision is the standard across the board.

Denmark:  Increased use of ECPs (2017-2021)

November 2022.  The Danish Health Data Agency has recorded an increase of about 27% in the number of emergency contraception pills (ECPs) sold in the past five years: from 107.000 units sold in 2017 to 136.000 in 2021. The largest increase was registered in the Zealand Region (44%).

The Danish Broadcasting Corporation published this news, with comments from representatives of Sex og Samfund and the Danish Society for Obstetrics and Gynaecology. Both agree that this increase reflects that women are increasingly aware of methods to prevent pregnancy, and more responsible. This increase may be related to the decrease in use of regular oral contraceptives, and the fact that some women started using ECPs as their main contraceptive method for a period of time.

“It is not irresponsible. It is rather responsible, because you act conscientiously and avoid a pregnancy.” Chairman of the Danish Society for Obstetrics and Gynecology.

Sex og Samfund also mentions that, although the fortrydelsespiller (the “regret pill”, as it is casually called in Danish) is a good alternative in case of unprotected sex or an accident with the regular method, using an ongoing method is always recommended.

Impact of banning EC ads on method awareness

November 2022.  An article recently published in the German edition of Glamour points at an important element in EC knowledge and use in many countries:  the ban on EC advertising in media outlets, and how it contributes to the low knowledge of this contraceptive method.
“I was unprepared for everything I had to endure that morning at the pharmacy. Because in Germany there is an advertising ban for the morning-after pill. So there is no way to find out about this very important drug that enables women to exercise their right to physical self-determination. As a result, every fourth woman in Germany is not even aware that the morning-after pill can be used to prevent an unwanted pregnancy if there is a contraceptive failure. Furthermore, 50 percent of women do not know that the morning-after pill is available in pharmacies without a prescription.”
The article is available on Glamour’s website:

EC101 at the International Conference of Family Planning

November 2022.  The International Conference on Family Planning, the world’s largest gathering on family planning and reproductive health, took place in Thailand on 14-17 November 2022. ECEC is proud to have participated in the organization of one segment of the Live Community Programming, that revised the basics of emergency contraception.

The segment, called “Emergency contraception 101”, can be view here.

 

Ready When She Is: Investing in On-Demand Contraception

October 2022.  A portion of sexually active women do not use contraception, because they do not have sex frequently. The on-demand use of levonorgestrel 1,5 mg pills is being studied, and could expand the choice of contraceptives for those who have infrequent sex and thus, do not want to use a regular method, but do not want to get pregnant.

The ReadyWhenSheIs movement has been recently established by PSI and partners, to advocate for the development of on-demand and women-controlled contraceptive options.

Although unrecognized and highly stigmatized, on-demand use of ECPs is already a reality in Europe. Data is very scarce, but some studies in Nordic countries identified that up to 50% of EC users, have used EC pills at more than once in their life time.1

The ReadyWhenSheIs movements targets mainly the estimated 150 million sexually active women in low- and middle-income countries that report having infrequent sex and not using contraception. However, exploring how to better respond to the needs of this population is also  a relevant issue for women in Europe.

Visit the ReadyWhenSheIs webiste to learn more and join this movement: https://www.psi.org/project/rwsi-home/

 

1 Guleria, S., Munk, C., Elfström, K., Hansen, B., Sundström, K., & Liaw, K. et al. (2020). Emergency contraceptive pill use among women in Denmark, Norway and Sweden: Population‐based survey. Acta Obstetricia Et Gynecologica Scandinavica, 99(9), 1214-1221. doi: 10.1111/aogs.13849. Retrived 23 November 2021, from https://obgyn.onlinelibrary.wiley.com/doi/full/10.1111/aogs.13849 

Stable rate of EC’ use in Spain

October 2022. The Spanish Society of Contraception (SEC) just published the findings of the Contraception in Spain 2022 Survey (“Anticoncepcion en España 2022”).  With this survey SEC aims to strengthen the knowledge on the female population’s habits with regards to contraceptive methods use in Spain. The survey was conducted between July 21 and August 17, 2022 among 1.800 women aged 15 to 49 throughout Spain.

According to the survey findings 31,4% of the surveyed population have ever used emergency contraception. This rate is very similar to the last one recorded by the SEC (30% in 2018).  You can read the survey findings at https://sec.es/la-sec-presenta-la-encuesta-sobre-la-anticoncepcion-en-espana-2022/  and here. To learn more about access to emergency contraception in Spain visit our country page.

 

France: free EC pills for all women

September 2022. The French Minister of Health, François Braun, announced that emergency contraception pills (ECPs) will be free for all women regardless of their age, in pharmacies and without a prescription. Read more here. ECPs are provided free of cost to women under 18 since 2013; this measure was extended to women up to the age of 25 a while ago, but a prescription was required. This new policy will remove financial and administrative barriers to all women, of any age, and is expected to be implemented in 2023.

The news have triggered discussions in neighboring countries, like in the Netherlands, where past political efforts to reimburse contraception have not succeed. Read more here in English and here in Dutch.