As evidenced by these pictures from Bulgaria, some European countries allow advertising of over-the-counter medical products. This particular ad is for EC and has been placed on the side of a shopping cart.
Following a long debate in Germany over whether LNG EC should have an over the counter status, the German Federal Institute for Drugs and Medical Devices recommended recently that emergency contraception pills should be available without a prescription. It is now up to the Minister of Health to decide whether he will adopt the recommendation or not.
It was recently reported that the Spanish National Health Service (NHS) does not fund EC nor does it reimburse patients who purchase EC. Furthermore, EC availability is dependent on the regions within Spain, and it is not universally available throughout the country. This issue was raised by Grupo Parlamentario de Unión Progreso y Democracia (UPyD), which is questioning the Spanish government’s commitment to sexual and reproductive health, especially considering that the Ministry of Health recently retired eight brands of oral contraceptives in the core portfolio of the NHS. UPyD also contends that Spain has suspended its sexual and reproductive health education programs. The Spanish Ministry of Health has responded that in regards to sexual and reproductive health, it has ratified all international agreements approved by the UN and its new Plan for Children and Adolescents promotes education around these issues.
ECEC has published an article in WHO’s Entre Nous European Magazine for Sexual and Reproductive Health. In it, ECEC outlines the unequal EC access situation in Europe and advocates for the standardization of EC guidelines across the continent to help reduce these inequalities. Ultimately, ECEC recommends that every woman seeking EC be informed of the methods available to her so she can truly exercise choice concerning her reproductive health. ECEC would like to extend a special thank you to all of the informants who helped us collect and validate this valuable data!
In a new study published in The Kennedy Institute of Ethics Journal, Italian researchers explore the empirical and theoretical reasons behind why doctors and pharmacists may refuse to provide women with EC. Although evidence suggests that refusal typically is based on grounds of conscious, the researchers argue that the category of conscientious objection is not the most appropriate one for making sense of these claims because they are not grounded in a conflict between two contrasting moral duties. Since EC is available only by prescription from pharmacies in Italy, the researchers propose that the seemingly forced choice between protecting doctors’ and pharmacists’ professional self-determination and women’s reproductive self-determination could be prevented by distributing EC without a prescription and in a number of outlets in addition to pharmacies, thus relieving doctors and pharmacists from the legal duty to provide it.
The French High Authority on Health has issued a new fact sheet regarding the use of EC, based on the latest recommendations. This fact sheet is part of a series of publications on contraception being issued by the Authority. To read the full fact sheet in French, please click here.
The European label for the EC product Norlevo has been updated with two major changes. In keeping with current evidence, the new label now says that LNG EC works by interfering with ovulation, and the language about the possibility that LNG EC might prevent implantation of a fertilized egg has been removed. The second change is that the label now says that efficacy is reduced in women weighing 75 kg (165 lbs) and that it is ineffective for women weighing more than 80 kg (176 lbs). Mother Jones reported on the story here and The New York Times covered it here. The patient leaflet for the Irish product can be found here. Additionally, the Reproductive Health Technologies Project created a fact sheet of FAQ’s about weight and EC which can be accessed here.
The National Institute for Health and Clinical Excellence (NICE) recommended in draft guidance proposed in 2010 that doctors, nurses, and pharmacies should “ensure all young women are able to obtain free emergency hormonal contraception, including advance provision.” The recommendation has been on the Health Secretary’s desk since the Spring but he has not yet given it approval over concerns that NICE has not provided any evidence that the move would bring down unwanted pregnancies.
In an effort to identify the main reasons for EC requests, observed failure rates, and the type and incidence of adverse effects among EC users in Poland, a prospective single-center observational study was conducted among 4655 women living in Warsaw. Data was collected via a questionnaire completed by healthcare providers prescribing EC and focused on the following outcomes: reason for EC request, time lapse between unprotected intercourse and EC use, age of women requesting EC, and reported cases of pregnancy. The study found that of the women requesting EC, 62.9% were ≤ 25 years old and 0.75% became pregnant; adverse effects were rare and mild; and the main reason for requesting EC was problems associated with condoms. Additionally, the mean interval between unprotected intercourse and EC use was 21.2 hours, although it was 26.7 hours when EC failed. The researchers concluded that women living in Warsaw seeking EC used it very soon after unprotected intercourse, and this was probably one of the most important reasons for the low pregnancy rates observed in the study population.
Thanks to the Nordic Federation of Societies of Obstetrics and Gynecology for sharing this article, which can be found in their journal Acta Obstetricia et Gynecologica Scandinavic.
According to the WHO report Global and regional estimates of violence against women, 25% of women in the European Region experience physical and/or sexual violence by intimate partners at some point of their life, and 5% experience sexual violence from people who are not their partners.
On the International Day for the Elimination of Violence against Women, ECEC shares some valuable tools to help ensure timely access to emergency contraception to rape survivors.
- WHO: Responding to intimate partner violence and sexual violence against women. WHO clinical and policy guidelines
- International Consortium for Emergency Contraception (ICEC): EC FOR RAPE SURVIVORS. A Human Rights and Public Health Imperative.