On June 20, the US Food and Drug Administration (FDA) officially announced its approval to sell LNG EC over-the-counter with no age or point-of-sale restrictions. This decision puts an end to an almost decade-long dispute over the accessibility of EC, and the US now joins a small group of countries where LNG EC is sold without restrictions. In Europe, according to the EC access mapping conducted by ECEC, LNG EC can be bought over the counter in only 8 countries: the Czech Republic, Denmark, Estonia, the Netherlands, Norway, Portugal, Slovakia, and Sweden. For more information, please visit Emergency Contraception Availability in Europe.
A recent UK study examined how the use of ulipristal acetate (UPA), levonorgestrel (LNG), and the copper-intrauterine device for emergency contraception changed following the introduction of new UK Faculty of Sexual & Reproductive Healthcare (FSRH) guidelines. The new guidelines recommend that for emergency contraception, health professionals should discuss individual needs and inform women of the different methods, efficacy, adverse effects, interactions, eligibility, and additional contraception. The researchers studied (1) how the use of EC changed, (2) which methods were offered and how this changed, (3) which method was chosen by women who were offered all three UK licensed methods of EC, and (4) the appropriateness of the offer of only LNG. The authors concluded that when comparing the period before the adoption of the new guidelines with that of the period after, more women were offered all three methods, the use of LNG fell (93.0% to 76.0%), and the use of UPA increased (3.0% to 18.7%). Additionally, women were encouraged to exercise choice. However, increasing choice did not lead to a wholesale change from LNG to UPA.
On May 15th, the Health Committee of the Bundestag (German parliament) resolved not to remove the prescription status of LNG EC. The coalition currently in office (CDU and FDP), turned down the request by the SPD and Die LINKE parties to change LNG to prescription-free status. The political parties that requested the change of status claim that the decision responds to pressures from professional groups and economic interests.
Unlike many other women in Europe, German women at risk of unwanted pregnancy will continue needing to visit a physician to get a prescription, before they can use EC.
Data from the study “Women’s perception of emergency contraceptive pills” are now available. The study examined Spanish women’s opinions and knowledge on hormonal EC. The researchers’ findings included the following:
- 84% of Spanish women consider that having the emergency contraceptive pill (ECP) available is a major breakthrough for woman.
- 76% considered that the ECP is a “responsible choice” to prevent an unwanted pregnancy.
- Only 1 out of 4 women exposed to risk of pregnancy, resorts to ECP. The main reason not to use ECP is the underestimation of the risk of pregnancy, in 63% of cases.
- Women who resorted to ECP made a rational use of it, and used ECP due to a failure of their contraceptive method.
- 86% want the taboos and sense of guilt related to ECP use, to disappear. 92% of them want more information and a greater involvement of health workers.
In Germany, the discussion continues over whether levonorgestrel-only emergency contraception should be issued in the future without a doctor’s prescription. Currently, a prescription is still needed in order to purchase Emergency Contraception, and only physicians can prescribe it. At a hearing of the Health Committee of the Bundestag in April, testimony was given by health educators and pharmacists advocating for a change to the prescription-only status of EC, while most doctors and the insurance association maintained that a medical consultation was needed before the EC pills could be dispensed. Click to read the article in German or English
A health group in Scotland is calling on government Ministers to allow school nurses to dispense Emergency Contraception to students. The Scottish Sexual Health Lead Clinicians Group suggests that nurses could dispense condoms and emergency contraception to school children in order to help reduce teen pregnancy rates, which have been holding steady at 7.1 per 1,000 for the past three years. Currently, the government’s policy does not support providing emergency contraception in schools. The group maintains, “Why are condoms and contraception not accessible? Vaccination against a sexually transmitted infection (HPV) is given in schools – why can’t pregnancy and other STIs be prevented?”
It was decided at the Swiss Catholic Bishops Conference that women who have been raped may use Emergency Contraception, echoing similar rulings made recently by German bishops. However, the Swiss bishops confused the issue by stating that EC can only be used when there is a contraceptive effect and not when it induces an abortion, incorrectly implying that EC pills may potentially cause an abortion. (Scientific research shows that Emergency Contraceptive pills only work by preventing fertilization from occurring, therefore even under the Church’s definition of pregnancy as beginning at the moment of conception, EC can only have a contraceptive effect and cannot induce an abortion.) The article reports that the Bishops’ decision to allow women who have been raped to use EC was based on the recommendation of the Conference’s Bioethics Committee and that “rape is an act of violence which transgresses the fundamental rights of women and cannot be accepted.”
In a welcome announcement, Cardinal Joachim Meisner of Cologne, Germany stated that he supported the use of Emergency Contraception in Catholic hospitals to treat rape victims since it did not induce abortions. This statement comes after two Catholic hospitals in Germany received widespread negative press after refusing to treat a female rape victim because they could not prescribe EC or counsel on abortion. Meisner’s announcement is especially notable because he is known for his outspoken conservative views. Apparently, Meisner changed his view after learning from scientists that EC pills prevent fertilization. According to Meisner, “if a medication that hinders conception is used after a rape with the purpose of avoiding fertilization, then this is acceptable in my view.”
The Center for Reproductive Rights recently released a fact sheet titled
“Access to Contraceptives in the European Union: Human Rights, Barriers and Good Practices,” which outlines different barriers to access in the region and highlights some examples considered best practices. Although states are obligated under international law to provide women with access to a full range of contraceptives and contraceptive information, and although most countries in the European Union include contraceptives in their public health and social policies, access still remains an issue in some Member States. As the Center explains, “this factsheet is intended to serve as a resource for those interested in understanding the human rights laws and policies, barriers, and good practices relating to contraceptive access in the European Union.”
ECEC will be attending the European Society of Contraception and
Reproductive Health’s first global conference on contraception, reproductive
and sexual health in May in Copenhagen, Denmark. The sessions that are
specifically focused on emergency contraception are highlighted below:
Friday, 24 May 2013
16:30 – 17:30 Sponsored Symposium HRA Pharma: The unpredictable
ovulation: critical in evolution and central in emergency contraception
Saturday, 25 May 2013
08:30 – 10:00 Educational Session 3: Emergency contraception
Click the link below for more information on the conference and registration: http://www.escrh.eu/events/esc-events/2013