6 December 2011

UK: Morning-after pill offered free by post

BPAS' Christmas campaign to encourage women to order emergency contraception in advance gained front-page coverage in the British press, and caught the attention of the Health Secretary, Andrew Lansley.

BPAS is offering emergency contraception free of charge in the post to women who fill in an online form and talk to a nurse over the phone.The British Pregnancy Advisory Service (BPAS) says women could find it difficult to obtain the drug quickly over the holiday period.

The Christmas and New Year period is seen by sexual health charities as a high-risk period for both unwanted pregnancy and sexual infections, BBC News Online reports.

Emergency contraception is effective for the first 72 hours after sex, but is more likely to work the sooner it is taken. It can cause side-effects such as nausea and diarrhoea in some women who take it.

The morning-after pill has been available for several years directly from pharmacies and walk-in-clinics, but BPAS fears that its £25 cost at pharmacies in some parts of the UK, combined with Christmas holiday closures, could discourage women from getting hold of it when needed.

With the BPAS initiative, women will leave their details and a time they can be called in privacy on the webform at www.santacomes.org. A nurse will phone to assess their suitability and to ensure it is not being requested for immediate use. The consultation, which will last about 15 minutes, will include an explanation about how the pill works, when to take it, and what to expect.

The nurse will also be able to answer any questions about more regular forms of contraception and sexual health, as well as provide details of local contraception and sexual health services. The pill will then be despatched with condoms and advice literature to her home address. 

Tracey Forsyth, one of the contraceptive specialist nurses working at BPAS, said:

“We know that women often do not take the morning-after pill after unprotected sex. They may not think their risk of pregnancy is high, and the cost, inconvenience or embarrassment of obtaining it may put them off.

“Having it at home means you are much more likely to take it as soon as you need it. Sometimes women worry that requesting the pill in advance makes it look like you are planning on taking chances. In fact the opposite is true - making sure you have a back-up to help prevent an unwanted pregnancy is making sure nothing is left to chance.”

The initiative was welcomed by sexual health charity FPA, which said it supported anything that might cut the number of unwanted pregnancies.

However, Life, a charity which opposes abortion, said there was no evidence that emergency contraception reduced unplanned pregnancy rates.

A spokesman said: “In fact, if a woman has the morning-after pill at home ‘just in case’ she may be more likely to engage in risky sexual behaviour than she would normally - particularly over the festive period with the associated increase in alcohol consumption.”

Health Secretary Andrew Lansley said of the initiative:

“Emergency contraception is intended to be exactly that - for emergencies not everyday use. Ideally, it would be better for it to be made available in person, which would mean any decisions were taken with the benefit of face-to-face advice.

“Women should be encouraged to use long-acting reversible contraception rather than emergency contraception.”

Ann Furedi, chief executive of BPAS, said she was astonished by Mr Lansley’s comment, given that increasing access to the morning after pill has been a long-standing policy. Furedi said:

“Only a minority of women use the long-acting contraceptives that give the best protection. Most women would benefit from backing up their birth control with emergency contraception to hand. The sooner a woman is able to take it, the more effective it is.

“It makes sense for women to get it in advance of need. You don’t wait until you have a headache to go in search of pain relief; why do politicians think women should wait until they’ve had sex to get emergency contraception? Being responsible is about anticipating when you may be at risk – even when you don’t plan to be.

“We are as committed to helping women avoid the need for abortion as we are to providing first class abortion care. We hope that being able to access the morning-after pill in advance over the phone for free will encourage more women to have one at home, just in case.”

Ann Furedi discussed the BPAS morning-after pill campaign on Radio Four’s Woman’s Hour on 13 December.

Writing on the British Medical Journal blog on 12 December, Marge Berer, founding editor of Reproductive Health Matters, argued:

“A Cochrane review in 2010 found that women who received an advance supply of the morning-after pill had the same chance of becoming pregnant as those who did not have early access to the method. However, these pills do prevent pregnancy when they are used. It seems that many of the women who have unprotected sex and get pregnant without wanting to are not the ones actually obtaining and using the morning-after pill. Perhaps Bpas’ campaign, with the help of all the media who have given it space, will help to change that. According to the Bpas press office, 1,000 women phoned in the first 48 hours. If many more women find out about this method and start to keep a dose or two at home in case they need it, there is a far better chance they can avoid an unwanted pregnancy.”

Morning-after pill offered free by post. BBC News Online, 6 December 2011

bpas launches scheme to allow women access to free emergency hormonal contraception in advance over the phone. BPAS, 6 December 2011

Marge Berer: Jingle pills indeed. BMJ blog, 12 December 2011

Morning After Pill Adverts. Woman’s Hour, BBC Radio Four, 13 December 2011

Women As Moral Agents and the Morning After Pill Debate. By Ann Furedi. Global Herald, 15 December 2011

Also read:

Emergency Contraception: What it does and does not do. By Jennie Bristow. Abortion Review, 9 February 2009

Clinical Update: Emergency contraception. By Patricia Lohr. Abortion Review, 9 February 2009

Abortion Review topic archive: Contraception (EC)