Don’t take the emergency contraceptive pill (ipill) too often!
Of late advertisers have bombarded the public with ads and television commercials of the ipill (emergency contraceptive pill). This has made a lot of people panic, from the moral guardians of our society, to the Advertising Council of India to doctors and the government as well. So much so that the Drug Controller General of India (DCGI) might change the ipill from an OTC (Over-The-Counter) drug to a prescription drug instead. I think this would be a mistake.
What’s it like in other parts of the world? Well, scores of countries allow the sale of the drug. For example, Estonia, Russia, United Kingdom, USA, Canada, three countries in South America, five in Africa and Asia (China, India, Malaysia, Thailand and Sri Lanka), Israel (only one in the middle east) and Australia and New Zealand. In most of these countries it is freely available over the counter without prescription (although with age restrictions) but in countries like Ireland, Italy, and Romania the buyer needs a medical prescription.
So if the ipill is an OTC drug in India, it’s not something unusual. It stands to reason that the Indian government took the decision to make the ipill an OTC drug. India follows aggressive family planning policies.
The ipill is nothing new. The emergency contraceptive pill has been in the market for some years now, although the hysteria around it started recently, along with the advertising blitzkrieg. Earlier, awareness of the existence of such a pill was low, what with doctors having been hesitant to recommend it to their patients. Apparently they think that it might encourage promiscuous behavior. Well, that is what one study says. Or maybe the ipill is simply not on top of mind with doctors, considering that it is not supposed to be a method of birth control, just an emergency pill. Nor can I imagine people rushing to their doctors after one “accident.” It could be embarrassing and they might fear a moral lecture. Therefore, making it a prescription drug may not work very well. India needs the ipill.
..that emergency contraceptive pills can prevent 75-85% of unintended pregnancies, if used within 72 hrs of unsafe sex. The women who had unsafe sex, had contraceptive failure, or had sexual assault can resort to emergency contraception(EC) to avoid unwanted pregnancy.
Though, legally one can opt for termination of pregnancy in India, but still owing to social reasons, majority of adolescents visit quacks instead of getting it done in medical institutions. Inspite of EC being available over the counter in India, still the rate of teenage and unintended pregnancies are high owing to it being the underused and unknown method. Also, the misconception that EC is an abortifacient and that its use promotes irresponsibility as well as promiscuous lifestyle particularly among adolescents, contribute to its under prescription by health professionals to prevent unintended pregnancies.
The ipill does more good than harm. The ipill is quite safe to use ocassionally, and there are no serious side-effects. Also, the risk of an unwanted pregnancy and attendant complications far outweighs the risk of taking it. So as long as one remembers that it is not a regular birth control pill, all is fine. Unfortunately, reports indicate that people are misusing this pill.
Misleading advertising is the culprit. If a young 23 year old domestic worker wants to buy Kellogg cornflakes as a “health tonic” you can imagine how she is going react to an advert of the ipill. And when it comes to educated people, they might use the ipill once too often, not quite understanding the implications of it, despite having read about the risks. It’s the same reason why people smoke despite knowing the risks and why people eat too much despite knowing that they are overweight. When it comes to contraception, people might be tardy when it comes to practicing it and take the easy way out. Take it the morning after.
The advertising does not emphasise emergency use strongly enough, and it also says that using the ipill can provide “tension-free” sex. This also seems to indicate that the advertisements are encouraging “free” sex, and has given rise to fears that such advertising will encourage promiscuity.
Does the free availability of the ipill and the advertising of it encourage promiscuity? I do not believe so. I doubt whether misleading advertising by itself can actually increase sexual activity in any significant way. Although there have been no studies in India regarding this, studies in other parts of the world have shown that selling the ipill as an OTC drug does not increase promiscuity.
I am sure that contraception by itself has given rise to a world where people can have “tension-free” sex. The ipill is but one kind of contraceptive method, and just by itself cannot possibly impact a society so much as to change sexual mores.
What needs to be done is to ensure that the advertising is truthful and responsible. The harmful effects of taking this drug on a regular basis need to be well advertised. What people need to know is that the emergency contraceptive pill is strong, “two to five” times stronger than one normal birth control pill. You can now deduce the harm it can do if it is had too often. But I do hope the government doesn’t make it go underground by making it a prescription drug. The ipill gives women control over their own body and that’s important.
(Minal has helped me research this post).