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Calls to drop emergency contraception ‘barrier’ consultation

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A charity is calling for the end of the obligatory consultation women wanting emergency contraception (EC) must go through, saying it is a barrier to access.

British Pregnancy Advisory Service (BPAS) is calling for EC to be reclassified and made available for women to purchase directly, with the option of seeking advice if needed – in line with countries including Sweden and the US.

The progestogen-based pill is currently sold behind the counter and is available only after a consultation. It can only be sold by a pharmacist.

In a poll carried out by the charity, 57% of women aged 18-45 said they wanted to buy it directly off the shelf and 64% of women aged 18-45 said they believed the consultation should be optional.

Women described their experiences of the consultation during the survey.

Responses ranged from: “Awful. Made to feel like a whore” and “quizzed and made to feel slightly slutty”, to “informative, respectful and swift” and “easy and pain free”.

BPAS undertook a “secret shopper” experiment across 30 pharmacies in England to shine a light on what requesting EC is like, in one instance being asked to present a used pregnancy test to get the drug.

The charity said their shopper, a 22-year-old woman, found the majority of pharmacists provided a “kind, non-judgemental interaction”, but there were dramatic exceptions.

A pharmacist at one branch of one chain said the woman would need to take a pregnancy test and show him the result before he could sell it.

In the scenario the shopper gave, she indicated she had used EC the previous week after having sex. He said he believed she may already have been pregnant from that incident.

BPAS found EC was hidden from view in the vast majority of pharmacies. File pic
Image:
BPAS found EC was hidden from view in the vast majority of pharmacies. File pic

The shopper said: “I felt totally shocked. No other pharmacist had asked this of me.

“I thought on my feet and fabricated a story about having a train to catch and not having time for a pregnancy test at that moment.

“The pharmacist ultimately agreed to sell me the product on the condition that I took a pregnancy test after my train journey. Although I agreed, I felt like I wasn’t in charge and that I had to bargain with him to get him to sell me something I needed.”

The woman said she left the store “feeling judged”.

At another pharmacy, she was repeatedly asked about her age, made to show ID, and whether she was purchasing the product for someone else.

Women under 16 are allowed to use EC and at no cost from a number of sources, including most pharmacies.

The shopper also found she had to deal with as many as four people during her requests.

Fewer than half (48%) of pharmacies visited offered a private room for consultation, meaning she would have to discuss her sex life in front of other customers.

The charity found the EC hidden from view in the vast majority of pharmacies and 83% had no indication on the shop floor or within the window that emergency contraception was available.

Clare Murphy, director of external affairs at BPAS, said: “The obligatory consultation is a barrier to access to this vital medicine.

“This is a medication with an impressive safety record, there are no contraindications to its use and it gives women a crucial second chance of avoiding an unwanted pregnancy.

“Pharmacists can be an excellent source of information, but most women know what they need and would like to see the end of a mandatory consultation, with further advice available only if they request it.”

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