Charter for Choice

Katherine O’Brien, bpas: Let’s Stop Treating Emergency Contraception As A Marker Of Female Irresponsibility

Katherine O’Brien is Media and Public Policy Manager at bpas.

The outcry that followed the decision last month to allow under-16s to buy the emergency contraceptive pill EllaOne was sadly predictable. As a society, we have decided that access to contraception is a good thing, and those women who take their pill regularly are given a pat on the back and awarded the prestigious title of “responsible.”

However, using emergency contraception is seen as a marker of quite the opposite. It’s viewed as a sign of failure, of irresponsibility. It’s a bit dirty, as much a symbol of a drunken one-night stand as sitting on the bus at 7am on a Saturday morning drinking a Lucozade in last night’s glad rags.
Because of the way we view EC, we have created a system that discourages women from using it. While women are able to get EC for free from their GP or local sexual health clinic, that’s not always convenient or indeed possible to do in the necessary time frame. Consequently, many women are forced to purchase it.

To buy EC, women have to jump through a series of hoops that we would never dream of putting in place for any other kind of medication with similar levels of safety and efficacy. Once you have found a pharmacists willing to sell it to you (not always an easy task), there’s the dreaded consultation. During this nice, informal chat with your pharmacist, you may be asked a range of rather pointless questions from how many times you’ve taken EC to if you had been drinking at the time of the “incident” (yes, that is a real thing that a real pharmacist asked a real woman.) While a discussion about contraception etc might be useful for some, it’s not medically necessary. So in the absence of clinical need, any conversation should be optional. To require a woman to discuss the last time she had an STI test in a not-exactly-soundproof curtained cubicle on the pharmacy shop floor only adds to a sense of embarrassment and shame.

Once you have completed the consultation, there’s the small matter of a rather large price tag. One can’t escape the feeling that the high cost (up to £40) is a way of communicating to women that this really isn’t something they should be doing – and certainly not on a regular basis (at least not without a massive overdraft.)

We have created a system which tells women who need EC that they have done something “wrong”, and made it ridiculously difficult to buy. Yet any move every move to make EC more accessible is roundly criticised. When, in 2014, new guidance was issued stating that under-25s should be allowed to keep EC at home and get it for free, a moral panic ensued, with warnings of young women running wild and having unprotected sex morning, noon, and night (when there was nothing good on Netflix, I presume.)

Nick Clegg, who has been nominated as a Champion of Choice, passionately rejected this view. In an interview at the time, Clegg stated that “women shouldn’t be told ‘We are not going to give you the freedom to buy something from a chemist because we don’t trust how you will behave sexually’. It’s a Victorian – worse than that, medieval – approach to women.”

And really, that is what our current treatment of EC is based on: patronising and sexist assumptions about women. And we need to challenge this. So let’s put it on the shelves, make consultations optional, and price it at a level that reflects what it is: a cheap to make and safe to take method of contraception. If we trust women, we should trust women with EC.