Morning-after pill ‘should be sold off the shelf’

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By BBC Health News

Women and girls should be able to get hold of emergency contraception more easily without the need for a consultation with a pharmacist, say women’s health experts.

A report by the Royal College of Obstetricians and Gynaecologists recommends the morning-after pill “should be sold straight off the shelf”, like condoms.

There are too many barriers to health services for women in the UK, it says.

And their needs should be a priority.

The report, Better for Women, is also calling for women to be allowed to take the first abortion pill at home, as well as the second, if they know they are less than 10 weeks pregnant.

It said women should be able to have a consultation for an early medical abortion over the phone or via Skype.

The report also recommends a network of one-stop health clinics for women, offering smear tests, contraceptives and advice all in one place.

At the moment, women and girls have to have a consultation with a pharmacist before they can be given an emergency contraceptive, or morning-after pill – taken within five days of unprotected sex.

This can leave them feeling “uncomfortable, embarrassed or judged”, the report says.

It recommends that the morning-after pill should be available “in front of the counter” and off the shelf, alongside pregnancy tests and condoms.

Emergency contraception is available free of charge without prescription from all pharmacies in Scotland and Wales.

In England, contraception services are commissioned locally and are on offer in sexual health clinics, some GP surgeries and most pharmacies – but are not always free of charge.

The College says cuts to public health budgets have made it more difficult for women to access the services they need – figures obtained by the BBC last year suggest nearly half of councils in England had plans to reduce contraception services.

This may have led to rising conception rates and abortions among older women, because of unplanned pregnancies, the report says.

In 2018, more than 205,000 abortions were performed in England and Wales.

The report also calls for the progestogen-only contraceptive pill, taken once a day, to be available over the counter in pharmacies instead of with a prescription from a GP.

It says girls and women should be able to order the pills online like any other pharmacy product.

Prof Lesley Regan, president of the Royal College of Obstetricians and Gynaecologists, said the progestogen-only contraceptive pill (Pop) was very safe, and a consultation with a GP before starting to take it was “unnecessary”.

The report also recommends:

  • long-term contraception should be discussed straight after a woman gives birth
  • improved access to abortions for all women
  • one-stop women’s health clinics should be set up and open at weekends and evenings
  • three full cycles of IVF should be offered to all eligible women in the UK
  • GP appointment times should be extended to 15 minutes

The report said: “Too many women are spending years in pain and discomfort because [GP] appointment times are too short and demands on the time of doctors and other healthcare professionals are too great.

“This makes women less likely to talk about their issues.”

The report points out that longer appointments would save the NHS money in the long term.

Dr Asha Kasliwal, president of the Faculty of Sexual and Reproductive Healthcare, said women and girls, including under-18s, must have free and timely access to all methods of emergency contraception.

“While emergency contraception is free in some places in England, many will choose to access it in pharmacies where cost and opening times vary considerably.

“Consultations with pharmacists are highly recommended and best practice, as this is a valuable opportunity for individuals to discuss their contraceptive needs with a healthcare professional.

“However, a consultation should not be a barrier to receiving emergency contraception.”

Prof Regan said the key was ensuring services were more joined up and responsive to the need of girls and women.

“It is important we provide a comprehensive health service for girls and women throughout their lives.

“We want to empower 51% of the population to be as healthy as possible and ensure no-one is left behind,” she said.