Wednesday, 25 September 2013

What people should know about the ‘once-a-month contraceptive pill’

The Guardian and other news outlets have highlighted a new journal article arguing that a ‘once-a-month contraceptive pill’ is ‘scientifically possible’.

Writing in the Journal of Family Planning and Reproductive Health Care, the researchers say such an advance would be welcomed by many women but the biggest hurdle to development is likely to be ‘political opposition’.

The new pill, they say, could be routinely used after, rather than before, sex. The idea would be that women wouldn’t have to take any precautions against pregnancy at all other than popping a pill whenever their period is delayed and they think they might possibly be pregnant.

What the Guardian doesn’t tell us is that such a pill would not be a ‘contraceptive’ (literally ‘against conception’) at all but rather an abortifacient (destroying an implanted human embryo). This is abortion and not contraception.

Nor does it tell us that a pill that acts in this way in the first few days after conception, ellaOne (ulipristal acetate), has already been available on prescription in the UK since 2009. Another similar drug, mifepristone (RU 486), is already used in Britain to procure medical abortions up to several weeks, but only under the auspices of the Abortion Act.

What is really being advocated is the deregulation of early abortion, by making it available over the counter. And there is no doubt that if such a move took place some women would stockpile the drugs and also use them in higher dose to procure their own later ‘do it yourself abortions’ at home. The thought of young girls disposing of their pregnancies at home – with all that might involve – is really quite horrifying. 

There are other huge dangers with such a strategy. British and American studies have already clearly demonstrated that  making emergency contraception available free over the counter without prescription leads to an increase in rates of sexually transmitted infections and does not decrease pregnancy or abortion rates. If this new pill were to be made available we would expect it to be at least as bad (see note on 'risk compensation below).

Britain already has the highest rate of teenage pregnancy in Western Europe.  Rates of sexually transmitted diseases are also rising. In 2009 there were 12,000 more cases than the previous year, when 470,701 cases were reported. The number of infections in 16-to 19 year-olds seen at genito-urinary medicine clinics rose from 46,856 in 2003 to 58,133 in 2007.

The availability of such pills would also expose women to greater risks of sexual abuse. The fact that one is not using contraception is a strong argument to avoid being coerced into having sex by a strong-willed boyfriend or someone wanting to cover up abuse. Having such a pill available for use by would-be abusers - ‘It doesn’t matter; if you miss a period you could just take this pill’ – actually makes women more vulnerable.

This latest ‘advice’ is not just another ill-conceived non evidence-based knee-jerk response to Britain’s spiralling epidemic of unplanned pregnancy, abortion and sexually transmitted disease. It is also an attempt to smuggle in even more abortion by the back door.

The best way to counter the epidemic of unplanned pregnancy and sexually transmitted disease is to promote real behaviour change. The government would be well advised to enter into dialogue with leaders of communities in Britain where rates of sexually transmitted diseases and unplanned pregnancy are very low, especially Christian faith communities, to learn about what actually works.

Note on risk compensation 

The phenomenon whereby applying a prevention measure results in an increase in the very thing it is trying to prevent is known as ‘risk compensation’. The term has been applied to the fact that the wearing of seatbelts does not decrease the level of some forms of road traffic injuries since drivers are thereby encouraged to drive more recklessly.

In the same way it has been argued that making condoms readily available actually increases rather than decreases rates of pregnancy and sexually transmitted infections because condoms encourage teenagers to take more sexual risks in the false belief that they will not suffer harm.

But whilst condoms offer some protection against sexually transmitted infections the morning-after pill offers absolutely none. Rather it encourages more risky behaviour in the false belief that one is safe.

Other blogs on related issues

What economics can tell us about teen pregnancy rates 
School contraceptives to 13 year olds 
Three false presuppositions about teenage pregnancies 

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