10.29.06
Give me the pill, not a lecture
I’m not pregnant. Thank God. I was worried for a couple of weeks, though. I felt dizzy one day and my mother immediately leapt to conclusions. Then the PMT set in, but every PMT symptom can be interpreted as a pregnancy symptom and I was getting paranoid.
Phew! We’re just emerging from the two-babies-in-two-years fog and I am not sure I could have stood up, physically or mentally, to another one. My husband says he’d have left the country. Thankfully he can remain here and ferry up my tea and toast in the morning.
It was a close call, though, and enough to get me exercised when I read the patronising comments of Martin Daly, chairman of the Irish Medical Organisation’s GP Committee, last week. Dr Daly believes that the morning-after pill should not be distributed by pharmacies; prescribing it should remain the preserve of GPs.
Well, I bet Dr Daly never woke up on a Saturday morning wondering if he was pregnant and realising that he couldn’t get his hands on the solution to his problem until Monday morning, when it might be too late. Funny how those who never have to face a problem can confidently assure the rest of us that there isn’t one.
I’d had a close call on a Friday night and when I woke up I had a choice. Do I spend three weeks panicking or take a morning-after pill and eliminate the anxiety? Actually, I didn’t have a choice because my GP doesn’t open on a Saturday. He only opens on a Monday, Wednesday and Friday between 10am and 12.
It’s bad enough when you get into the surgery; it’s so humiliating. You have to give the “details” of the “incident”. You may have to explain to the receptionist why you must see the doctor that day and no other. So much for confidentiality.
Then the doctor gets to shake his patrician head at your silliness and gives you a contraception lecture. Possibly justifiable when I was 18 and drunk. Now I’m 35 and just tired. Give me the stupid pill and spare me the lecture. Oh, and here’s your €50 even though you haven’t had to do anything since I told you what was wrong with me and what I need.
There’s the rub. It’s a nice little earner: a steady queue of healthy women coming into your office requiring nothing other than your signature and your disapproval for which you get handsomely paid. Hardly surprising that Dr Daly doesn’t want to let go of that revenue stream. Naturally he’ll deny that finance is the source of his concern. It’s not just the money — it’s the control.
“We believe that the vast majority of women who seek it are in their late teens and early 20s and the opportunity should be taken to explain that emergency contraception is just that,” Daly said last week. “It’s a last resort.” He wants to talk to the women about “the implications of being sexually active and how to protect against sexually transmitted diseases”.
Quite frankly he’s wrong — on all counts. Firstly, regardless of age, if a woman is responsible enough to look for the pill in the first place then I think it’s fair to assume that she is quite well aware of the “implications” of being sexually active. Secondly, there was a lot of fuss about a survey on Irish people’s sexual habits a fortnight ago. Most media headlined the highly predictable fact that young people are having lots of sex with lots of different people. Dr Daly might have found the section on contraception interesting: some 90% of the allegedly slutty teenagers he wants to talk to about “the implications of sexual activity” are using contraception.
Guess who is using the least? Married women aged 35-44. These are women sick of being dosed with artificial hormones and who believe that their fertility is low enough not to warrant using contraception. Perhaps they believe they have low fertility because they read headlines screeching about women who postpone child-bearing until their thirties when their fertility has dropped to disastrous levels.
The bottom line is that doctors won’t give up the morning-after pill because they want to give the safe-sex lecture. Well thanks, but I’ve had enough of the lectures. I am responsible for my own fertility and I’d like to be able to buy the pill in a chemist without the moralizing.
I see that the Irish Family Planning Association opened an emergency contraception clinic in Tallaght on Sunday. Guess who’s going to it? People from Carlow and Kildare. It makes no sense for people to travel these distances to get a pill they could just as easily get in their local chemist.
Levonelle, the brand name of the pill, has only been available in this country since June 2003. Prior to that the “morning-after pill” that doctors were lowering themselves to hand out was just a double dose of the normal pill, though they didn’t like you to know that.
“In the UK, the NHS has gone down the route of making it available over the counter for the past five years and it has made no difference,” Daly said. Difference to what? Pregnancy rates? Well, obviously, those who don’t think they need the pill are still going to get pregnant. For those who know they need it, why make it as difficult and expensive as possible to get? €50-€80 is a lot of money. Cheaper than being pregnant and cheaper than a flight to London for an abortion. But enough to put someone off, especially when they aren’t certain if the risk warrants the inconvenience, the mortification and the investment.
Daly again: “If there was a clear-cut advantage to making it available over the counter, I would consider it but so far there has been none.” Well, there is no clear-cut advantage to him obviously, but there would be to panic-stricken women.
Why not just dispense it in a pharmacy? Their opening hours are better and it would be cheaper. There could always be some deal whereby they tell your GP that you came in for it, and an obligation on them to give you a leaflet on non-emergency contraception.
Most disappointingly Mary Harney, the health minister, hasn’t the slightest intention of putting pressure on doctors to let go this control over women. “Clearly, it can only be done if it’s medically safe to do so and until we get the advice of the regulatory body that has responsibility in this area, I wouldn’t be in a position to make a decision,” she has said.
But it is medically safe. Safe as houses. It’s so safe that breast-feeding women can take it, and they aren’t allowed take an anti-histamine. This has nothing to do with safety. It’s just old-fashioned protectionism by the establishment to defend their income and their status.
Anonymonster said,
October 29, 2006 at 8:46 pm
Agree 100%
empirestateview said,
October 30, 2006 at 4:50 am
Well said. It’s so much worse over here, though, where a huge number of pharmacists will actually refuse to dispense monthly contraceptives to women with prescriptions. They’ll lecture them at the counter, saying that the pill is tantamount to abortion and that they’re under no obligation to sell it because it’s against their beliefs. The Government tacitly supports this. You can get emergency contraception in some pharmacists here, but possibly not for much longer. As for condoms, don’t ask. Actually, in case you do ask, here’s an example: in Duane Reade on Union Square, Manhattan, they’re kept in a little plastic basket UNDER THE TILL and you have to ask for them, go through the basket in front of the sales clerk, and then endure him smirking and telling your partner to “have a good night”. It’s the same in Walmart, I believe; certain chains exercise the right to run a conservative ship.
Daniel Sullivan said,
October 31, 2006 at 3:04 am
Sarah, part of the problem is that the doctors believe they are the only one of the old Irish trinity, of the priest, the doctor and the máistir, that ran most rural communities to have any crediblity left.
In their worldview, the teachers are all communist, the clergy have to be keep away from the children and they are the sole preservers of all that id good and right and moral. They seem to have missed out how the public view their behaviour around ‘investigating’ Neary and taking organs and the lads at the top wanting to be paid a fulltime wage for a part time work.
laura said,
November 2, 2006 at 10:01 pm
Sarah, I can only speculate on this, but, you must have a middle aged old fart of a GP. Time to find yourself a young female GP. No lectures from them. Well, lectures about smears, but those lectures are good for us.
As for sunday opening etc there are clinics in Dublin that open on a saturday and sunday. Hassle, but they are open. They are in the golden pages.
I think that every woman in Ireland below a certain age has probably had a morning after pill experience. We would all dearly love it to be available more freely. So, next time you are in the UK, stock up. Mind you, pharmacists can be just as bad in their condemnation and disapproval when handing you the perscription.
You could probably get an emergency Ryanair flight to the UK and back to buy it in a pharmacy over there less expensively than it would cost you to go to a GP here.
Remember Nell McCafferty and all the other empowered women of the day going up north and coming back with condoms e.t.c. It is scary to think that we have not moved on from those days. First condoms, then the pill, now the morning after pill. Maybe it is time to have a whole bunch of women go over to the UK and come back with morning after pills.
Can I be arrested if I happen to have a stock of those in my luggage?
I don’t think men should have a say in this. Do we have a say in their fertility? Like hell we do.
Maggie said,
November 7, 2006 at 4:28 pm
Obviously not a solution for all Irish women, but those living near the Border can go to Northern Ireland and get the morning after pill from pharmacists there.
cindy said,
May 28, 2007 at 8:38 am
I am Dutch and have been living in beautiful Ireland for quite some years. I have regularly felt frustrated by the attitude of GP’s here towards contraception. In the Netherland you call the receptionist of your doctor and later that day you collect a prescription for 6 months (the very first prescription is ofcourse only obtained after smeartesting). Here you get one month…or 3 months prescription? and if after argueing that you do have other things to do then run to the doctor every few months you do get your 6 months prescription, you get advised that you should call in for check up after the 6 months. Major concerns about their wallets, not just our health? In Europe it is generally advised to have a smear every 3/4 years. (The nurse in my CP centre advised me the same way?) So I don’t need to visit my FEMALE GP every year, unless I have noticed any changes and have reasons for concern!
Nearing 40, like so many woman, you’re fed up of ‘being dosed with artificial hormones’. As partners often need some time to consider vasectomy or sterilisation, you choose the condom. When something goes ‘wrong’, you want to go to your pharmacist and buy the Morning After Pill over the counter for about 36 euro (like in England, France, Belgium, Netherlands) and avoid an unwanted pregnancy. There have been enough of those, and instead of the ‘every sperm is sacred’ attitude, it is time for an ‘every child was really wanted’ attitude. The world is too filled already with children that were not planned and not wanted!
I agree that it is important that the Morning After Pill is not viewed as a form of contraception, but if your contraception fails you should have quick and easy access to a solution -with no unneccessary extra cost- to end your worries.
15 yr old boy said,
December 20, 2007 at 12:16 am
in a case i no a 15 girl went into the local hospital to get the morning after pill,after their condom ripped. not only was she given a lecture but given out to, got terible abuse and was crying on her way out. she was being sensible by using a condom, 80% of people my age (15) wouldn’t. in canada the pill and morning after pill are both given over the counter. i no myself that making it difficult to get the morning after pill is NOT going to stop young people having sex, it is only going to increase the amount of abortions and children having children. it is totally and absolutely bulls**t!!!!!!
pharma said,
February 17, 2008 at 11:38 am
I am a pharmacist who has worked in the UK and Ireland, and have just come across the comments on these sites…..can I add in my tuppence ha’penny worth? I am a young woman in my twenties who has been in the position of both needing and supplying emergency contraception.
Firstly, the morning after pill is a Prescription ONLY medicine in Ireland, which means that legally it can only be supplied by a doctor, or on foot of a prescription. The first article (Feminism, Sunday Times) mentions safety not being an issue….the drug is an artificial hormone, and works by interfering with normal body systems. Safety in breastfeeding does not imply safety in all situations. I give you the example of warfarin, a powerful anticoagulant drug. Taking it without proper monitoring can lead to fatal bleeding, but it doesn’t pass into breastmilk so it’s perfectly safe for a breastfed infant whose mother is taking warfarin. Of course the morning after pill has been tested for safety but , as with every drug, there is always the risk of some poor person being the one in a million that has an extreme adverse effect to it. That’s why it (and many other drugs, relating to contraception or not) are Prescription only – the onus of responsibility is on the prescriber/supplier; it’s not like taking vitamins! It may seem like a nannyish point of view, and lots of people can take responsibility for their own health/decisions…..but lots of people can’t or don’t. It’s not about power, it’s about reponsibility, and that’s why there is legislation relating to the supply of medication.
Even in countries where the drug is available over the counter, it is Pharmacy only i.e. the pharmacist has to make an assessment as to whether the drug is safe and appropriate. Lets get one thing straight, a drug being available from a pharmacy does not mean it is available on demand, it’s not like getting a Big Mac from McDonalds!! A chemists shop is not the ideal environment for this by any means. You have to ask very personal questions to an embarrassed or worse, demanding, patient and then justify your decision. I know it might seem hard to understand why it can’t be readily available, and the manner of some pharmacists can be, or can interpreted to be, condescending. But from my experience, it wasn’t pleasant for me either, but it’s my professional duty to the patient (not to mention the legal duty) to make sure that a medicine sold over the counter is correct for them.
And from my experience, the morning after pill is being used most often by women of all ages as a from of contraception, not for rare emergencies – which defeats the purpose. Of course, everybody is different, that’s my point about responsibility. Maybe it’s a “for the greater good” kind of arguement, I don’t know the answer myself. Some people might think I’m being condescending and think I know better, but that’s not the case at all. It’s about science, not morals. A pharmacist knows more about medicines that Joanne Soap walking in from the street who wants something on demand. You wouldn’t go to a financial advisor and respect them if they sold you something inappropriate, even if you asked them too…
Access to services such as GPs, family planning clinics etc is a problem that goes beyond just emergency contraception. The HSE lurches from one crisis to another, there is no long term planning or thought put into health promotion/ primary care prevention strategies realting to this or many other Health Care issues. Part of it this is inherited from the 80s, a lot of it is poor management from the central HSE who have no idea what is needed on the ground, and part of it is the whole Irish attitude of “it’ll do”. I can see some politician using emergency contraception for electioneering, rushing the legislation through to get it made available from pharmacies, and then the media and blogs like this being full of comments about pharmacies who won’t supply (which might or might not be for good reason for individual patients) or about patients who bought it “too easily” or had adverse effects…..what gives??
2 comments from the previous blogs:
Morality aside, having sex with a girl of 15 is ILLEGAL. Even if the morning after pill was available from pharmacies they would not be allowed to sell it to her as she is underage (part of the restrictions of the drug)
To the dutch blogger – OTC does not mean on demand, I don’t think that anyone realises that.
perry said,
January 11, 2010 at 9:24 pm
What ever happened to responsibility? Taking responsibility for one’s own actions? A simple case of cause and effect… yes, our government should do more to support young pregnant women and indeed support for young, single mothers.
further, how dare anyone judge someone in a time of distress – surely this only fuels the problem and alienates young women in need? but perhaps withholding the pill will allow people to face the grim reality of sexual promiscuity – e.g. unwanted pregnancies, std’s and abortion?
personally, i just think it sad how ireland (religious or otherwise) has become such a secular, commercial, fast-food (and sex) nation. has ireland thrown the baby out with the bathwater and lost the values of our society, do we realise or appreciate the value of anything any more?
eilis said,
February 8, 2010 at 12:09 pm
hi just read this. notice that in all comments no one mentions the human life that is destroyed when the morning after pill is taken (in the cases where fertilisation has taken place) Sure people have different views on whether that human life has rights or not but can we at least acknowledge that the life is there from fertilisation? After all nothing added except time and nutrition between moment of conception and first cry of the newborn child.