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Over-charged and humiliated: why is getting the morning-after pill such an ordeal?

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A woman awkwardly approaches a pharmacy counter, weighing up whether she has the courage to ask for the morning-after pill in front of a queue of customers. She’s told she’ll have to wait for half an hour before she’s taken aside for an intrusive, unnecessary consultation with a complete stranger – after which, she’ll be charged £30 for the privilege.

She’d rather not go through the embarrassment and expense, but unless she wants to run the gauntlet of a potential unwanted pregnancy, she doesn’t have much choice.

Welcome to Britain in 2016: a place where women are routinely made to feel uncomfortable and financially penalized for having sex.

levonelle

Levonelle is available to buy from pharmacies in the UK and usually costs around £25, according to NHS Choices.

It might sound dramatic, but all too often, this is what it comes down to. Women in the UK currently pay more for emergency contraception than anywhere else in Europe: up to £35 a pop for the main two brands of emergency contraception, Levonelle One Step and ellaOne.

In France, women pay around €7 (£6) for the equivalent.

The only European country that charges more than us is Ireland (which, let’s remember, doesn’t have the greatest track record of allowing women control over their own bodies).


Read more: “It’s 2016. Why is contraception still a woman’s job?”


On top of the hefty fee, we also have to undergo a grilling from a pharmacist who decides whether we’re allowed to take a drug described by the British Pregnancy Advisory Service (BPAS) as “considerably safer” than other easily obtainable medications, including painkillers and nicotine replacement therapies.

Of course, we could just go to a sexual health clinic or our GP and get the morning-after pill for free. But in a country where vast amounts of funding have been slashed from frontline sexual health services and the average waiting time for a surgery appointment stands at just under 13 days – not to mention weekend closure times – this often isn’t an option, especially as the efficacy of the morning-after pill depends on how soon you take it after having unprotected sex.

french pharmacy

French pharmacies: not just good for cosmetics.

This week, BPAS finally waded into the debate. “There is no financial justification for the high price of this pill, nor clinical reason for a consultation before it can be sold,” says Ann Furedi, the charity’s chief executive.

“It’s time to ditch what is the ultimate sexist surcharge and put emergency contraception where it belongs – on the shelf, at a price women can afford.”

It’s time to ditch the ultimate sexist surcharge and put emergency contraception where it belongs– on the shelf, at a price women can afford

The only surprising thing about this is how long it’s taken for anyone to point out what should be an obvious truth: that our current system for acquiring the morning-after pill requires drastic change.

Anyone who’s ever attempted to get emergency contraception in the UK will know it can be far from a straightforward process. Sure, you might get lucky and have a quick, respectful and hassle-free consultation with your GP. Or you might not.

A straw poll among women we know revealed a worrying trend for a service that is at best haphazard, and at worst seems designed to deliberately humiliate women when they’re already feeling stressed and alone. 

bus

Trying to find somewhere to access free emergency contraception can be a lengthy and frustrating experience.

“A few months ago I needed the morning-after pill and was told that I could just walk up to the front desk at my local free clinic in London,” says Ashley*, 27. “But when I arrived the woman at the front desk refused, despite having the name and details of the nurse on the 111 line who I’d spoken to, and said I’d have to wait two hours to get hold of it.”

It was the middle of the week; Ashley has a demanding, full-time job. She couldn’t wait two hours. Resigned to shelling out for the full-price pill, she visited a nearby pharmacy instead. “Then the pharmacist asked me the questions – what time exactly did I have sex, when was my last period, etc. – on the shop floor, which I thought was quite unprofessional as it was so public.”


Read more: “It was a risk I was willing to take: why I had an abortion aged 35”


Even if you’re not unfortunate enough to be interrogated in front of other customers, the mandatory consultation with a pharmacist before being presented with that all-important pill can be a deeply uncomfortable experience.

“I hate having to sit and wait around for 40 minutes to sit in a tiny, cordoned-off room to then have some pharmacist ask me a series of questions about how frequently I am having unprotected sex and how I feel about it,” says Grace*, 32.

“Add to this I am usually hungover and utterly self-loathing at this stage, really all this does is recreate that dreaded feeling of waiting to see the headmaster – only you just so happen to now be a grown woman who definitely should know better.”


Watch: We need to talk about periods


I myself once spent an awful afternoon trudging around an unfamiliar corner of London, trying in vain to find somewhere that would dispense the necessary goods for free. I was new to the capital, so I didn’t yet have a GP to write me a prescription – and I was totally broke, so the prospect of paying £30 was genuinely daunting.

The panic rose in my chest as I was rebuffed by each and every “community pharmacy” in the area, some more kindly than others. Eventually, I caught a bus to a walk-in clinic, where the receptionist informed me loudly and tersely that I could buy the morning-after pill at the pharmacy downstairs. Otherwise, a sexual health adviser would be available on Tuesday morning.

“But it’s Saturday,” I said, as quietly as I could. She shrugged.

The price of emergency contraception in the UK was deliberately inflated to deter women from taking it too often

When so many women have similar stories, it would be easy to feel paranoid that we’re somehow being penalised for seeking out emergency contraception – for being so careless as to have sex without a condom, or unlucky enough to use one that split (and let’s not forget, there is another person in this equation. Always).

And actually, that’s not far from the truth. According to a 2003 report in the Pharmaceutical Journal, the price of emergency contraception in the UK was deliberately inflated when it first became available in pharmacies – in part to deter women from taking it too often.

BPAS say that the mandatory consultation that comes with it was also introduced to discourage women from relying on the morning-after pill regularly. In other words, make the experience of obtaining emergency contraception as uncomfortable and inconvenient as possible, and women might be less likely to use it.

morning after pill

The British Pregnancy Advisory Service says that the morning after pill should be made more easily accessible.

And that strategy is “working” – if that’s what you can call it. Around two thirds of women aged between 16 and 45 who have unprotected sex do not go on to take emergency contraception, according to a 2014 study published in the European Journal of Contraception and Reproductive Health Care.

Meanwhile, BPAS – which is the UK’s largest provider of abortion services – say that they regularly work with women experiencing unplanned pregnancy who were put off from taking the morning-after pill because of obstacles to access, including the price.

Of course, there are instances where a pharmacist should invite a respectful, private conversation with a woman seeking emergency contraception: if she seems particularly young, vulnerable, or distressed, for example. And if a woman wants to discuss her sexual health and contraceptive options with a pharmacist, she should be able to do so.

But the key here is choice.

In modern Britain, we should be shocked by the fact that adult women are still not reliably able to access affordable emergency contraception. We should demand to know why we’re not trusted to know what is best for our own bodies and futures.

And we should be furious – really furious – that we’re being slapped with an unnecessary surcharge for medication that could change the course of our lives forever.

Images: iStock, Getty

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