The Morning After is a podcast presented by Alix Fox, who has one thing she wants to chat loudly about: women’s contraception. She talks to Stylist about why this is still such an important conversation in 2019.
It’s a woman’s right to have access to contraception. But, damn, is it a headache. Whether this involves the uncomfortable process of getting a coil fitted or having to book a GP appoinment every three months just to get a repeat prescription for the pill — the burden of birth control very much falls on women. Just last month, Stylist’s contributing women’s editor Moya Crockett unpacked the contraceptive admin that women endure, which thousands of others related to.
When it comes to emergency contraception, things are just as frustrating. Invasive questions at a pharmacy appointment that’s squeezed into your lunch hour is one option. Or, for the cost of up to £25, buying it online gives you the “privelege” of not having to endure any awkward conversations.
Women are often left feeling embarrassed, uncomfortable or ashamed because of the barriers that come with getting the morning after pill. But there really shouldn’t be any stigma around a woman taking control of her reproductive rights in 2019, which is why it’s so important to continue and amplify the conversations around the issue.
Enter: My Morning After.
This new four-part podcast by ellaOne, presented by Alix Fox, explores the world of emergency contraception by inviting guests (including Gina Martin and The Receipts host Tolani Shoneye) and listeners to share their own experiences. Stylist caught up with Fox to chat about why and how the podcast is part of this vital conversation.
Can you tell us a bit about what My Morning After is and why it has been created?
My Morning After is a series of frank, fearless, conversations about emergency contraception, which also explores the related broader issues of sexual health, gender politics and education…and busts taboos about things like what you can do if a busted condom and a busted nut has landed you in a tricky spot!
When it comes to matters of sex, my mantra is that knowledge is power, and silence is dangerous. No matter how awkward or stigmatised it may feel to speak about such things, brushing them under the carpet only ever creates hazardous lumps for us to trip and fall over. And no-one wants a hazardous lump in their love life! At present, there’s an insidious level of silence surrounding emergency contraception: few people are properly taught about it or tend to talk about it until they’re in a scenario where they might require it, and even then, they may not know who or what to ask.
I want My Morning After listeners to be left with a much clearer idea of what forms of emergency contraception are available; an accurate basic picture of how they work; the facts required to make informed personal choices; and the confidence to then feel empowered and equipped to act upon them. I also hope that, after tuning in, anyone who finds themselves in circumstances where they’re considering emergency contraception feels less alone. It’s far from a rare scenario. It’s just painfully rare that we chat about it.
What’s the most worrying or shocking experience a woman has shared with you about the morning after pill?
There are so many inventive rumours about the morning after pill that Fleetwood Mac could write an album about it! It’s steeped in confusion, delusion and scaremongering. Several of the guests on the podcast told me they’d heard that you’re only allowed to take emergency contraception three times in your lifetime. After that, it would supposedly stop working, or cause some kind of physical damage. Nope. Absolute codswallop – but taken as absolute gospel by many.
One of the most widespread and damaging misunderstandings - aka ‘pillusions’ - about emergency pills is the erroneous belief that they cause abortions. They don’t: they work in the main by delaying or preventing ovulation from occurring, so there is no egg present to meet sperm in the body. Both medical research and legal judgement are crystal clear: emergency contraception can only prevent pregnancy, whereas a termination ends a pregnancy. Whilst I am pro-choice and strongly believe that abortions should absolutely be available to those women who choose or require them, many people feel differently – and because they mistakenly think that emergency contraceptive pills induce terminations, they associate them with the same feelings of ethical challenge, distaste, or religious judgment.
One of our guests, Dr Annabel Sowemimo, shares a horror story on the pod of being in a queue at a chemists and hearing a pharmacist ask two young girls seeking emergency contraception if they could pop back in a few hours, because staff were too busy sorting other prescriptions. While emergency tablets containing the active ingredient ulipristal acetate, like EllaOne, can be taken up to 120 hours after unprotected intercourse, and pills that use levonorgestrel have a 72 hour window, both are more effective the earlier you take them – so this pharmacist was actively increasing the risk of unplanned pregnancy for this patient by asking them to wait. This also shows a complete lack of awareness about the pressures those young women may have been under; some people travel for miles to get emergency contraception because they fear that if they buy it somewhere local, word will get back to their families or communities and they’ll be judged. They can’t come back later.
Do you think the processes around getting emergency contraception could be improved?
In a recent ellaOne survey, of the women who had bought the morning after pill from a healthcare professional, 58% of those surveyed felt embarrassed or awkward doing so. In my discussions, it became evident that a lot of women weren’t expecting some of the questions they were asked by pharmacists and doctors in such situations, and didn’t know how to interpret them.
72% of women surveyed said they would rather fill out a short questionnaire at the chemist than have a face-to-face consultation. As a direct result of this data, ellaOne launched a new checklist form in pharmacies nationwide last year, along with a digital version, so women can provide essential details discreetly and make the purchase process less intimidating.
Do you think a woman’s attitude towards getting the morning after pill shifts as she gets older?
Kieran Yates brought this up on the podcast, referencing the scene in Master of None where Aziz Ansari’s character goes to get an emergency pill with a lover: rather than cringing so hard they turn inside out, they’re both pretty pragmatic about it, but view trekking across town in a taxi as a bit of a necessary pest. There are now systems in place that make obtaining emergency contraception easier: you can order it online and get it delivered, or purchase a ‘standby stash’ of emergency contraceptives to keep at home, or take with you if you’re travelling (whilst you can buy them over the counter from pharmacies in many countries, in others a prescription is required, and in some places they are illegal or in short supply).
However, I think it’s naïve to assume that all older women are blasé about getting emergency contraceptives. Fear, worry and cluelessness abound throughout age groups. That’s why education needs to be inclusive and diverse, and people like teachers, community leaders and healthcare professionals need to be aware and compassionate towards all the many influences and pressures that may be affecting any one woman’s beliefs and needs.
Do you think that we are educated enough about emergency contraception?
Only 17% of women learned about emergency contraception in their sex education. In addition to that, a third of women are too embarrassed to talk about emergency contraception with their pharmacist. We don’t know nearly enough about the topic, yet we feel embarrassed to talk openly about it, which impedes our learning, and limits our abilities and confidence in making the right decisions for ourselves – a truly toxic situation.
There’s no risk of an unplanned pregnancy without the key involvement of a penis either, so it shouldn’t only fall to those with wombs to be wise about emergency contraception. I think men need better education too. Whilst any decisions about what a woman does or doesn’t do with her body should always be down to her, it can be useful and reassuring to both partners to have a good grounded knowledge about contraceptive options – and at the moment, many men are clueless about even the most basic facts about women’s bodies and reproductive systems. I recently finished filming the second season of Channel 4’s Sex Clinic, where I appear on screen advising the public on all things sexual, sensual and erotic, and I spoke to an otherwise smart 27-year-old man who thought that women urinated and gave birth through the same opening. That’s a serious hole in knowledge about a woman’s holes.
What other podcasts are helping to break the taboos around women’s health?
I was something of an early voice on the UK podcast scene, particularly within the sex positivity sector. I’ve been resident ‘erotic agony aunt’ on The Modern Mann show with Olly Mann, answering listeners’ sex questions in my ‘Foxhole’ advice section since 2015, and two years ago I was deeply chuffed to bag a silver ARIA award for ‘Best Podcast’ for Close Encounters – an audio documentary series that discussed topics such as vaginismus, asexuality and sex and disability.
It’s made my heart soar to see the genre boom since then, with the launch of shows like Project Pleasure, the Meg-John and Justin pod, and Brown Girls Do It Too, which focuses on British Asian women’s experiences. I particularly welcome more diverse voices – and I’d love to see more straight men talking constructively and honestly about sex and relationships too, backed up by proper research. This is one of the rare corners of society where they’re underrepresented. Holland and Barratt’s Healthy For Men pod has made steps in that direction lately, and I applaud them for it.