It’s hard enough asking for a cream for that rash, let alone asking for the morning-after pill.
The emergency medication is just that — medication for an emergency. When something’s gone wrong. When a woman fears she may be pregnant because she was raped, or stealthed, or unprepared, or made a mistake, or the contraception failed. And now she’s plucking up the courage to do something about it. To not be pregnant.
So news of a plan for pharmacists to offer women counselling when they ask for the morning-after pill or fill their prescription for the early abortion drug RU486 was met with predictable outrage. Many women, myself included, pictured the horror of a condescending dude in a white lab coat talking to them about a vulnerable, intimate or abusive matter.
Victoria’s Minister for Women Gabrielle Williams even accused the federal government — which is funding the trial — of pushing a “not-so-subtle pro-life agenda”.
While she supported giving women more information about their contraceptive options, she worried that having those conversations “at a time of potential crisis” could leave women feeling judged, and put them off getting more help.
The second point is fair enough, but the “pro-life agenda” line was utter tosh.
The $2.5 million trial being run by Monash University is based on good science. The results of a similar trial in Scotland, published in The Lancet, found that women offered counselling at a pharmacist had a 20% higher uptake of effective contraception in the months after accessing emergency contraception.
The trial leader, Monash Professor Danielle Mazza, emphasises that the counselling is optional, would be done only in private consulting rooms, and is about giving women more options — and encouraging them to consider long-acting reversible contraception (LARC).
She’s also working on a trial with GPs to increase the uptake of LARCs to shrink the number of unwanted pregnancies, because LARCs are a more effective contraceptive choice but have a dismally low usage rate in Australia.
The bullshit here is not the trial itself but the pervasive barriers to contraception that Australian women face.
The bullshit is the shame and the stigma of unwanted pregnancies that could see a woman hesitate to ask for the morning-after pill — and that hesitancy could increase if they fear some well-intentioned pharmacist trying to strike up a conversation about it.
The unintended consequence of women being more afraid to go to a pharmacist is not something this trial will or could measure. But the fault lies in the stigma and shame women are made to feel, not the trial.
The bullshit is that some doctors can’t or won’t prescribe RU486. And the increased barriers for culturally and linguistically diverse women, and women in rural or regional Australia.
The bullshit is that women disproportionately feel the responsibility for contraception, and the stigma when it fails.
The bullshit is that, after about three decades on the daily pill, I can’t remember ever being offered an LARC.
This is a trial. It will give insights into possible solutions. Personally I’d be horrified if my pharmacist offered to have a chat with me about contraception. But it’s also horrifying that no one has ever even slipped me a leaflet about my choices.
Have you ever been offered long-acting reversible contraception? Write to letters@crikey.com.au, and don’t forget to include your full name if you’d like to be considered for publication.
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