Current Obsessions

The Politics of the Morning After Pill



Navigating confusing websites. Booking appointments. Lying. Awkward hushed over-the-counter conversation. Interrogation. Guilt. A bit more lying. Shelling out £30 you probably can’t really afford after last night. You’d think that getting the morning after pill would be pretty simple for the modern 21st century woman, but sometimes it feels more challenging than trying to complete a round of Takeshi’s castle – drunk.

Unprotected sex happens for a whole variety of reasons. Perhaps you got carried away with a casual hookup and both forgot. The condom broke. You and your boyfriend fancied a quickie whilst staying at his family home and the only ones he had were from when he was 16 with a use-by date of October 2007. You forgot to take your pill. You’re not on the pill. Shit happens. It really shouldn’t matter – although it certainly feels like it does. But let’s say it has happened, and you being the responsible adult you are, plan to sort the problem. Yet if you want to get the morning after pill, you have to be prepared to jump through a whole variety of hoops to get it – then pay up around £30 at the end. If you want to get your hands on it for free? Be prepared to jump through those hoops blindfolded, naked, and wearing roller skates. It ain't easy.


The infamous walk of shame becomes a queue of shame. Then an interview of shame is conducted in some dusty white room of shame in your local Boots.


Pharmacist:

When did the incident happen?

How many hours ago – exactly?

Who was your partner?

How long have you been together?

Did you use protection?

Are you on the pill?

Why did you have sex without birth control?

Would you like a side of holy water to cleanse you of your sins?



Me/You:

It happened an hour ago! (and last night…)

He was my boyfriend! (he isn't)

We’ve been together for six years! (try sixth date)

We used a condom but it split! (Lie)


Er, ah, as if my head wasn’t killing enough from this hangover, this judgy pharmacist is trying piece together my night like some form of sexual detective. And despite the fact you’re a proper adult with a driving license and a house plant that still isn’t dead yet, you sit there as they watch you take it like your mum forcing you to eat your carrots. Swallow it down with water like an overpriced entrée served with a side salad of shame.

It doesn’t matter if there’s a 5-strong queue of twenty-something women waiting outside - best friend in tow, hair in hangover buns, and probably heading to brunch right after like I am (see you all in the breakfast club babes) – the feeling is still so isolating and humiliating. Shame on you for having sex! Shame! But why should we feel ashamed when taking emergency contraception is the responsible choice in that situation? You pop the pill, head out of Boots £30 lighter, head feeling 30 pounds heavier, and slink off to wallow in the BS you have to deal with being a woman whilst simultaneously thanking your lucky stars we live in a society where we can sort our shit out – albeit with a heavy dose of judgement.



And it is utter BS, really. £30 might only be a slight inconvenient pay-out for an experience that may have well not been worth the dollar, but to others it’s a much more unattainable cost. The cost of emergency contraception in the UK is one of the highest in Europe, whereas in France you can get it over the counter – without a humiliating “consultation” – for under £10. What about those here who can’t afford it? When I was studying my MA I was living in London on around £80 a week inclusive of food and travel, so I most certainly couldn't afford to ever let myself be in that situation. I'm lucky that my parents were always on standby to help out financially, but I never quite fancied a "Heeeeeeeey mum so I may have had unprotected sex last night can you sub me £30 for the morning after pill? Think of it as a good investment because imagine how much more out of pocket you'd be if I was preggo with your grandbaby..." But imagine that you're 16 or younger, live in a small town that requires lifts from your parents everywhere, and it's a Sunday where no shops are open and the GP's are shut. How do you go about getting the pill? How do you even afford that?

Navigating how to get emergency contraception – and most importantly, free of charge - on the NHS’s website is a challenge, met by a vague list along the lines of

Brook centres

Some pharmacies

Most sexual health clinics

Most NHS walk-in centres

Most GP surgeries

Some A&E


Some? Most? In the words of Justin Bieber, what do you mean? Those words are so vague and empty. The few links there are take you to sites that are rarely updated for places that are unsurprisingly not open at weekends - hardly friendly to a 9-5 worker. And don’t expect to get it for free without booking an appointment, which then of course means there's more time since you had unprotected sex and the effectivness of the pill decreases, or taking time off work to fit the awkward opening hours of the clinics and GP. At present, there’s a total lack of clarity to the system of who will give it and who will make you pay. Boots seems the default option – everyone’s friendly, high-street pharmacy that has your back when you’re in need of tampons, 2-4-1 hair dye and budget nail polish. But their website leaves a lot to be desired in terms of information:


The cost of the morning after pill at Boots pharmacies can depend on your individual circumstances and which pill is the most appropriate.


GR8. Two of the few times I’ve taken it were at my local Boots. The first, I walked in sheepishly asking if they did it for free to which they clearly took mercy and said yes. One year later, however, at the exact same store, they wouldn’t dispense it without me dishing out £30. I’d had unprotected sex again - I find it hard to see how my 'circumstances' had changed to the previous time? It’s a kick in the ovaries for any woman, let alone young girls who might be confused, frightened, and embarrassed.



So with the same price-tag of your entry-level All Bar One Prosecco, it seems a bit of an irritating cost to pay when it reality, it takes two to tango. What of the lucky fella? I’m all for splitting the bill on a date, but something feels so awkward asking a guy to cough up half of a baby-preventing pill. Plus, there’s the general consensus from men that as women are the ones to actually get preggo and have the baby, we’re the ones who are ultimately responsible for potential consequences.

To find out their POV, I asked a few of my guy friends what they would do if they had unprotected sex with a girl and found out she wasn’t on the pill. Their reactions? (apart from asking me if I was the girl and if I was ok – thanks for your concerns boys)


Sam*: Panic

Adam*: Panic

John*: Panic

Tom*: Panic

Ben*: Get on a plane back to Australia

(Names have been changed so that I don't embarrass any of them)

But after the initial terror, they all said they’d take a trip to the pharmacy to get the morning after pill with the girl – one even saying they'd pop in on the way to taking her to brunch. I never realised I was friends with such gents. So the lesson learnt? Next time you’re in this situation, don’t be afraid to ask to go splits. If they pull a face, tell them how the average cost to raise a child is £281,483 – and if they’d rather go halves on that cost, then be our guest.

And remember kids...

via GIPHY




Images via Steve Gallagher, Still Life

7 comments

  1. I really appreciate your honesty! Dealing with this shit is hard and it's so refreshing to hear your thoughts on it. I know the judgey eyes you get from the pharmacists! This is a topic that should be wider spoken about! Great post👏

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  2. I feel you on this. It's like we're being overcharged for having ovaries. In my country, we have the same deal. It's available at some/most/etc for free, but it's never very clear and mostly luck of the drawer. I've had to get it 3 times in my life and all three times I've gone to a popular chemist rather than try navigate the free route (just cos it's complicated and more time consuming). The 1st time I was young, in school and freaking the hell out. I messaged a male friend of mine who was older and asked for help and help he did. He bought it for me, brought it over and explained everything (he'd been in a similar situation himself before). The other 2 times I went with my boyfriend at the time, which helped calm the nerves but didn't douse the flames of shame thanks to the pharmacist.

    I wish there was some way we could take charge of our sexuality and not have to feel ashamed for making a mistake. It was just as much my mistake as it was my boyfriends. Sex doesn't happen in a vacuum, and shaming doesn't actually help the situation. If anything, it could really turn you off from getting the assistance you need.

    Anyway, thanks for the food for thought!

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  3. Hey Sophie.
    This was a really interesting read. I'm a FY1 doctor and I'm thinking of going into obstetrics so this is a rather interesting issue that I really didn't know much about. I agree with you that the thought of charging 30£ for the pill seems outrageous, especially when you can get an abortion for free. That just seems like a ludicrous way of making girls and women who can't spare the 30£ to end up requiring an invasive and emotionally charged procedure. The fact that it is only free in GUM clinics isn't exactly helpful either, with the stigma and general grim around those places.

    Maybe a change to that system would stop epidemiologists scratching their heads as to why England has one of the highest rates of underage pregnancy in Europe. I think there needs to be more education about what the options in terms of emergency contraception are. One of the best methods that practically no one knows about is to have a copper coil fitted. It works up to 7 days after the incident and then can be kept as contraception for up to 10 years. You have a lot of young readers maybe it would be worth writing about the options ? (I am willing to help if you would like or there is loooooads of information on the website patient.co.uk)

    The consultation you were subjected to sounds horrific. That pharmacist clearly had no idea what he was doing. I do however empathise with him a bit because despite coming across as judgemental and shaming you, part of his job is safeguarding. If a young girl came in and had been raped, abused, forced in any way or worse being a victim of trafficking then those questions (if asked correctly) can lead a good healthcare practitioner onto the problem. The thing is he seemed to be very paternalistic and not very inspiring of confidence and if you lied to him clearly he is failing at his job.

    I think this is such an important issue that clearly is not talked about enough so thank you for speaking up !

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    Replies
    1. oh wows! Thanks for taking the time to write that comment - such an interesting perspective ! I actually have the copper coil fitted now ( I wrote about it here - love to overshare on contraception! http://www.fashionslave.co.uk/2016/04/the-coil-iud-need-to-know-on-nailing.html) but back before I had it and used the normal pill/ condoms and had a slip up and had to get emergency contraception I just don't think given the choice I'd have wanted an IUD fitted then and there! It took a lot of thinking about and building up the courage to get the darn thing fitted! But i totally agree, there does need to be more information about.

      Anyway, thank you so much again for this super informed comment, and if I touch around this subject again (which I'm sure I will - this is my third post on contraception!) I'll be sure to give you a shout!

      Soph xx

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    2. I agree getting a coil does feel like a big deal but it really is the most effective method and GPs just don't offer it enough ! I like your post on the coil, and it is great that you talk about STIs in there too because that is something that isn't nearly talked about enough (did you know that well over 50% of women with gonorrhoea or chlamydia have no symptoms but it can still make them infertile)

      Anyway i'll stop badgering on. Thanks for the reply and all the best

      Ella x

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  4. Clincally there are quite a number of important points to cover with the patient whether supplying either EHC drug. For example Ulipristal Acetate is not recommended in severe asthma. There are situations where both drugs become less efficacious due to interactions with other medicines. Certain conditions can reduce efficacy e.g. severe malabsorption syndrome can reduce efficacy of Levonorgestrel. The issue of existing or future contraception and the effect of EHC need to be covered. Patients will in my experience seek reassurance on where they stand in terms of current contraception for example if they are using EHC because of a missed contraceptive pill. The pharmacist needs to satisfy him/herself that the patient is not currently pregnant before supply is made. Previous allergy to the drugs is a consideration. The list goes on.
    The final reason that I am an advocate of the face to face consultation is because the encounter presents an opportunity to reassure or give advice on sexually transmitted disease.
    I do understand the perceived ‘shame’ or loss of dignity by having to walk in to a pharmacy and ask for EHC. However my experience of supplying EHC has taught me first hand that there is a clear range of benefits of a pharmacist making that supply. I absolutely accept that pharmacists perhaps need to reflect on their own practice and the environment within which they practice. Listening to patients and meeting the needs of as many as possible is something we should strive for.

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  5. I'm not suggesting making it free as a cost,
    I'm suggesting looking into the system of how its distributed as it seems that our country, in comparison to others like France, seems to be missing a trick.

    I would never ever suggest you should be able to just pick it up over the counter! Not sure where you picked that up from, but I completely understand having taken the interview that certain questions need to be asked in order to make sure it is the right option for the patient. there are definitely ways to make the process less difficult for women.

    I feel like you missed the point of this article and are focusing on the smaller points rather than the bigger picture. It's an option piece criticising the system for being a difficult and embarrassing process to navigate, not a medical piece.

    ReplyDelete

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