By Vaishnavi Sundar
Emergency Contraceptive Pills (ECPs) have remained unofficially banned in Tamil Nadu since 2005. This is despite the clear Guidelines for Administration of Emergency Contraceptive Pills by Health Care Providers, which were released by the Union Ministry of Health and Family Welfare in November 2008, and maintain that ECPs can be provided safely by a healthcare provider, such as doctors, nurses, midwives, pharmacists, paramedics, family welfare assistants, health assistants, and community-based health workers.
This September I revived the dialogue around ECPs in a piece which contemplates why there is such little discussion on the subject of the unofficial ban. Together with the good folks at the grassroots organisation Jhatkaa, I was able to gather wider attention to this issue through an online petition. After we had collected over 2000 signatures supporting the petition to lift the ban on emergency contraceptive pills, we got in touch with S. Abdul Khader, Director of Drugs Control.
Emergency contraceptives have been a subject of intense debate for having become a matter of moral concern, rather than what it should be: a purely medical concern affecting sexually active women. After two months of email and telephonic exchanges, thanks to the petition, we finally have some good news! The Drug Control Director sent us the following response:
“A proposal has been submitted to Drug Consultative Committee, to include the Levonorgestrol 0.75/1.5mg Tablets in S.No. 15 of Schedule K of the Drugs and Cosmetics Rules 1945, so that these Emergency Contraceptive Pills can be sold as over-the-counter drugs without the prescription of a Registered Medical Practitioner.”
This proposal to increase the availability and accessibility of ECPs is now being considered by the Drugs Technical Advisory Committee (DTAC). The Drugs Controller General of India Dr. GN Singh and the DTAC are meeting in one month to discuss the proposal and make a decision. Dr. Singh himself acknowledged the proposal and promised to deliberate on it carefully before making a decision. He has also said: “The idea behind the proposal is to increase availability and accessibility of the medicine in remote areas and therefore, it is important to also keep ECPs “affordable””.
This would mean that an emergency contraceptive pill (Levonorgestrol 0.75/1.5mg) can be purchased at a drugstore by anybody of a legal age, without a prescription from a doctor. One can only speculate on the enormity of this news, considering just how many women go through unnecessary, painful (and often unaffordable) abortions, continue to get pregnant against their will, or worse, are forced to keep a child born out of rape. This step, after 10 years of the unofficial ban, is very significant. With this proposal, women across India might be able to exercise their reproductive rights, over the counter.
There is a lot of information online about the efficacy of ECPs, precautions to be taken and the side effects of the medicines. Providing women access to this information along with the medicines would put women in control of their choices without being infantilised and having their decisions taken for them by men. A moral ban on ECPs is merely a short-term fix for a larger problem of lack of sex and reproductive education in schools. To that effect, I am hoping to produce helpful videos explaining how ECPs work, containing personal anecdotes from those who have used the pill, as well as advice from medical practitioners.
Having said that, there are some important things you need to know as a consumer of emergency contraceptive pills.
An emergency contraceptive pill (also known as the morning-after pill) is not an abortion pill. It should not be consumed regularly or used as an alternative to primary methods of birth control like condoms or regular birth control pills. As Dr Louisa Draper makes clear, “The ‘morning-after pill’ should be used in emergencies only. It helps to prevent pregnancy if you have had unprotected sex or when your contraception has failed. You should not take it on a regular basis, as there are much better forms of contraception.
The ones that are consumed everyday are called ‘birth control pills.’ You may remember the advertisement of a shy woman on Doordarshan using ‘Mala D’ – the brand of oral contraceptive pill that is provided at a subsidised price under the Contraceptive Social Marketing Program of the government through HLFPPT (Hindustan Latex Family Planning Promotion Trust).
The most common side effects are nausea, vomit and menstrual abnormalities (your period may come earlier, later, with more or less blood than usual); more rare side effects are fatigue, breast tenderness, headache and abdominal pain. Here is a friendly FAQ.
It is heartening to observe that Dr. Singh understands the need for the ‘moral free’ availability of ECPs, and the impact this will have on the lives of women all over India. We are fully appreciative of this move by the Director of Drug Control and the DTAC: it is indeed an enormous step forward for women’s reproductive rights. This is of particular relevance in a country where morality holds high grounds, often sidestepping the autonomy women ought to have with their bodies. We also cannot reiterate enough the importance of your support. You helped us convince the TN Director to take action after all these years; the verdict of DTAC will be made available after the meeting in January. Once again, you can sway this crucial decision and benefit women all over India with your signatures. Please do share the petition and let more people know about it. Sign the petition here.