Posted by: Benedict Lam23 APR 2013
Recently, the US government has been ordered by a federal judge to make emergency hormonal contraception available over the counter to girls of all ages within 30 days.
The Centre for Reproductive Rights, which brought the case, said politics has played a role in decision making and that there was no scientific proof that girls younger than 17 could not safely use EHC without supervision.
A US government lawyer said it was considering legal options.
In the UK, EHC is licensed for sale OTC to girls 16 years and over. Those under 16 need to see a doctor to obtain a prescription or go to a pharmacy that offers EHC under a patient group direction (this varies from area to area), which allows an accredited pharmacist to make a supply to those as young as 13 years old. (The supply of EHC to those under 13 years is not allowed because sexual activity involving a child under 13 is considered as sexual abuse.)
Those pharmacists who undergo accreditation to supply EHC to girls under 16 would have been taught Gillick competence and the Fraser guidelines (ie, deciding whether a child is mature enough to make decisions). Child protection issues would also have been discussed.
The main problem with EHC is not usually side effects or failure rate, both of which are low if it is taken correctly, but access. Adult women are probably more likely than young teenage girls to access a pharmacy and purchase EHC without hesitation. Girls could be worried that the doctors may disclose information to their parents, they may struggle to get an appointment (weekends, bank holidays) or they may simply not have the money to purchase EHC (which does not come cheap for the one tablet).
I work at weekends in a pharmacy that supplies EHC under a PGD (and I am accredited to make the supply). The PGD allows me to supply EHC free to women and girls (from 13 years of age). Although I do not have many girls under 16 requesting EHC, I am relieved to know that, if they do, I’d be in a position to supply it if necessary and provide advice.
My wish is to see more pharmacies being able to supply EHC to girls and women of all ages under a PGD and research data showing the positive impact this has on reducing unwanted teenage pregnancies. And of course we’d be in the perfect position to give advice on sexual health during the consultation.