Are the questions pharmacists ask before giving emergency contraception really necessary?

Things don’t always go to plan as far as contraception is concerned. Thankfully, when there is a slip up (pun not intended), emergency contraception is available for women to access. But some experts don’t believe that access is quite as easy as it needs to be.

As it stands right now if you need emergency contraception you can try and sort an appointment with your GP (not always easy at short notice), or you pop down to a pharmacy where you’ll be asked potentially awkward questions such as: when did you have sex, which protection did you use, how often have you taken emergency contraception?

But are these questions really necessary? Will knowing the answer determine how safe it is for us to take the morning after pill? Or how effective it will be? Some experts don’t believe so.

Dr Jane Dickson, from the Faculty of Sexual and Reproductive Health (FRSH) penned a blog on the subject for the British Medical Journal. When it comes to efficacy of oral emergency contraception, she said that weight and interacting medication can play a role which may suggest why certain questions are asked.

“Some evidence now suggests that effectiveness of EC is reduced in women who weigh over 70kg,” she explains. “I am not aware that weighing women requesting EC has become routine in pharmacies. Women usually have an idea of their body weight and could judge for themselves, which again calls into question the added value of having mandatory consultations at the pharmacy.”

Furthermore, Dr Dickson believes that the questions asked by pharmacies don’t necessarily impact the safety aspect of taking emergency contraception.

“EC is not ‘toxic’, ‘strong’, ‘laced with side effects’, or indeed a drug of abuse,” she writes. “Despite occasional minor side effects, no woman has poisoned herself with EC, unlike paracetamol, which is readily available in supermarkets. If a woman has a headache, she does not need a risk assessment or consultation to decide if she can buy some analgesics.”

Dr Dickson also points out that “the timing of ‘accidents’ and proximity to free supply cannot be foreseen,” which is why access to emergency contraception via pharmacies has such a vital role to play.

But are barriers to women accessing the service, such as cost (remember the furore last month when Boots refused to reduce the price of emergency contraception?) and the asking of intrusive questions, still too high?

BBC 5 Live spoke to one woman who believes the questions asked by the pharmacists are somewhat unnecessary.

Niamh, 26, has taken the morning after pill eight times. “I don’t know why I have to sit there and talk to a complete stranger about my sex life and my periods,” she tells BBC 5 Live.

“Going and getting it is the responsible thing but I’m sick of feeling judged for it and I’m sick of feeling like I’m doing something wrong when I’m trying to be responsible and adult,” she says.

Last year the British Pregnancy Advisory Service (BPAS) called on the Department of Health to make EC more affordable and easily available, much like other over-the-counter drugs. The charity is also campaigning for an end to the mandatory consultation women must undergo before receiving emergency contraception, describing the current system “sexist”.

Chief Executive of BPAS Ann Furedi said in a press release that there is no clinical reason for a woman to consult with a healthcare professional before she obtains emergency contraception, unless of course she wants to.

But pharmacists have defended the need for consultation periods with women wanting to access the morning after pill.

Sandra Gidley, the Chair of the Royal Pharmaceutical Society, told BBC 5 Live that these questions are asked because the pill isn’t as effective during certain parts of a woman’s cycle. She also says that the consultation makes sure that women are given the right medication or directed to a doctor or sexual health clinic.

“Having a discussion with the pharmacist is central to providing emergency contraception,” she explained last year. “It further supports a woman to consider her future use of contraception, her risk of sexually transmitted infections and help with any other sexual health questions she may have.”

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