This is a sidebar from an article published in 2002 about emergency contraception (EC), sometimes called “the morning-after pill” or “Plan B” and the debate then occurring in the USA about making it an over-the-counter medication rather than one available only on prescription. It is sad to note that the debate over this in the USA is not yet resolved, with anti-contraception activists claiming erroneously that the contraceptive action is an abortifacent. The whole article is interesting, but this bit about how the French, whose abortion rate is one of the lowest in the world, have handled the issue jumped out at me,
Improving Access: The French Experience
The abortion rate for France is already one of the lowest in the world: At 12 per 1,000 women aged 14-44, it is half the U.S. rate. Even so, when emerging evidence in the late 1990s suggested that the rate was stabilizing instead of continuing to decrease, the French government responded swiftly – in part, by providing better access to emergency contraception.
Emergency contraception has been available in France since the early 1970s, and a product specifically packaged for postcoital use became available in May 1999. Just one month later, the French government decided to switch the drug to nonprescription status, making it available on request from pharmacists, who in France are gatekeepers for all medications. (France does not have an over-the-counter status equivalent to that in the United States.) Women who purchase emergency contraception from pharmacies can have 65% of the cost reimbursed to them under national health insurance; the method is available for free from family planning clinics.
The French government has taken extraordinary steps to ensure that adolescents in particular have access to the method. After 18 months of debate, the national assembly passed a law in December 2000 allowing public and parochial high school nurses to provide emergency contraception. In January 2002, French officials issued a decree allowing minors to obtain emergency contraceptives from a pharmacy at no charge and without requiring authorization from a parent; pharmacists are required to counsel young women and provide them with information about other forms of birth control.
Since 1999, over 1.5 million treatments have been sold in France, 97% without a prescription. There have been no reports of adverse events. Moreover, experts note that widespread availability of emergency contraception has spurred a renewed interest in all methods of contraception. “There is a more open discussion – among pharmacists, nurses in school, across all society – about what to do to prevent pregnancy and sexually transmitted diseases,” says Elizabeth Aubeny, president of the French Association for Contraception. “And the more you talk about contraception, the more women use it and the fewer abortions there are.”
Australia made EC available without prescription in January 2004. As I’m outside the firing lines on this at the moment (vasectomised husband and only just-turned-pubescent children) I have no idea how comprehensive the general sexual education in Australia about EC is, but I don’t think we’re as comprehensive as the French. It is obviously an area I do need to become more informed about, because I don’t think that last line in the quote above can be emphasised enough:
the more you talk about contraception, the more women use it and the fewer abortions there are.
Isn’t “emergency contraception” basically the same thing as an abortion?The person who uses this pill would likely end up having an abortion at some point.France may have lower abortion numbers, but look at the numbers for this pill. I have no doubt that this pill is the most popular form of “contraception” in France.
No, EC is not an abortifacent, it is a contraceptive, and is only taken within days of intercourse, before pregnancy is actually known. RU-486 is an abortifacent, not a contraceptive, and is an entirely different medication which is taken weeks after pregnancy is known. Perhaps you are confusing the two?With EC, the hormonal dose suppresses the hormones that triggers ovulation, so that the egg is not released from the ovary to be fertilised. (You did know that fertilisation takes place days after sex, not during, right?) EC does not prevent implantation of already fertilised eggs.Only women who are already pregnant, for whom EC will not prevent the pregnancy continuing, will have to face the choice of whether or not to have an abortion.
Isn’t “emergency contraception” basically the same thing as an abortion?No, emergency contraception is emergency contraception. If anything, it is functionally the same as taking birth control pills—it literally IS a double dose of birth control pills from the middle of monthly pack, containing the highest dose of hormones to prevent ovulation. And by preventing ovulation, it prevents conception from happening, because even if sperm are present, the egg is not.The person who uses this pill would likely end up having an abortion at some point.Um . . . why? At least in the US, emergency contraception is employed most commonly by women who have been raped and therefore may have had no opportunity to make a decision about contraception unless they were already employing a permanent form of contraception and by women who are already using another form of contraception but have reason to suspect a failure (e.g., condom breakage). France may have lower abortion numbers, but look at the numbers for this pill. I have no doubt that this pill is the most popular form of “contraception” in France.I’m not sure on what your certainty was based, but pubmet articles from 1995 and 2000 indicate that oral contraception is the most common method of birth control among French women, although condom usage steadily increased with AIDS awareness.