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Access to emergency contraception is a fundamental part of women’s reproductive rights—so why aren’t enough Australian pharmacies stocking the one that works best?
New research from Flinders University has found that one-third of Australian pharmacies do not stock the most effective oral contraceptive pill—ulipristal acetate (UPA).
Despite studies confirming that UPA is more effective than levonorgestrel (the other oral emergency contraceptive option), levonorgestrel (LNG) remains the most commonly stocked and used form of emergency oral contraception in Australia.
Even more concerningly, this research has also reveals a deeper, more systemic issue about how emergency contraception is accessed in Australia, with many women not understanding that there was ever any more than one option to choose from.
So, what are our emergency contraceptive options? We spoke to Senior Pharmacy Research Manager at Peter MacCallum Cancer Centre, Associate Professor Safeera Hussainy to find out.
The Different Types Of Emergency Contraception
If until now, you have simply being asking your pharmacist for the ‘morning after pill’ then it’s time to listen up.
According to Safeera, there are three types of emergency contraception to choose from.
“There are only two types of oral emergency contraceptives—levonorgestrel (LNG) and ulipristral acetate (UPAl), ” Safeera tells marie claire Australia. “There is also the copper IUD (intrauterine device), however that requires insertion by a skilled doctor and an appointment to do so.”
Studies have shown that UPA is up to 2.5 more times more effective at preventing pregnancies if its taken within 24 hours of unprotected sex than LNG.
UPA is also more effective for a longer period of time, with the contraceptive being effective at preventing pregnancies when taken up to five days after unprotected sex. In comparison, LNG’s effectiveness wears off after three days.
While the effectiveness of UPA makes it seem like the obvious choice, Safeera warns that there are other factors to consider when choosing an emergency oral contraceptive.
“Given that the options are limited, pharmacies need to stock the two oral forms so that people seeking emergency contraception can decide which is best for their circumstance,” Safeera explains.
“For example, if someone has a certain medical condition, or is already on “the pill”, or is breastfeeding, then one emergency contraceptive is more suitable than the other.”
What Type Of Emergency Contraception Is Right For Me?
If your pharmacy stocks both types of emergency oral contractive pills then they can help you make the right decision.
“The decision depends on several factors, including but not limited to time since unprotected sex, current medical conditions, current medications, body mass index, whether the person is breastfeeding,” Safeera says.
“Pharmacists are trained to gather this information through conversation with the person seeking emergency contraception. They can explain why they are collecting the information, and then what it all means in terms of the best emergency contraceptive for the person. There is even a cool decision-making wheel that pharmacists can use to help the person arrive at a shared decision.
“For example, if someone had unprotected sex yesterday morning (> 24 hours ago) and missed a dose of their regular pill, levonorgestrel is the best choice for them because ulipristal (UPA) can interact with the regular pill.”
Those wanting to opt for a more long-term form of contraception can also consider the copper IUD (intrauterine device). However, this decision is best discussed with your doctor.
How Do I Ask For The Right Morning After Pill?
You have every right to discuss your emergency contraceptive options with your pharmacist.
While many women default to the “can I get the morning after pill?’ line—which Safeera notes is actually incorrect since “emergency contraception can be used not just the morning after unprotected sex”, there are some alternative ways to begin the conversation.
“People can alternatively say something like: “I need emergency contraception and I’ve heard there’s a few options, can I discuss these with the pharmacist?'” Safeera explains.
“This states the request discreetly, indicates the person is aware that there are options and not just one medication, and ends with an invitation to chat with the pharmacist about the options.”
How Effective Is The Morning After Pill?
You can rest assured that if you take your emergency contraception within the right timeframe—within three days for LNG and within five days for UPA—then it should be very effective at preventing pregnancy.
If taken within 120 hours after unprotected sex, LNG has just a 2.2 percent rate of getting pregnant. UPA’s rate is just 1.4 percent and the Copper IUD is less than 1 percent.
However, it’s important to know that there is no guarantee and it is still possible to get pregnant after taking the morning after pill.
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