About half of school leavers (schoolies) believe emergency contraception is only effective 12 or 24 hours after sexual intercourse, according to a new study urging a re-think of the term “morning after pill”.
Led by researchers from Griffith University’s School of Pharmacy and Pharmacology and published in the Journal of Pharmacy Practice and Research, the study analysed 500 responses from teenagers ‘on the first day of the Queensland Schoolies Week’ at Surfers Paradise in 2017, with the aim of ‘[exploring] the awareness of … schoolies regarding the use and availability of emergency contraception’.
It found 65% of respondents were unaware that emergency contraception (EC) was available from a community pharmacy without prescription and 25% believed the medication was harmful.
Although oral levonorgestrel has been available as a non-prescription EC in Australia since 2004 (with ulipristal made available without prescription in 2017), the researchers said consumer awareness of EC in Australia has been ‘traditionally poor’.
While the rates of understanding of EC in respondents paralleled the general population, the researchers, led by pharmacist and lecturer Denise Hope, said schoolies are a more vulnerable cohort.
“Morning after” a misnomer
Although levonorgestrel is approved for use up to 3 days after unprotected sex, and ulipristal for up to 5 days, just 18.5% of survey respondents said they believed EC to be effective either 72 or 120 hours after sex.
University of New England Pharmacy Lecturer Anna Barwick MPS said pharmacists have an important role to play in reducing the misinformation around EC, beginning with the terminology.
‘As pharmacists, we need to change the language and call it an “emergency contraceptive” rather than the morning after pill,’ Ms Barwick told Australian Pharmacist.
‘It’s misleading; calling it the “morning after pill” suggests it can only be used in that timeframe.
‘It’s quite clear from this research that people take it to mean that and believe it is potentially only effective for the morning after, which is incorrect.’
Education and engagement
Ms Barwick said community pharmacists are well-placed to engage with young women about EC, for example when a customer is picking up her regular oral contraceptive.
‘We need to use our opportunities to speak to younger women, and women of childbearing age more broadly, so they understand what’s available to them,’ she said.
‘You can explain that EC is an option if they have missed one of their regular contraceptive pills or they have been vomiting or experienced something else that might affect the absorption, and therefore the effectiveness, of their regular contraception.’
This could also lead to a broader conversation about the different methods of contraception available to women, Ms Barwick said.
‘I think women, and young women in particular, often feel it’s limited and that there’s only the oral contraceptive, but we have IUDs and other options now, which is fantastic,’ she said.
‘As pharmacists, we’re very well placed to discuss those options and refer women back to their regular GP or healthcare provider who can prescribe these options.’
She said community pharmacists could also play a more active role in educating younger generations.
‘I feel that there’s not enough known [about EC] and it’s not discussed openly,’ Ms Barwick said.
‘Our job is to improve the use of medicines and make sure people are confident about using them in the right way.
‘I’d encourage my colleagues to try and get into schools or go to events where they can have these open conversations.’