According to the unpublished findings of a study conducted by the Foundation for Reproductive Health Services India in early 2020, only 3% pharmacies among the five states analysed (Chennai, Coimbatore, Madurai, Tiruchirappalli, and Tiruppur) stocked Emergency Contraceptive Pills (ECPs).
Why is this surprising? Because in Tamil Nadu, the sale of over-the-counter contraceptives is completely legal – it has posed an informal ban on them.
Why are ECPs contentious in the state?
Emergency contraceptive pills (ECPs) were introduced as over-the-counter items a decade ago. Tamil Nadu, however, has had an ambivalent relationship with ECPs – pharmacies in the state, over time, reduced the number of pills they stocked, and in 2016, the pills disappeared from pharmacies completely. Tamil Nadu had posed an informal shadow ban on ECPs.
In 2019, the Tamil Nadu Drugs Control Administration clarified in an interview with The Hindu that there is no ban or restriction on the sale of emergency contraceptives. A senior official had said that the advisory was issued for abortion pills. Levonorgestrel, a component covered under Schedule ‘K’ of the Drugs and Cosmetics Rules 1945 and the main component of the iPill, is exempted from sale licenses.
Why is there a problem with stocking the drug? Legal regulatory issue, according to the Tamil Nadu government. 90% of pharmacies that did not stock ECPs reported that ECPs have been banned.
Women are more at risk of unwanted pregnancies and abortions.
Tamil Nadu has a unique situation when it comes to contraceptive measures – the study found that only 0.2% of women relied on the pill as a contraceptive method, and the state is mostly dependent on female sterilization for contraception.
Owing to the lockdown, over 5 lakh women could not access their preferred method of contraception, and this problem is likely to be prolonged because family planning services are not going to be easily accessible. This is where ECPs would come in handy – the lack of access to them will likely cause 1,24,086 unwanted pregnancies, 35,489 live births, and 75,446 increased abortions. It will also likely end in close to 90 maternal deaths.
Facing a surge of patients during the lockdown, gynaecologists have been prescribing high dose progesterone pills to prevent unwanted pregnancies, because prescribing an ECP would lead nowhere since they aren’t available. But even then, not everyone has access to doctors or pills.
The pandemic has caused physical, mental, social, and economic devastation among women, and it’s imperative for the government to make better decisions on women’s sexual and reproductive health.
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