The morning-after pill, available without a prescription, but what are its repercussions on our health?

The morning-after pill is available without a prescription, but it's not safe. Since March 2015, the morning-after pill can be purchased over the counter at pharmacies. However, a non-representative survey conducted by the federal association pro familia in the same year showed that women often encounter obstacles when requesting emergency contraceptives.

Attempts to discipline women and deny them access to emergency contraceptives

Since March 2015, the morning-after pill can be purchased over the counter at pharmacies. However, a non-representative survey conducted by the federal association pro familia in the same year showed that women often encounter obstacles when requesting emergency contraceptives. For the first time in Germany, a two-semester research project of the Master of Public Health at the University of Applied Sciences in Fulda provided reliable quantitative data. Throughout Hesse, it surveyed 143 pharmacies about the use of the emergency contraceptive pill and also recorded the subjective experiences of women and men who had visited a pharmacy to purchase the pill. The result confirmed the findings of the pro familia survey: although the preparation is available without a prescription as a painkiller, quick access to advice and application is not always guaranteed. The survey also shows that dispensing practices and advice in pharmacies differ widely. Although the Federal Chamber of Pharmacists (BAK) has made recommendations for action for pharmacies, the legal situation is still unclear on many points - for example, with regard to dispensing the medicine to people under 14 years of age. Dispensing of the drug therefore also depends on the attitude of pharmacy staff towards emergency contraceptives. In order to find out which factors exactly determine whether a woman receives the morning-after pill or not, the two master's graduates conducted an additional qualitative survey among pharmacists in Hesse.

More than 70 percent of those surveyed consider the morning-after pill to be a special medicine

The two graduates of the Fulda University of Applied Sciences were able to show that 70.3 percent of the pharmacists questioned considered the morning-after pill to be a special drug, the administration of which is not comparable to conventional over-the-counter drugs. 70.4 percent were even convinced that the emergency contraceptive pill was a medically dubious drug. A majority of respondents also considered it quite likely that women are using contraception irresponsibly by purchasing the emergency contraceptive pill. Although the morning-after pill contains a high dose of hormones and should not be taken in exceptional cases, side effects and interactions have been shown to be minor and no abortive effects can be proven. "Other drugs have a higher potential for abuse and danger than the morning-after pill. Presumably, first, moral concerns, second, the recommendation of the Federal Office of Public Health, and third, the long-standing discourse on prescription approval lead to this assumption among pharmaceutical personnel," the master's graduates state. They have established that the argument that it is a special drug apparently justifies disciplinary action and refusal to dispense it. We have, for example, recorded discriminatory 'education attempts' that not only jeopardize access to education, but are also inconsistent with sexual and reproductive rights," they explain. Moral concerns jeopardize the best possible health care Because of moral concerns and the resulting practice of attribution, the best possible health care is virtually no longer guaranteed, they write in their master's thesis. For example, one interviewee described a client as a "repeat offender" because she had needed the drug repeatedly. Taking the morning-after pill seems to be justified only if there is a true one-time 'emergency'," the two graduates conclude. This finding surprised them even more: if the client was suspected to need the pill because of rape, pharmacies only dispensed the morning-after pill in slightly more than half the cases. "Pharmacy staff seem to be very insecure when it comes to treating victims of violence," the two master's graduates conclude. "They obviously do not know how to provide adequate help, although even the distribution of the morning-after pill is a great relief for women." Based on the results of the study, the two master's graduates conclude that the recommendations of the Federal Office of Public Health need to be revised "to protect women from discriminatory statements and exaggerated medical dangers of the morning-after pill." Clear legal regulation could reduce discrepancies in allocation practices and promote unimpeded access, they stress.

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