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Emergency contraception could be banned in India

Regulatory bodies are considering restricting access to over-the-counter morning after pills. This has sparked a debate about women’s reproductive rights and public health priorities.

India’s Central Drugs Standard Control Organisation (CDSCO) is currently considering banning the sale of over-the-counter emergency contraception, particularly that which contains Levonorgestrel.

Until now, morning after pills including Ipill and Unwanted 72 have been safely accessible without a prescription.

The proposed restriction, which was initially put forward by Tamil Nadu’s government, would change that, requiring people to provide a doctor’s note when buying hormonal ECPs.

Behind the potential policy shift is a lot of institutional weight, with specialists from Lady Hardinge Medical College and members of ICMR and DGCA part of the expert subcommittee pushing for this.

Several states where it’s still legally available have already made the process of obtaining this medication more challenging by implementing informal ‘shadow bans.’

The proposal would nationalise these restrictions, which healthcare providers fear will most impact vulnerable women in rural and underserved areas where there are very few doctors within range and where they face barriers that include stigma, as well as financial and geographical constraints.

Contrary to widespread misconception – 96 per cent of gynecologists stated they had unfounded beliefs about blood clots and infertility in a 2015 study – scientific evidence shows that emergency contraception is safe.

The World Health Organisation recognises Levonorgestrel as low risk, even for breastfeeding women.

While side effects like nausea and minor bleeding are indeed possible, severe complications are extremely rare.

Notably, NFHS-5 data reveals that less than one per cent of Indian women use emergency contraceptives, which disputes claims that they are being largey misused.

‘It is clear that there is no evidence to back this recommendation from a scientific point of view,’ says expert Dr Christianez Ratna Kiruba.

As she explains, when taken within the 72-hour window after intercourse, ECPs prevent approximately 89 per cent of pregnancies.

Healthcare professionals argue that although judicious use is important, the benefits far outweigh the risks, especially when those risks are compared to alternatives such as unwanted pregnancies or unsafe abortions.

On this note, the proposal appears to stem more from social concerns than medical evidence.

Imposing limits could have serious repercussions for reproductive healthcare in India.

With condom usage at just 9.5 per cent and many women struggling to negotiate contraceptive use with their partners, ECPs offer a highly necessary safety net.

Experts warn that prescription requirements could lead to increased unwanted pregnancies, unsafe abortions, and maternal deaths.

The need for emergency contraception arises in various situations, from condom failure to cases of sexual assault. This makes accessibility crucial for women’s reproductive rights and health autonomy.

Critics stress that instead of enforcing this policy shift, authorities should focus on bolstering awareness and education about proper use.

And some healthcare providers have suggested that the introduction of counselling programmes in pharmacies would be most beneficial.

But the ideal approach, as many have outlined, would be to use ECPS as a bridge to more regular methods of contraception while guaranteeing its availability for genuine emergencies.

This would involve better education on family planning, improved access to regular contraception, and comprehensive sexual health services.

As the decision looks to be made, the balance between regulation and accessibility must be addressed for the millions of women it will have consequences for.

The final outcome will set a precedent for Indian reproductive rights in the decades to come.

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