Contraception

2000 - current

SPUC fail to get morning after pill banned (July 2002)
Morning-after pill advert sparks criticism (April 2002)
Court challenge to over-the-counter abortion pill (July 2001)
Chemists warned about morning-after pill (July 2001)
Morning-after Pill on Sale (April 2001)
Abortion pill may be sold as contraceptive (January 2001)
Morning-after pill a "success" (January 2001)
Pill fails to Prevent Teenage Pregnancies (October 2000)
Morning-after pill free to schoolgirls (July 2000)
Abortion rates rise after Y2K (July 2000)
Male Pill Approaching (April 2000)
Free Morning-After-Pill Trial (April 2000)
Contraception and Abortion in the Third World (April 2000)

1997 - 1999

Side Effects of the Pill (April 1999)
Male Pill within five years (April 1999)
Teenage and Unmarried Pregnancies (April 1999)
Contraception update (January 1999)
Preventing teen pregnancies (July 1998)
Contraception update (April 1998)

news index

contraception index

resource centre

July 2002

SPUC fail to get morning-after pill banned

Pro-life campaigners have failed in their attempt to have the morning-after pill banned. The Society for the Protection of the Unborn Child sought a judicial review to prevent the medication being sold over the counter without a prescription. The group argued that it was not a contraceptive but an abortifacient as it does not prevent the act of fertilisation but stops a fertilised egg implanting in the uterus. This constitutes a miscarriage according to the Offences Against the Person Act 1861. Therefore, if the court had agreed that it was an abortifacient, the morningafter pill would be regulated by the Abortion Act 1967, and should not be available without the written consent of two doctors.

However, the claim was categorically rejected by a High Court judge who made it clear that he felt the issue should not be decided in court. Mr Justice Munby pointed out that decisions about contraception must be left up to the individual and were not the business of Government, judges or the law. He also felt that the SPUC's legal argument was wrong as the definition of miscarriage used in the 1861 Act is no longer applicable today. It is now accepted that a miscarriage marks the end of a viable pregnancy in which the fertilised egg has implanted in the uterus.

Even though the SPUC claimed that it was only targeting the morning-after pill, such a ban could also have had a big impact on the use of other forms of contraception including intrauterine devices which also prevent implantation. (Guardian 2002; 19 April)

April 2002

Morning-after pill advert sparks criticism

The first advertisement for the morning-after pill has been widely criticised by both religious and pro-life groups. Due to appear in magazines for young women later this year it reads: 'Split Condom. Oops. Emergency Contraception!!! Quick. Pharmacy. Buy Levonelle . . . Phew.'

The campaign is the first since the morning-after pill, which can prevent pregnancy if it is taken up to 72 hours after sex, was licensed for sale over the counter last year. However, a spokesman for the Church of England, said: 'It's not contraception, because conception has already taken place. It's actually nearer to abortion. It would be better if the need to take it did not arise - in other words, don't get pregnant.'

In response a spokesman for the drug company marketing Levonelle said: 'Of course we are used to hearing some negative opinions about it. But we want to be responsible and try very hard not to offend.' (Telegraph 2002; 24 January)

July 2001

Court challenge to over-the-counter abortion pill

In a challenge to recent legislation allowing the sale of the morning-after pill ver the counter of pharmacies, the Society for the Protection of Unborn Children (SPUC) is arguing that the pill effectively causes a miscarriage of a fertilised embryo in the uterus. The high court has agreed to hear SPUC's challenge that the health secretary has broken the law, by allowing over-the-counter sales of the pill. This is because the pill is available without prescription, contradicting the Abortion Act that allows only doctors to terminate pregnancies. (Telegraph 2001; 3 May)

Chemists warned about morning-after pill

High street chemists are being warned by letter that they could face legal action if they sell the morning-after pill to women who then experience adverse side-effects.

The pro-life organisation, Life, has asked members in all its British branches to copy the warning letter and deliver it by hand to local pharmacies. The campaign is the latest problem facing the Government in its bid to halve teenage pregnancies by 2010 by taking Levonelle off prescription for women aged 16 and over. Life's letter says that use of Levonelle 'does nothing to address the issues of low aspirations or peer pressure. It makes girls readily available to persuasive men. It will encourage sexual activity and provides no protection against sexually transmitted diseases.'

Dr Liam Fox, shadow health secretary has expressed concern about the availability of the morning-after pill without a prescription: 'My worry is not about the ability of pharmacists but about whether the high street chemist is the appropriate place for it to be given'. Judy McRae, chairman of the Royal College of Nursing's school nurses forum, argued that any 'backwards' step 'would completely undermine the hard work school nurses and family planning nurses have done with young people'. (Telegraph 2001, 3 January; Telegraph 2001, 24 January)


April 2001

Morning-after Pill on Sale

Alan Milburn, the Health Secretary, paved the way for emergency 'contraception' to be available without prescription for the first time by laying an order in Parliament in December. Since January 1, pharmacists have been able to sell emergency contraception, in the form of the drug Levonorgestrel, for £20 to anyone over 16. Britain has the highest level of teenage pregnancies in Europe and the Government has declared its determination to halve the number by 2010.

Under the new regulations chemists will only be allowed to sell the morning-after-pill to women over the age of 16; younger girls must still see a doctor. Some doctors have urged the Government to extend the rules and allow girls under 16 the morning-after-pill over the counter. However, a pilot scheme being conducted in a number of schools across Britain to allow students under 16 free access to emergency contraception has sparked controversy. But Michael Crane, head teacher at John Port School in Etwall, Derbyshire which is taking part in the pilot scheme considers the availability of the morning after pill as 'part of a bigger package of pastoral support, offered in the context of health education, for the 2,000 students at our school'. The school nurse, Val Oborn, emphasises, 'I take their blood pressure and discuss their family medical history before I give it. And, unlike a pharmacist, I offer a follow-up service'.

However, the nursing and medical professions have mixed views about the availability of the morning-after pill to under-16s. The Royal College of Nursing has said that it would like to see emergency 'contraception' available in all schools. Whilst the BMA has raised concerns about 'fragmentation' of medical records if GPs are not informed when it is given. The BMA GP committee has stated that the morning-after pill should be supplied by pharmacists without prescription to anyone who needed it. (Times 2000; 10 December, Times 2000; 12 December, Times 2001; 11 January)

January 2001

Abortion pill may be sold as contraceptive

An abortion pill that is given to women who are up to nine weeks pregnant could be marketed as a contraceptive, after trials have shown it efficient at preventing pregnancy. Mifepristone (RU-486), which was only recently approved for use in the USA, starves the embryo of progesterone and is taken in pill form followed two days later by a prostaglandin which stimulates contractions and causes the abortion.Researchers, who carried out a four-month trial on 90 women, claim that the drug was largely successful in preventing ovulation and was 100 per cent effective in preventing pregnancy. They believe it could be marketed as an alternative form of contraception for women who are at risk from side-effects of the pill, such as thrombosis. They are now trying to persuade a drugs manufacturer to carry out a large-scale trial of the drug, which could lead to it becoming available commercially. However Pro-life campaigners argue that marketing an abortion pill as a contraceptive was misleading. 'If it does not stop ovulation in all cases and actually stops an embryo from growing to full term then it causes abortion. That is not contraception'. (Telegraph 2000; 22 September)

Morning-after pill 'a success'

Since the launch of a campaign in Manchester last year, figures suggest that over 3,000 women have requested the morning-after pill over the counter. More than 70 chemists in Greater Manchester are offering the emergency pill free of charge as part of a pilot scheme. Critics such as anti-abortion groups had voiced concern that the scheme would encourage young people to have unprotected sex, but the figures show that 55 per cent of the women requesting the drug are aged 20 to 29. (Times 2000; 9 August)


October 2000

Pill fails to Prevent Teenage Pregnancies

A new study from the University of Nottingham has shown that over half of the teenage girls who become pregnant are actually on the pill. Britain currently has the highest teenage pregnancy rate in Western Europe. Over 100,000 women under the age of 20 conceived in 1998 with two-thirds of them going on to have the baby. It was previously thought that the high rate was the result of poor sex education in this country along with a reluctance amongst young people to seek medical help. However, the new research calls these claims into question and suggests that teenagers are not provided with enough information about taking the pill properly. It is also thought that many teenagers are not mature enough to cope with taking an oral contraceptive at the same time each day. (Weekly Telegraph 2000 [Australasian Edition]; 474:14, 23-30 August)

July 2000

Morning-after pill free to schoolgirls

Schoolgirls are being offered the morning-after-pill in pharmacies without a prescription. This pilot scheme, being run in Manchester, is the second stage of a study where the pill is being made available free of charge. Girls under the age of consent will be given the pill, but only if the chemist is satisfied that they understand the consequences of their request. The scheme is in response to demands by doctors, pharmacists and family planning groups, and could soon be spread nationwide. (Times 2000; 8 January)

In what has been called the 'ultimate form of contraception', girls and boys aged thirteen were given babies to look after for a television programme designed to discourage under-age sex. The programme 'Borrow a baby' will be screened on Channel Four. (Times 2000; 9 March, Times 2000; 10 March)

Abortion rates rise after Y2K

The aftermath of the millennium celebrations has led to a record 20% rise in the number of abortions performed in the UK so far this year. The rise was blamed on the closure of many clinics and GP surgeries over the festive period, leading to a difficulty in obtaining emergency contraception. This news coincides with an all-party parliamentary pro-choice group report claiming that women face 'significant delays and obstacles' when seeking to end a pregnancy. The group found that three out of ten women got no help at all from their doctor when they asked for an abortion.

However, pro-life activists point to the example of an aborted 22-week baby which survived for 80 minutes while hospital staff waited for it to die in Darwin, Australia last month. Such incidents are by no means uncommon in the UK. Last year a normal baby was aborted at Birmingham City Hospital at just under twenty three weeks gestation, because tests had shown he might suffer from Down's Syndrome. He lived for two hours (Times 2000; 2 March, Times 2000; 11 April).

April 2000

Male Pill Approaching

Scientists at Leicester University have developed a technique to boost or diminish fertility in mice; this could lead to the long sought-after male contraceptive pill. A receptor called P2X1 is found in the smooth muscle of the vas deferens; if a working copy of this receptor is absent, sperm is not added to the seminal fluid. Drugs already exist to block this receptor, or alternatively to stimulate it in cases of low sperm count, and it is hoped that drug companies will be interested in developing a human pill. (Telegraph 2000; 6 January)

Free Morning-After-Pill Trial

85,000 women between 16 and 29 years of age are to be offered five free packs of the morning-after-pill in 100 GP practices and family planning clinics in Lothian. This follows on from plans last summer by the British Pregnancy Advisory Service which allows women to buy the pill in advance. The BMA and the RCOG support over-the-counter sales of the morning-after-pill, which may act to prevent implantation of a fertilised egg. Drug companies are reluctant to produce it because of opposition from pro-life supporters (Telegraph 1999; 2 September, BMJ 1999;319:661, 11 September).

Contraception and Abortion in the Third World

Increasing contraceptive availability means that 50% of couples in the developing world use contraception, compared to just 10% in the 1960's. In Africa, however, usage is only 18%. Total fertility has fallen from 6 children to just over 3. However, abortion rates are rising unprecedentedly. 35 million abortions are performed annually in developing countries, and 1 in 4 births are unwanted. More than 150 million women have an unmet need for contraception; annual global spending on family planning is £3.75 billion, but only 37% of the funding actually goes on family planning services. (BMJ 1999;319:932-933, 9 October)

April 1999

Side Effects of the Pill

The Royal College of General Practitioners' 25 year-long follow-up study has shown that ten years after stopping taking the Pill, women have no greater risk of dying of heart disease or Pill-associated cancers than those who have never used it. However, it was confirmed that the risk of developing heart disease, strokes, cervical and breast cancer is higher for those women who are on the Pill and the risk remains high for the first few years after cessation. The use of the Pill (which currently accounts for about 25% of all contraceptive use) seems to keep abortion rates at lower levels; during the last Pill scare of 1995, when women stopped using it, the abortion rate surged to its highest level since records began. (The Telegraph 1999; 8 January)

Male Pill within five years

An effective birth control pill for men could become a reality within five years. Doctors at St Mary's Hospital in Manchester have launched a trial of the new contraceptive: testosterone is given as an implant that lasts six months and a prolactin pill (that switches off a hidden secondary sperm-production mechanism) is taken every day. Current male contraceptives are only 70-80% reliable, and it is hoped that the new contraceptive will be on a par with the female Pill (99% effective). (The Telegraph 1998; 26 October)

Teenage and Unmarried Pregnancies

Recent research by the Government has revealed that the conception rate for teenage girls has risen by 11%. The survey, Birth Statistics 1997, has shown that three quarters of the pregnant girls were 15 years old, and more than half had had abortions. There has also been an increase in the number of children born outside marriage from 23% ten years ago to 37% now.

Boots, the chemist chain store, has set up the first family planning clinic in a Glasgow pharmacy. This is part of an attempt to reduce the number of teenage pregnancies by making services more accessible. It is hoped that emergency contraception will be available over the counter at such clinics, reducing the number of abortions. However, pro-life groups are unhappy and suggest that this will encourage teenagers to have underage and premarital sex.

The Family Planning Association has launched a new initiative to get the message of safe sex across to university students. About £1000 worth of ten pence pieces have been scattered in 96 union bars, and when picked up, the coins are found to have a sticker describing the dangers of unprotected sex on the back. The combination of cash and beer has proved to be successful, and many students have found the coins and read the message. (The Telegraph 1998; 12 December, BMJ 1998;317:1612, 12 December, The Telegraph 1998; 11 December)

January 1999

Contraception Update

The British manager of Durex has signed a deal to build a factory and produce up to 200 million condoms a year for 1.2 billion Chinese people. China has recently seen a sexual revolution, with sex-parlours springing up in many cities.

In America, a special contraceptive kit has been approved by the Food and Drug Administration, in the hope that this will reduce the number of unwanted pregnancies. The Preven Emergency Contraceptive Kit costs about $20 and contains four birth control pills (levonorgestrel and ethinyl oestradiol). The kits are 75% effective in preventing pregnancy. Pregnancy among American teenagers has fallen to a 20 year low. A survey by the Centers for Disease Control and Prevention (CDC) has shown that the percentage of American teenagers, especially males, who have had sex has declined in the 1990s. Teenagers are also more likely to use condoms now than in the early 1990s. (The Telegraph 1998, 11 October, BMJ 1998;317:697, 12 September, The Telegraph 1998, 17 October, BMJ 1998;317:834, 26 September)

July 1998

Preventing Teen Pregnancies

More than 80% of hospital doctors believe that the contraceptive pill should be available to girls below the legal age of consent. 49% say doctors should consult the girls' parents beforehand and 55% say doctors should take the opportunity to give moral advice.

These were the central findings of a BMA News Review survey of 150 hospital doctors on the subject of under age prescribing. The equivalent figures for GPs were 94%, 67% and 38% respectively. The number of conceptions in girls aged under 16 has risen for the third consecutive year in England and Wales to 9.4 per 1,000.

But is contraception really the answer? There is substantial evidence that contraceptive failure is a major factor in unplanned pregnancy; 80% of teenagers with unplanned pregnancy in one study claimed to have been using contraception at the time of conception. 87% of teenage mothers in Britain are unmarried; the highest level anywhere in the world. (BMA News Review 1998; April: 14, BMJ 1998;316:882, 21 March, BMJ 1995;311:807, 23 September, BMJ 1995;310:1644, 24 June)

April 1998

Contraception

The Department of Health has advised GPs that the contraceptive device Persona may have an unacceptably high failure rate for some couples. After an investigation, the Medical Devices Agency stated: 'Persona is basically a test-based form of the rhythm method of contraception'. Persona, which has been bought by 100,000 British women, is being blamed for 60 abortions (following failed contraception) each month.

The Contraceptive Service's Emergency Contraceptive Pack was launched on 11 February. The poster, leaflet and 'credit card' campaign is advocating emergency 'contraception' up to 72 hours after unprotected intercourse, and the IUD up to five days after. Obviously the later the intervention, the more likely that the mechanism of action will be prevention of implantation (ie abortifacient) rather than prevention of conception.

Meanwhile the medical director of the International Planned Parenthood Federation of America, Dr Jerry Edwards, has devised a hand-held syringe technique that will enable women to have abortions as early as eight days after conception. (BMJ 1998;316:168, 17 January, The Times 1998; 10 January:7, CES Press Release 1998, 30 January, The Times 1997; 22 December:13)