Concerns over repeat use of emergency contraception pills

October 2024.  According to local news, in India the Central Drugs Standard Control Organisation (CDSCO) is considering recommending a ban on over-the-counter sales of emergency contraceptive pills (ECPs). The reason suggested for the ban is that what is considered “ an irrational and excessive use” of the ECPs might lead to health complications for women, and the believe that making a doctor’s prescription mandatory, would safeguard women’s health and avoid complications due to unnecessary use of emergency contraceptives. India’s Public Health Platform, Nivarana, just published an article listing the multiple reasons why restricting access to EC pills would go against evidence, and be contra productive for India’s women’s health. 

Concerns about the growing use of EC pills are rising in a number of countries, as seen in recent news from Uganda and Ghana. This has always been a sensitive topic, strongly associated to the stigma attached to ECPs and to ECPs users.

ECPs are safe and effective even when use repeatedly, and such use should not raise concerns. In many settings, ECP may be repeatedly used because they are the only method women can access, afford and/or use discreetly and autonomously; ECPs may be virtually the only contraceptive choice available to them. It is time to retake the conversation about repeat use of EC: about what women need to know to use ECPs safely and effectively as many times as needed; and about the pocket costs for women, of only being able to resource to ECPs.