Emergency contraception refers to a method of contraception that can be used to prevent pregnancy after sexual intercourse. | Photo Credit: Getty Images / iStockphoto
A The new study is published in the journal Contraception X highlighted the potential role of Levonorgestrel 1.5mg for pericoital use. Pericoital contraception refers to methods used during sex, such as condoms and diaphragms. It is a reminder that there is a need for a variety of contraceptive options and to respond to the unique needs of women and girls. Data shows that in India, sales of oral emergency contraceptive pills (ECPs) are over 35 million annually, with a decadal compound annual growth rate (CAGR) of 12%. This proves that women and girls and their partners choose to manage their fertility as needed.
Emergency contraception
Emergency contraception refers to a method of contraception that can be used to prevent pregnancy after sexual intercourse. It is recommended to use it within five days of unprotected sex but it is more effective if it is used sooner. ECPs prevent pregnancy by delaying or preventing ovulation.
The World Health Organization (WHO) states that all women, including those unable to use hormonal contraceptive methods, can use ECPs safely and effectively. Due to the short-term nature of its use, there are no medical conditions that make ECP unsafe for women. WHO says there is no health risk when using emergency contraception. However, using ECPs is also a reminder to start using regular contraceptive methods in consultation with health providers because ECPs prevent pregnancy from sexual activity that took place only in the past five days; they will not protect a woman from pregnancy from having sex more than 24 hours after she takes ECPs.
While the public sector continues to be the main source of family planning, specifically for female and male sterilization, and long-acting reversible contraception including intrauterine devices and post-partum intrauterine devices, the private sector is the main source of oral contraceptives. contraceptive pills as well as ECPs and barrier methods such as condoms. Reversible contraception puts the decision in the hands of girls and women, supporting their reproductive agency and autonomy in deciding if, when, and how many children they want to have.
A significant move
Earlier this year, the government included a single dose regimen of Levonorgestrel 1.5 mg in the National List of Essential Medicines (NLEM). This list is issued by the Department of Pharmacy to provide drugs at affordable cost and quality assured based on the disease burden of the people. It is intended to promote the rational use of medicines with a focus on cost, safety, and efficacy. This move is important because it is the preferred regimen for women who use ECP and despite the annual sale of more than 35 million tablets from chemists and private pharmacies, it is not price controlled, while the two-dose regimen (tablet 0.75 mg) in NLEM has since been included in 2015. The emergency contraceptive pill Levonorgestrel 0.75 mg tablet was included in the National Family Planning Program in 2003 but was later replaced by Levonorgestrel 1.5 mg tablet to be available free of charge in the public health system. The same pill in the private sector continues to be sold without price control in the price range of ₹ 99-110. The two-tablet pack is controlled at ₹22.53 per tablet with the presence of NLEM. This has become a significant market gap between what women want and what is affordable.
India has reached the replacement rate of fertility, which means that the average number of children born per woman is such that the population exactly replaces itself from one generation to the next without migration. This is the result of the government’s efforts to prioritize more contraceptive options, increase access to quality counseling, contraceptive services, and focus on education as a path to a good quality of life.
There continues to be variation in demand for access to contraception and family planning in different regions, and a focus on ensuring access to information and counseling on contraceptive options and seamless access in the public and private sectors is critical. Total demand for family planning among currently married women aged 15-49 in India increased from 66% (2015-16) to 76% (2019-21). Unmet need for family planning decreased from 13% in 2015-16 to 9% in 2019-21. This means that while more women in India express a desire to use contraception to delay their first birth, space pregnancy, or childlessness, there are still 9% (which is lower than in 2015-16) who want to. contraception but currently do not have access to it for several reasons.
With research and technological advances, contraceptive options will continue to expand for men and women to respond to their unique needs for contraception. Policy makers must continue to listen and respond to the needs of women and their partners at different stages of life with critical decisions like these. The wider availability of single-dose emergency contraceptive pills is an example of the government’s response to the choices women are making. With the recent introduction of subcutaneous injectable contraceptives with the opportunity to expand self-care and sub-dermal single-rod contraceptive implants in the national program, and the decision on price control of single-dose ECPs, a conscious effort is being made to support women. in making an informed choice.
