What the morning-after pill means to women

THE Emergency contraception (EC), or morning-after pill,. is a contraceptive pill, taken as soon as possible after sex, preferably within three days. In 2003, EC was legally shifted from prescription-only to pharmacist-controlled status in Jamaica. Making EC available without a prescription was intended to make it more accessible to Jamaican women, thus decreasing unwanted pregnancy.

Five years ago, I started research work in Kingston and St Andrew on EC. Some women (EC clients) said they had negative feelings about it but took it anyway. Pregnancy was unwanted by all of them. I looked at the significance to the women of not getting pregnant, and the significance of EC to them in that endeavour. See below some of the meanings that women attached to EC:

1. Plan B

EC was a back-up contraceptive when principal methods of contraception (condom, rhythm and withdrawal methods) failed. One woman said the purpose for EC was when 'withdrawal' did not happen or the condom failed.

2. A second chance

EC offered some women the opportunity to make good on their 'wasted' first chance at contraception. One EC client felt that EC offered women the second of two chances that every woman gets to prevent pregnancy.

3. An alternating contraceptive

Some women who regularly used the withdrawal method consistently used EC when their partners did not withdraw.

EC Client #05: ... Sometimes him don't dweet (withdraw).

DM: And what do you do at those times?

EC Client #05: Buy the [EC].

4. An 'abortion tablet'

A client who incorrectly thought that EC could be an abortifacient (drug used to induce abortion) said she was told that EC could help her with pregnancy.

EC Client #04: She sey, 'yes, in case of anything, it (EC) will dissolve the problem.'

DM: Explain to me what you mean by 'the problem'?

EC Client #04: Like if I'm getting pregnant, like if it young, it [EC] can terminate it.

5. An alternative to abortion

Some women spoke about the significance of EC to them in averting medical abortions and other consequences of unwanted pregnancies. According to one client, it was better to end 'the problem' before it got worse.

6. Final word on contraception

EC gave some clients the final word on contraception when their partners wanted pregnancy. They took EC although their partners wanted to make them pregnant and begged them not to take EC. Others took EC without their partners' knowledge.

One client who said she consistently used the withdrawal method, insisted that provided that she had EC and her partner did not fake withdrawal, she could not get pregnant.

DM: What do you think is the likelihood, chance for you to get pregnant?

Client #05: Once yuh have the pill (EC), yuh can't get catch (pregnant) unless the man trick you.

Dr Dahlia McDaniel is a pharmacist with a doctorate in public health. She is the chief executive officer of two pharmacies and a medical practice in Kingston; email: yourhealth@gleanerjm.com.