Misinformation, stigma plague emergency contraception in Hamilton

Misinformation, lack of awareness about accessibility and stigma may be a barrier to the use of emergency contraception in Hamilton.

Hamilton has higher rate of teen pregnancies than the provincial average

Plan B' One-Step, an emergency contraceptive. (Barr Pharmaceuticals Inc./ Associated Press)

Misinformation, lack of awareness about accessibility and stigma may be a barrier to the use of emergency contraception in Hamilton, which has a higher rate of teenage pregnancies than the provincial average.

"Even in this day and age obviously there are a large number of unplanned pregnancies," said Dr. Nicholas Leyland, Chairman of the Department of Gynaecology and Obstetrics at McMaster University.

"When a woman finds herself in a situation where it's necessary—whether the condom or something else—there is a need for post-coital birth control," he added.

The Society of Obstetricians and Gynaecologists of Canada (SOGC) said that more than half of Canadian women are unfamiliar with emergency birth control. To encourage greater awareness about emergency contraception--sometimes known as the "morning after pill"-- the SOGC made a public appeal on World Conception Day (Sept. 26) to dispel some of the myths and misinformation surrounding its use and accessibility.

"Teenagers seem to be aware of its existence, but have little awareness of how it works," said Jane Howard, a nurse at the Hamilton Initiatives for Youth on York Blvd. The non-profit sexual health clinic services teens between the ages of 14 and 20 mainly, said Howard (STI testing and treatment is offered to all age groups at the clinic).

Jane Howard, a nurse at the Hamilton Initiatives for Youth. (Flannery Dean)

That lack of awareness about how emergency contraception works can have serious consequences.

"Occasionally a person comes in who is already pregnant and thinks they can abort the baby with Plan B.," said Howard.  That moment is not the time to talk about emergency contraception, she added.

While Leyland said that the adult women he sees in his practice at Hamilton Health Sciences generally don't labour under the false idea that Plan B terminates an existing pregnancy, they, too, may be unaware of how it functions.

Emergency contraception doesn't terminate a pregnancy, rather it simply stops it from happening, he explained.

"All [emergency contraception] interferes with the process that leads to implantation and the fertilization of an embryo," said Leyland.

It's also highly effective.

Emergency contraception in pill form, or hormonal contraception, can be taken between three and five days after unprotected sex. Use reduces the chances of conception by 75 to 89 per cent.

Though there is that window of time available for preventing an unwanted pregnancy, "the sooner you take it, the better," said Leyland.

One of the things that may prevent its use, however, is the stigma associated with emergency contraception, said Leyland.

"It indicates people have made a mistake," he said. "And nobody likes to look like they've made a mistake."

Where to get it

Emergency contraception has been available in Canada for three decades. In 2005, hormonal EC, in the form of tablets, became available at Ontario pharmacies and drug stores without a prescription. (I.U.D. EC needs to be implanted by a physician)

Shoppers Drug Mart, for example, carries Plan B, which is the commercial name for emergency contraception, in its Hamilton stores. But it's not on the shelves.

"Plan B is kept behind the counter. You have to ask the pharmacist for it," said Lana Gogas, a spokesperson for Shoppers Drug Mart. "The reason for that is because patient counselling is related to the product—so people know how to use it and risk factors, etc."

It's not cheap though, and can run about $40 for a one-time use.

Emergency contraception is also available from your doctor and from many of the city's sexual health clinics (see a list here).

Howard said the clinic began offering Plan B to teens free nearly a year ago because many didn't have the $12 the clinic was charging for it. She uses conversations about EC to talk about use of contraception generally and the need to have safe sex.

Some teens, she said, who seek EC are using the rhythm method or are simply "burying their head in the sand," thinking "it won't happen to me."

Leyland thinks it's wise for people to think about stocking it in their medicine chest "pre-emptively," especially given the fact that many clinics and pharmacies aren't open late at night or early in the morning.

And though there are concerns about too-frequent use or reliance—it doesn't protect against STIs--Leyland said that generally most people "don't rely on it too often" and will generally seek to use more reliable and consistent birth control.