Morning-after pill a missed opportunity

By Susan Babirye

ONE of the televisions recently featured a story on emergency contraceptive pills commonly referred to as ‘the morning-after pill’. In the story, the use of this pill was reported to be increasing with access mainly being over-the-counter purchases from pharmacies and drug shops.

This pill is a back-up contraceptive method that provides women a chance to avoid unwanted pregnancy after unprotected or poorly protected sex. For instance, in cases of rape, missed regular pills, condom breakage or if a coil is expelled.

However, as the use of the emergency contraception increases and repeated use becoming common, one wonders whether these clients are given counseling on regular family planning methods. The fact that the pill is mainly accessed overthe- counter highlights a gap in linkage to other reproductive health services.

This implies this pill clients miss out on general family planning counselling. This missed opportunity leads to continued nonuse or poor use of regular contraceptives and hence recurrent unwanted or mistimed pregnancies.

This explains why women repeatedly seek emergency contraception. Research shows that nearly 700.000 pregnancies of the 1.4 million annual pregnancies occurring in Uganda are unwanted or not planned due to lack of birth control.

These unwanted pregnancies have been linked to unsafe abortions. According to 2005 research on the incidence of induced abortion in Uganda, an estimate of 297.000 induced abortions are performed each year in Uganda.

These abortions occur at a rate of 54 per 1,000 women aged 15-49. Unsafe induced abortions contribute signifi cantly to Uganda’s high maternal mortality ratio of 435 deaths per 100.000 live births. It accounts for nearly one third of maternal deaths in Uganda.

Much has been done by the Government to expand access to contraceptives to enable women have control of their fertility, but the use of modern family planning methods is still low at 18%. Reaching women with preventive reproductive health services remains a major challenge.

The writer is a MakSPH-CDC Fellow