On Emergency Contraception, The Hindu publishes rubbish

These emergency contraceptives are available in India.

These emergency contraceptives are available in India.

Surveys have repeatedly found that young women in India have poor knowledge of contraception and very low usage of contraceptives. The lack of contraception usage leads to unintented or mistimed pregnancies, some of which are also unwanted pregnancies that women then try to terminate. Emergency contraception pills, commonly known as the morning-after pills, can help prevent many of these pregnancies. Better information availability would help with the issue. Unfortunately, The Hindu, one of India’s most read and respected English newspapers, published false and discouraging information that will only make the problem worse.

The article starts by stating that “experts point out that rampant abuse of morning-after pills (emergency contraception) by women has become a major reason for tubal defects (damage or infection to fallopian tubes), which in turn plays a big role in causing secondary infertility.” The article only cites one gynaecologist and no scientific studies or published research to back up the claim. It also gets the issue quite wrong.

Emergency contraception can refer to a few different drugs, but the one that is legally available in India, levonorgestrel, does not cause an abortion. Rather, it delays the ovaries from releasing an egg. If it works, by the time the egg is released, any sperm cells would have ceased to be active, and therefore no fertilization would ever place. Therefore this form of birth control does not work if taken after ovulation.

To be clear, there have been no published studies showing a link between emergency contraception and infertility, and quite a few that did not find such a link. The World Health Organization (WHO) states that repeated use of emergency contraception poses no health risks, although it may cause menstrual irregularities. Moreover, emergency contraception has nothing to do with the fallopian tubes getting infected.

The author of the Hindu article may have gotten confused by something else the gynaecologist said, which was, “Terminations of pregnancies…are known to cause infections leading to tubal defects.” That is factually true but such infections are also preventable by following proper medical procedures. While it may be that government or private hospitals are not doing enough to prevent infections, another issue is that some women who seek to medically terminate their pregnancies (have an abortion) go to unlicensed, illegal providers. The reasons for this vary and include cost, privacy and lack of trust. However, unlicensed illegal providers can also do a lot of harm.

The Hindu also publised several other statements or quotes which are completely incorrect. Here is a rundown:

  • Gynaecologist: “According to the rule book, even the doctor is not supposed to prescribe such pills.” In fact no prescription is needed, the pills may be sold without one.
  • Gynaecologist: “They have to make the patient take the pills in their presence.” There is no such requirement.
  • Gynaecologist: “Such pills are for emergency only, but these days, they have become the norm. Traditional contraceptive devices have been forgotten. This abuse plays a big role with women’s body.” While the WHO and other health authorities discourage the use of ECPs as the only form of contraception because of their higher rate of failure to prevent pregnancies and the disruptions to the menstrual cycle, no other long-term effects have been found.
  • The Hindu: “Many point out that there is no regulation” Emergency Contraception Pills are regulated by the Central Drugs Standard Control Organization and state drugs controllers.
  • The Hindu: “drug stores in Hyderabad indulge in sale of the pills over the counter.” Emergency Contraception Pills are even sold online, without a prescription, in India through e-commerce web sites.

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