The Telegraph
Since 1st March, 1999
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Ruptured condom' Back-up’s here
- Over-the-counter emergency contraceptive soon

New Delhi, Sept. 2: A drug that prevents the embryo from implanting itself in the womb if taken within 48 hours after unprotected sex will soon be available in India as an over-the-counter (OTC) emergency contraception.

Following discussions with medical experts, the health ministry has decided to notify the oral contraceptive containing a drug called levonorgestrel as an OTC product, a senior health official said today.

Gynaecologists have welcomed the decision, saying the product would increase options available to women and provide a “back-up” in situations where a condom has ruptured or when a woman is not on conventional daily oral contraceptives. But some experts have also cautioned that couples might need to be educated to prevent them from abusing emergency contraception.

“By the time sexually active women who’ve had unprotected sex during ovulation get a prescription, they might have crossed the 48-hour limit,” said Dr Duru Shah, president-elect of the Federation of Obstetric and Gynaecological Societies of India (Fogsi). “A woman who’s become pregnant would then need an abortion.”

The emergency contraception needs to be taken ideally within 24 hours and at the most 72 hours after unprotected sex but, doctors said, it should not be used as a regular means of preventing pregnancy.

The emergency contraception works by preventing the blastocyte ' the earliest stage of the developing embryo ' from implanting itself on the wall of the uterus.

“There’s a risk that this might get abused. Even educated girls might take it out of pure fright of pregnancy,” said Dr Sonia Malik, a gynaecologist and member of Fogsi’s family welfare committee.

“This should not be seen as an easy alternative to daily oral pills,” Malik said. Traditional contraception methods such as condoms and oral pills are far more reliable.

Doctors say unprotected sex is common in India and leads to unplanned or unwanted pregnancies and a few million abortions each year. Until now, doctors used to prescribe high doses of conventional oral pills to prevent pregnancy after unprotected sex.

“But these high doses could only be taken on prescription,” said Dr Urvashi Jha, a gynaecologist in New Delhi. “High doses of the oral pills carried a small risk of deep vein thrombosis which was something to worry about,” Jha said.

A recent study of 400 college-going students in Mumbai indicated that about 100 were sexually active, but 80 per cent of them did not even think about contraception during the first six months of sexually active life, the Fogsi president said.

Some doctors have also cautioned that widespread publicity for emergency contraception might lead to abuse of the product in India, a largely male-dominated society where women are exploring sexual freedom.

“Men will hold emergency contraception as a green signal to have sex in a male-dominated society,” an expert had warned in a debate four years ago on the ethics of wide publicity for emergency contraception in India.

“In situations where girls or women refuse sex, male partners could pressure them saying emergency contraception is easily available,” the expert from the Institute for Research in Reproduction, Mumbai, had said.

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