I’ve purchased the emergency contraceptive pill twice in my life.
The first time, it was a straightforward process: the pharmacist asked me to fill in a form, explained how the medication worked, and handed me the tablet in a blister pack. She was helpful, approachable, and if she was judging me… she didn’t let it show.
The second time was different. I would have been 20 at the time. With my then-boyfriend by my side, I approached the counter and made my request. The response was polite, yet a punch in the gut: “Our pharmacist doesn’t sell that due to his religious beliefs. You’ll have to try another pharmacy down the road.”
I’ll never forget how I felt in that moment. It was a hot cocktail of indignation, rage and I’m sad to say, a little bit of shame – despite the fact I’d been raised and educated to believe contraception, and access to it, is a human right. I was too stunned to even speak, so we quickly retreated and set out to find a more accommodating business. Thankfully this was possible – although I live in a country town, there are several pharmacies in the area.
Although it worked out okay for me, I’ve often wondered how a woman who was younger, or more vulnerable, or who didn’t have the same emotional support that I did might have reacted. Would that pharmacist’s words have scared or shamed her enough to prevent her from seeking the pill elsewhere? What if this was someone living in an even more remote area of the country, where an alternative pharmacy may have been an hours’ drive away or inaccessible within the time frame emergency contraception needs to be taken in?
Just imagine how serious, even devastating, the consequences could be. WATCH: 5 things you need to know about PCOS. (Post continues after video.)
Although it was a first for me, this is far from an isolated incident.
Last year, Soul Pattinson pharmacies cut ties with an Albury pharmacist after discovering he’d been slipping notes into oral contraceptive packets for 12 years, stating he accepted the teachings of the Catholic Church and was opposed to artificial contraception. He also refused to stock the morning after pill and condoms.
What you may not not realise is that pharmacists are well within their rights to do so. Under section 2.4 of the Pharmacy Board of Australia (PBA)’s Code of Conduct – which sets the professional standards all registered pharmacists must adhere to – practitioners have the right to not provide or “participate directly” in treatments they conscientiously object to. This principle applies to any medication, not just contraceptives, and is also common across all 14 regulated health professions in the National Scheme.
However, the Code also stipulates that care and access still needs to be considered for the customer in spite of this, meaning that a pharmacist would be required to inform the customer of an alternative option or source (eg. pointing them to another pharmacy). According to Nicole Newton, spokesperson for the PBA, the body has not come under pressure from the industry or external sources to change this aspect of the Code since it was put in place in 2010.
In fact, in a recent study of morning after pill recommendations in Australia, 22% of the pharmacists surveyed said they felt it was reasonable for their religious faith to influence supply of emergency contraception.
Not everybody agrees with this, however.
“In an ideal world, all pharmacies would provide emergency contraception,” says Dr Deborah Bateson, Medical Director of Family Planning NSW. “We certainly don’t want women to be put in a difficult situation where they’re turned away, as it were … I’m sure it can make them feel quite challenged. We want women to feel confident about going into their nearest pharmacy to access emergency contraception.”
Dr Bateson says it doesn't help that emergency contraception is surrounded by misconception and misinformation - in particular, the idea that the pill works by inducing abortion.
"We know from World Health Organisation (WHO) documents, as well as all the evidence, that shows it works by delaying or preventing ovulation ... It's not what we call an abortifacient," she explains. "It's a very, very safe medication indeed."
Perhaps there's a case for making this medication available in other locations - for instance, some countries including the UK have trialled selling emergency contraception in supermarkets. At least, Dr Bateson says, pharmacies where emergency contraception isn't sold due to personal beliefs should make this clear so women can go elsewhere.
"We want women to have easy access to emergency contraception to prevent unintended pregnancies. We certainly want to remove any stigma and make it as straightforward as possible for them."
Women already encounter so much stigma and judgement when it comes to their bodies and their sexual health and behaviour. While I believe pharmacists - indeed, anybody - are entitled to their own religious and ethical beliefs, should they be allowed to influence the availability of treatments and medications that could be potentially life-changing for any woman?
Surely a pharmacist's role in the community is to prove access to legal medication when someone needs it. When it comes to sex, accidents can happen anywhere, to anybody. Condoms can break. The contraceptive pill can be missed. It's essential that emergency contraception be easily accessible in a way that doesn't make women, or their partners, feel attacked or judged.
What do you think?