Since January 12 emergency contraception has been available over the counter from pharmacies across the country. The controversial decision caused a stir in the medical world and although it was considered to be an “exciting” development in Ireland, questions continue to arise as to whether the new over-the-counter policy maintains the same level of privacy and care that a patient can be ensured at the medical centre or family planning clinic.
It was one of the UK’s most popular chemists; Boots that initially began supplying the drug under what were called “patient group directions” in January. However, the chain was told by the Irish Medicines Board (IMB) that it was breaking the law by making the morning-after pill available without prescription under the protocol drawn up by its medical director. However, after much consideration the IMB gave pharmacies across Ireland the go-ahead to sell the French – made contraceptive pill NorLevo without prescription. There are only two emergency contraceptive pills available to Irish women, NorLevo and Levonelle, which is manufactured in Germany. Levonelle can be obtained with a prescription from the doctor.
Emergency contraception (EC) has been available in Ireland since 2001 and is recommended by doctors only as an occasional method. According to the Medicines Information Online (MIO) it should in no instance replace a regular contraceptive method. The NorLevo drug which is currently being sold over the counter is 95% effective if taken within the first 24 hours. This drops to 85% between 25 and 48 hours and 58% if taken between 49 and 72 hours. Efficiency after 72 hours is unknown.
Medical expert working at the clinic in Dublin Institute of Technolgy, Dr. Brendan Clune said that “the emergency contraceptive is not 100% reliable; people should know that, women assume that they can be sexually active and that emergency contraceptives are going to protect them automatically.” He added that contraception is as effective as the time of the month when the accident takes place, “so if the emergency contraceptive is taken whilst you’re ovulating the effectiveness rate is a lot less than if you were at the end of your cycle or at the beginning,” he said. He added that every year, one person within the student population falls pregnant despite taking the morning after pill. When asked about the dangers of taking the morning after pill more than once he replied, “you can take it more than once but every time a person goes on the regular pill, the risk of blood clotting increases, it is the same with EC, recent studies show that a person who takes EC is at a higher risk of blood clotting then someone who is staying on the pill for a regular amount of time.” In a chemist there is no way for the pharmacist to keep a record. They must rely on the trust between themselves and the patient. Chain-store Boots assured that “healthcare is based on trust. Usage of contraception, including emergency contraception, will be discussed as part of the consultation to ensure that the patient gets the best service and outcome possible.”
As with all medicine there are side effects and dangers to consider when taking the morning – after pill. If someone has a history of blood clotting or thrombolis they cannot have the MAP as it will make it worse. According to the Irish Pharmaceutical Society of Ireland, the drug sold over the counter should not be supplied to patients with the rare hereditary problems of galactose intolerance, the Lapp lactase deficiency or glucose-galactose malabsorption. The pharmacy regulator also states that Norlevo is not recommended for patients with a history of infection of the fallopian tubes (salpingitis), ectopic pregnancy or severe hepatic dysfunction.
A short survey was carried out amongst eleven Irish women aged between 20 and 30. They were asked whether they thought selling emergency contraception over the counter was a good idea. Out of the total asked, 60 per cent agreed that yes, it is a good idea, the other 40 per cent of the women disagreed. When asked why, the reasons varied.
Eleanor, aged 22 said; “The previous method of obtaining the morning after pill was more stressful and in some cases (relating to unhelpful/judgemental doctors) embarrassing and demeaning to women who had the need for it.”
“I think girls would be careless with contraception knowing that they can just take the ‘quick fix’ the next morning,” said Carmel, 20 years old.
“I think it’s a good idea because let’s face it as long as unplanned pregnancy is prevented who cares how and where the contraception is provided. Also this makes it readily available to everyone as it would be less costly,” stated Aisling, 26 years old.
The survey proved that there is an alarming sense of uncertainty about the selling of the MAP over the counter. Some women felt that going to the medical centre or family planning centre would be safer than buying the pill at the chemist. The majority of women asked said that they would prefer the doctor because of privacy.
“The pharmacist seems like the easier option, but I would probably go to the doctor to be safer,” said Michelle who has never had the morning – after pill.
Sharon, aged 29 said, “I’d rather go to the doctor as I would be able to talk about it with them in a more private place. Boots and other pharmacies are very public places and I would feel a bit embarrassed if there were many other customers about as they told me about it. In saying this, I probably would have chosen to get it in a pharmacy if I needed it a few years ago as when I was younger, I would have been less comfortable to visit the doctor on my own for this sort of thing.”
“If I was going to take it I would go to a doctor it is much more confidential and the medical advice would probably be better., admitted 24 year old Niamh.
However, there was a general viewpoint that although the pharmacist might be more “impersonal” than a doctor, this could be a good thing.
One woman who received the pill over the counter said the entire consultation took place “over the counter.” I felt “very awkward.”
The Pharmaceutical Society of Ireland (PSI) introduced an interim guidance on safe supply to patients of the NorLevo drug. The PSI states that “consultations between the pharmacist and the patient should take place in the pharmacy’s patient consultation area and due consideration must be given to the patient’s right to privacy and confidentiality.” The society outlines that a pharmacist must ask the patient about medical history and background.
As she gears up for the re-release of Paul Howard’s latest on-stage instalment of Ross O’Carroll Kelly, ‘Breaking Dad’, Lisa Lambe admits that she would jump at the chance of sitcom, based around the fictional Dublin 4 character.
Having written 16 novels, and three plays, being linked with the small screen is inevitable for Howard, and Lambe, who plays Ross’s wife, Sorcha, is sure that the show could be an on-screen success.
“I would love to be involved in a TV show, if it were to happen. I’m sure the whole cast from ‘Breaking Dad’ would,” says Lambe.
The stage-actor, who was also involved in the previous play ‘Between Foxrock and a hard place’, is delighted to have the opportunity to take to the stage as Sorcha again, although is worried at what the character would make of her native roots.
“I’m a Northsider,” Lambe confesses. “My parents are from Fairview, and I grew up in Clontarf, so I’m not sure if Sorcha would approve. I hope she doesn’t mind.”
In the previous plays, Sorcha is portrayed as a desperate housewife, worried about what her husband has been up to and who he has been sleeping with, but, it’s a lot different this time around, insists Lambe, with Sorcha setting the wheels in motion to become the next female president of Ireland.
“For once, Sorcha has no time for her marriage and she’s totally career driven, so she’s a lot different to other plays, where she was previously worried about Ross (Rory Nolan) being with this girl and that girl, whereas now she feels like the Hilary Clinton or Mary Robinson of her time,” explains Lambe.
“It’s great fun to play, because it’s the complete opposite of how I am in real life, and in this play in particular, people who know Sorcha well, will see a different woman. Sorcha has her eyes set on the president’s role and she’s also a human rights lawyer, so she’s all high shoes and power suits, it’s brilliant,” says Lambe.
With the play set in the future, and Ross and Sorcha in their mid-forties, the couple’s 18 year old daughter brings home a boyfriend from Wesley, and Ross gets a taste of his own medicine, according to Lambe.
“Their daughter brings home a boy, and Ross cannot stand him, because they’re exactly alike. Ross sees himself in him and can’t handle it,” says Lambe.
Rehearsal time is up as they returned to the stage, in Cork’s Opera House on Monday, where they will perform for a week, before a February 16 return to the Gaiety Theatre for a two week stint. However, that’s not the only thing that’s keeping Lambe occupied.
After three years in the immensely successful group, Celtic Woman, Lambe launched her first solo album, ‘Hiding Away’ in the Sugar Club on Thursday, and admits it was strange working on her own.
“It was different doing a solo album, but it’s something I always wanted to do. Although, I thought that I would do it over here in Ireland, around people that I knew and worked with, so I kind of surprised myself, when I went to record it in Nashville. I ended up working with the most amazing people. People who had won loads of Grammy awards. It was an incredible 10 days,” says Lambe.
The former Celtic Woman singer, is set for a solo tour in March, with Whelan’s the first port of call, on March 4, and with it being a totally acoustic album, she feels intimate settings such as the Wexford Street venue, are best suited to her style.
“It’s a very intimate album, so it suits an intimate setting. I can’t wait to do Whelan’s, it’s a place I’ve grown up with, seeing so many great Irish artists perform there in the past, the likes of Mary Coughlan. It’s just great to be able to tell my family that I’m playing there, because they all know it so well,” explains Lambe.
The affection held by the likes of Lambe and Ed Sheeran for Whelans in recent weeks indicates there’s certainly something very special about the venue, given the worldwide the other worldwide stages both have performed on.
“I played Radio City and it was amazing and Red Rocks in Colorado, where U2 made Under the Blood Red Sky. It’s a natural amphitheatre, really, really high up and we had some oxegen beside the stage in case we (Celtic Woman) got light headed,” which happened to each member at one stage, admits Lambe.
The singer also launched her new video ‘Heaven’ from the new album, and has dedicated it to the charity ALONE, which cares for the older community, with all proceeds from sales on iTunes going to the organisation.
Photo: Anthony Woods/lisalambe.ie