Contraception will prevent unwanted pregnancy and thus reduce the morbidity and
mortality related to unsafe abortion. This will improve the reproductive health
of women. Hence Emergency Contraception can play an important role in National
Family Welfare programme of India. But for this, strategies need to be formulated
keeping in mind the ethical aspects.
is unethical that emergency contraception service is not always accessible to
women who need it. The important ethical issues are :
Service-providers may be unware of Emergency Contraception due to lack of training.
Existence of such contraception after unprotected coitus
is not always known to public.
There are dilemmas
about the different modalities. Yuzpe method is available and cheap whereas, levonorgestrel
which is more effective than Yuzpe method, is not available in India. So, there
is an ethical dilemma: which product is to be used? Should we wait till we get
levonorgestrel which is a little more effective, or should we compromise?
It is sad that misconception about EC prevails among both
service-providers and clients. Women may have reservations using EC, thinking
that the product is an abortifacient.
Contraceptives are for emergency situations. Repeated use of EC instead of regular
contraception for birth control may result in adverse health problems.
Client is upset if there is pregnancy even after emergency
contraception. This demands ethical consideration and pre-counselling.
Main ethical issues are related to regulation and monitoring
of Emergency Contraception.
to resolve some of the ethical dilemmas:
Assessment of client needs.
Training of service
providers : Information should include indications of EC, recommended dosage,
mode of action, efficacy, side-effects, precautions.
Friendly and co-operative attitude of providers caring for clients privacy and
During counselling, it must be stressed
- it is not an abortifacient.
- it is not an alternative to regular contraception.
- it is effective for that particular coitus only.
- it does not protect from HIV/AIDS/STI.
are some side-effects such as nausea, vomiting, abdominal pain, breast tenderness,
irregular vaginal bleeding.
- failure rate is
about 2%. If the period is delayed, she should see the service-provider for possible
Emergency Contraception is an essential armament in family welfare programs in
special circumstances. But ethical issues are to be given due consideration and
all measures taken for proper introduction of Emergency Contraception.
Role of counselling is immense, because counselling can
help the woman resolve her conflict and dilemmas, as well as advice about regular