Birth control accessibility questioned
Over-the-counter contraceptive unlikely; teen pregnancy rates high
Meagan Leonard
Northern News Services
Friday, April 10, 2015
SOMBA K'E/YELLOWKNIFE
Over-the-counter birth control is little more than a pipe dream for women in the Northwest Territories.
Making oral contraceptives available over the counter could lower rates of teen pregnancy according to a recent study, but those in the field say it is unlikely to happen in the territory. - Meagan Leonard/NNSL photo |
A recent study published in the Journal of Contraception suggested if low-cost oral contraceptives were made available over the counter, it would be possible to prevent a quarter of unplanned pregnancies. However, territorial pharmacists and health officials say this is an unlikely scenario here, despite staggering teen pregnancy statistics and limited sexual health resources.
In a 2012 study conducted by Candice Lys and Charlotte Reading, NWT's youth pregnancy rate was cited at nearly three times the Canadian average. Testing found that more than 100 out of 1,000 girls aged 15 to 19 became pregnant annually in the territory, compared to just less than 40 nationally.
Many participants revealed they often avoided community clinics because of confidentiality concerns or fear of judgment from peers and practitioners.
Caroline Johnson, executive director at the Centre for Northern Families attributes this phenomenon to the bigger issue of social stigma and lax sexual education - which she sees regularly in the
women's shelter.
"If we don't take the stigma away from seeing (sex) as a bad thing, then we will always have young women who are trying to hide it and not accessing support or information," she said, adding appointments for birth control prescriptions have traditionally been the easiest avenue to provide one-on-one counselling and ensure women are getting regular checkups.
"If the government does decide to make birth control over-the-counter, they need to make sure they have other ways to educate women and promote (them) to go in for regular checkups."
Because this stigma - particularly in the smaller communities - is so great, Johnson emphasized even if birth control were made available in drug stores, this would not necessarily be enough of an incentive for many women.
"I think the biggest challenge is educating youth," she explained. "Unplanned pregnancy isn't just about women making the wrong choice and having access to birth control, (there's) also violence within that, relationship violence and rape that forces women into these situations."
That being said, NWT does not have any independent sexual health centres, such as Planned Parenthood, so young women seeking help face long wait-times at the city's two clinics. When Yellowknifer called the Primary Care Centre, staff were unable to provide information on contraceptive options over the phone without an appointment and the earliest vacancy was three weeks away.
Placing pills on the shelves of the local pharmacy might seem like a no-brainer, but the nature of the product itself makes an easy transition problematic, said Range Lake MLA Daryl Dolynny.
Dolynny, a pharmacist and co-owner of the Yellowknife Shoppers Drug Mart, said because contraceptives are so individualized it would be difficult for the average person to choose the right medication on their own - especially since finding the right fit often requires a period of trial and error.
"Birth control is a very finicky product," he said. "You have to get the right (hormone) balance in order for it to work for that patient. So, going through a physician, I think, is a crucial step ... even after a period of time, the effectiveness of birth control tends to wane and sometimes prescriptions have to be switched."
He added having an over-the-counter contraceptive option is not a total impossibility, but he does not see it happening in the near future. He explained drugs crossing over that barrier do not do so overnight, but must go under an extensive period of testing.
"The safer a product is, the more suitable it becomes to be brought over the counter and usually it's a product that has a long history," Dolynny said. "We might see certain birth controls, with time, becoming over-the-counter and I'm not ruling that out, but it would have to be proven safe and effective."
GNWT Health and Social Services spokesperson Damien Healy told Yellowknifer the territory follows federal guidelines when it comes to contraceptives and no moves have been made to create an exception.
"Health Canada makes the decision as to what drugs require a prescription or may be sold over the counter," he stated in an e-mail, adding most residents receive coverage for such medications through their employer or government-funded health benefit plans.
Ultimately, Johnson argues more work needs to be done to alleviate the root causes of the problem. She points out that condoms are readily available, proving that just because something is provided, doesn't mean people will take advantage.
"It's a whole education process that has to happen within society that sees sexual health and sexual activity as a normal process, and stops the ugliness people associate with that," she said.
