In August 2020, a youth from Pollachi, near Coimbatore, emailed me in a panic: “I am searching for the pills in all the medical shops from morning... I got another 48 hours to stop this unwanted pregnancy for me and my girlfriend! Its our rights and I don’t know why this unofficial Ban. I lost my piece of mind when I found that I am not getting this tablet from any medical shop around me (sic).”
The medicine for which he was frantically searching is the Emergency Contraceptive Pill (ECP). I receive desperate messages like this daily on email and social media from across Tamil Nadu. The ECP has to be taken orally within 72 hours of unprotected sex to avoid pregnancy. The WHO says emergency contraception (EC) can prevent up to over 95% of pregnancies when taken within five days of intercourse. Levonorgestrel, the drug used in ECPs, is on the National List of Essential Medicines to be stocked at all levels of the health system. Yet, in TN’s pharmacies, ECPs are almost impossible to find.
It might be easy to dismiss this as an urban or niche problem. However, my inboxes tell a different tale. For a few years now, a few activists and I have sourced ECPs from online portals or other States, to give them to anyone in TN in need. It is the countrywide lockdown in 2020 that taught us how desperate the situation could be and how diverse the people in need of the pills. By mid-2020, we had all run out of stock. With so many people still reaching out for the ECPs, we somehow managed to we source a few dozen pills from Bengaluru. Once I shared on social media that I had stock, at least 70 people approached me in a matter of a couple of months, amid lockdown restrictions, needing the pills and stopping by my house to pick them up. By ‘pick up’ I mean they would come home, stay for a chat, have questions answered, and share their harrowing experience of searching for ECPs.
What I learned is that more people are sexually active than we, as a society, would like to acknowledge. I found that access to the internet may help someone reach out to a stranger but does not mean that they will able to access the right information.
I realised that taking the shame out of sex might take the stigma out of seeking contraception — even married, middle-aged couples with children are stigmatised for seeking contraception, especially emergency contraception, as it implies they are sexually active but not for the purpose of procreation. In November 2020, I filed a representation with different TN government authorities seeking clarification on the unavailability of ECPs. The zonal drug inspector promptly called on me at my home. He reiterated that ECPs are not banned in TN, should be sold over the counter, and then urged me to ‘close the ticket’.
Nearly two years later, I am still waiting for an official notice from the Drugs Control department to all pharmacies to put the assurance in writing. Meanwhile, pharmacists unclear about whether ECPs are legal, and can be given without prescription fail to stock them. Strangely, oral abortion pills are far easier to source on the drug black market in TN than ECPs.
Without an official clarification from the State, ECPs will remain scarce on the ground. Contraception is a right and access to contraceptives is imperative for women to maintain bodily autonomy. Without control over reproduction, a woman cannot be truly free. It is time for the State government to ignore any possible moral backlash and promote access to contraceptives, including ECPs, as a matter of public health. A Dravidian model government is best placed to realise this and fulfill this Periyarist dream.
Unwanted pregnancies
The ECP has to be taken orally within 72 hours of unprotected sex to avoid pregnancy. The WHO says emergency contraception (EC) can prevent up to over 95% of pregnancies when taken within five days of intercourse
Archanaa Seker is a Chennai-based writer, researcher and rights activist
Footnote is a weekly column that discusses the world from Tamil Nadu’s perspective