Sexual and reproductive health, particularly topics such as family planning, emergency contraception (ECP), and women’s rights, are often considered taboo in many Pacific Islands countries and beyond. However, these discussions are of high importance. Raising awareness will ensure women understand and advocate for their rights, make informed decisions, and access safer options for their health.
As a pharmacy student, I am sharing this information to guide us towards better health and pass information to women to better understand contraception and emergency contraception pills (ECPs).
Disclaimer: FOR ANY FURTHER MEDICAL INFORMATION, PLEASE CONTACT AN AUTHORIZED MEDICAL PRACTITIONER OR REGISTERED PHARMACIST.
IMPORTANCE OF FAMILY PLANNING
Making wise decisions about family planning and contraception promotes healthier families and healthier living, and planning prevents many unwanted pregnancies. Having a better understanding of such topics also promotes women’s rights and protects young teenage girls from early pregnancies.
Recent media reports in Fiji revealed 489 teen pregnancies in just six months, including eight cases involving girls under fifteen years of age. As puberty begins, hormonal changes may encourage experimentation, sometimes leading to unwanted situations such as unplanned pregnancies. Discussions with Pacific Island friends highlight that knowledge of sexual and reproductive health is often very limited, and little support is available for teenagers facing such circumstances ( https://www.fbcnews.com.fj/news/health/teen-pregnancies-hit-489-in-six-months/?fbclid=IwY2xjawM8TyFleHRuA2FlbQIxMABicmlkETFCOFluamM0WGNDWVVyUXpYAR5yxlYrPZmCJOoz8zPz2BzNXZ4n5krln34r723qDM6ih3KcUcs7Hk9jDJKgQw_aem_MNRL5AKBq5JZmUtP3wVgZg ).
By increasing awareness and educating children early, many unwanted circumstances can be prevented, school dropout rates can be reduced, and national economies may benefit.
Breaking the Taboo Around ECP
One common misconception is that ECPs are abortion pills. This is not true. ECPs are not designed to terminate an existing pregnancy — rather, they are meant to prevent pregnancy before it happens.
They are used in emergencies, such as:
• Contraception failure (e.g., condom breakage)
• Missed contraceptive pills or late injections
• Unprotected intercourse
• Cases of sexual assault
In such cases, women have the right to access ECPs.
Different countries regulate access differently. For example, in Fiji, any person over 18 years old can access ECPs, while those under 18 require a doctor’s referral or parental consent.
Is this appropriate? In my view, every woman should have access to ECPs, provided she understands how they work, their side effects, and when not to use them.
How ECPs work
ECPs contain levonorgestrel, a synthetic form of the naturally occurring hormone progesterone. They are usually available as either:
- A single 1.5 mg tablet, or
- Two 0.75 mg tablets, taken together or 12 hours apart.
Efficacy is highest when taken as soon as possible after unprotected intercourse, ideally within 72 hours. The effectiveness decreases with time. After 5 days, other methods may be considered, which require a doctor’s prescription.
What to Expect After Taking ECP
- Nausea or vomiting may occur. If vomiting or diarrhoea happens within 2 hours of taking the pill, another dose is required.
- Your next period may come slightly earlier or later, and the flow may be heavier or lighter. If your period is more than one week late, do a pregnancy test.
- Other possible side effects: breast tenderness, headache, dizziness, fatigue, abdominal pain, and diarrhoea.
- If you are already on regular combined oral contraceptive pills (e.g., Microgynon 30 ED), you may resume them 12 hours after taking the ECP.
When Not to Take an ECP
- Allergy to levonorgestrel
- Current breast cancer
- Unexplained vaginal bleeding
- Already pregnant
Common Misconceptions
- One pill = long-term protection? No. ECPs only protect against the act of unprotected intercourse that occurred within the last 72 hours. They do not protect against future acts.
- Frequent use is safe – While occasional repeated use is not harmful, ECPs are not meant for regular contraception. Repeated use may increase the risk of ectopic pregnancy. In addition, a regular contraception method would be more effective than frequently using ECPs.
If you find yourself requiring ECPs often, consult a doctor for advice on regular contraceptive methods better suited for long-term protection.
Access to ECPs in Fiji
If cost is a concern, organizations such as OXFAM and Medical Services Pacific (MSP) provide free services and even distribute free ECPs during working hours. Pharmacists can also provide counselling while ensuring the matter is discussed in a more private space and confidentiality is maintained. They will ensure every individual is treated without judgment or embarrassment about anything.
The Bigger Picture: Beyond Pregnancy Protection
Neither ECPs nor regular contraceptives protect against sexually transmitted infections (STIs). Condoms remain the only effective method that prevents both unwanted pregnancies and STIs.
Although some people may feel embarrassed to purchase condoms, pharmacists maintain confidentiality. You can discuss your concerns freely, and pharmacists are trained to guide you respectfully and without judgment.
Conclusion
In a nutshell, talking about sexual and reproductive health should not be taboo. It is not only about family planning but also about protecting women’s health and rights in a world where crimes such as sexual assault are still far too common.
Awareness, education, and access to safe contraception empower women, reduce teenage pregnancies, prevent school dropouts, and contribute to healthier communities and stronger economies.
