Ask a lot of women in their 20s and 30s when they first took the morning-after pill, and it’ll be as distant a memory as losing their virginity.
“The first time I took the morning-after pill was the first time I had sex, at 16,” says Lauren, 30 and from south London. “I remember I put the empty pill packet in the bin in my bedroom after and my dog turned the bin over. My mum was clearing it up and found the empty packet and was so furious that a) I’d had sex and b) I hadn’t used protection. That didn’t put me off though, clearly, because I’ve taken it about 10 times since.”
Marianne, 25, from Yorkshire says much the same: “I used it from 15 to 17 a couple of times, when condoms split or I wasn’t certain that I’d used one properly... basically until I was brave enough to tell my parents I was having sex so I could go on the pill.” After that, she was on the contraceptive pill for a while but came off when she started dating girls as well as boys. She estimates that the number of times she’s had sex without any protection and taken the morning-after pill as a precaution is around 20.
For Faye, 24, from Sussex, the last time she took it was the sixth in 10 years. “I slept with the boy I was dating and we got carried away and had unprotected sex. That was about three months ago, and a rare one-off for me these days.” It’s never tricky to get hold of, she says: “I got it from an independent pharmacy near my house and I didn't pay because I specifically looked up where I could get it for free in my local area. The chemist looked at me disapprovingly but I just ignored him.”
Like Lauren, Marianne and Faye, I first took the morning-after pill when I was in my mid-teens and it’s been a recurring staple of my sex life ever since. I’m now 25. A quick survey of my female friends suggests most have taken it, and the statistics back this up: 61% of UK women are thought to have accessed emergency contraception – a higher rate than any country in the European Union, according to the Independent. Women are likely to use it more frequently in their 20s than at any other age.
There are no accurate, collated statistics of how much emergency contraception is taken each year from GP surgeries, pharmacies and Sexual Reproductive Health (SRH) services, but how often we access the morning-after pill or emergency coil in the UK does seem to be falling. From 2015-16, the women of Britain accessed emergency contraception from SRH services roughly 300,000 times. A decade earlier, between 2005 and 2006, the number was closer to 500,000.
Over the course of 10 years, then, our use of emergency contraception as accessed from specific sexual health centres has gone down 40%. This could be because we’re getting it elsewhere – it’s now available online, while pharmacies are increasingly popular places to pick up the morning-after pill, since it became available over-the-counter in 2001. But it could also be due to the rise of alternative measures such as LARCs – Long-Acting Reversible Contraceptives such as contraceptive injections, intrauterine devices (IUD) like the copper coil, and intrauterine systems (IUS) like the Mirena – as well as better awareness around safe sex.
For future generations, we may see usage of emergency contraception fall even further. As of this week, sex education has been made compulsory in UK schools, which may affect the number of emergencies women are having. Hopefully, it may also improve women’s understanding of emergency contraception and what it does – research from the Family Planning Association in 2014 found that the majority (59%) of 16-54-year-old UK women said they knew only “a little” about it.
Lauren admits minimal knowledge; “I know it’s a last resort. I don’t know anything about the health risks though,” she says. That’s despite the fact that she once took it four times in a week. “I had gone on a debauched ski trip with a group of newly single girls. We all ended up hooking up with people on the same night (I took the boot room) and the next morning sheepishly lined up at the one lodge pharmacy to get the morning-after pill. I carried on in that vein.”
Without googling, Faye said she couldn’t be totally sure how it works or what the risks are, either. “My guess would be that it prevents an egg from being released. And immediately starts a shedding of the womb so that if there is a fertilised egg it can't embed. But short answer, no, I don’t know,” she says. She also doesn’t know how often is too often to take it, but thinks “too many times could make you infertile.”
The lack of information about emergency contraception may be due to the persisting stigma of taking it; the FPA found that “one-third (39%) of [2,509] women surveyed thought asking for emergency contraception can be embarrassing.” This went up to more than half of 16-24-year-olds.
While our use of it may be falling, then, anecdotal evidence suggests we’re still relying on the morning-after pill or emergency coil well into our 20s and beyond, while failing to educate ourselves on what it is, what it does to us and what better, alternative options there might be. The morning-after pill, essentially, is shrouded in myth.
If, like me, Lauren, Marianne and Faye, you don’t know much about emergency contraception and you’re too embarrassed to ask (especially if you’ve already taken it more than 20 times over the last 10 years – oops), relax and scroll on for more information from the NHS, as well as advice from Karin O’Sullivan, clinical lead at the Family Planning Association.