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Government must ensure that contraception policy does not steer women towards less reliable methods

By 11 July 2019News

The Irish Family Planning Association (IFPA) has warned against any contraception policy that steers women towards less reliable methods and away from the long-acting reversible contraceptives that are most effective at preventing unintended pregnancy. Welcoming government proposals to remove cost as a barrier to access to contraception, the IFPA emphasised that any proposed reforms must include all forms of contraception.

Speaking at a briefing for TDs and senators convened by the All-Party Oireachtas Interest Group on Sexual and Reproductive Health and Rights, IFPA medical director Dr Caitriona Henchion said: “If only a limited range of methods, such as the condom and pill only, are provided without cost, many women’s choices will be limited to those methods. But it’s essential that that State fund a wide variety of contraceptive options. Each woman’s medical history and risk factors are unique, so not every contraceptive will work for everyone and the same contraception won’t suit every woman throughout her life course.”

The meeting heard that long-acting reversible contraceptives (LARCs)—which include implants, patches, intrauterine devices, such as copper coils, and hormonal intrauterine systems, such as Mirena, are the most effective methods for preventing unintended pregnancy. They are also more cost-effective in the long-term than short-acting methods; what makes LARCs unaffordable for some women is the upfront cost.

Dr Henchion added: “Not all women will choose a long-acting reversible method of contraception. But all women should have the choice and that choice should not be curtailed by her income, her age, where she lives, her ability to speak English, or what school she attended.”

Director of Women’s Health of the Irish College of General Practitioners, Dr Mary Short, who is also President of the European Society of Contraception and Reproductive Health, told the meeting that cost was not the only barrier individuals face when trying to access contraception. She said: “We see regional disparities in the quality and availability of services, and people contend with stigma and lack of confidentiality. Any proposals to improve access to contraception should be designed to fulfil the essential elements of the right to health: availability, accessibility, acceptability and quality.”

A working group established in the Department of Health to examine access to contraception is looking at how best to implement the recommendation of the Joint Oireachtas Committee on the Eighth Amendment, which called for “the introduction of a scheme for the provision of the most effective method of contraception, free of charge and having regard to personal circumstances, to all people who wish to avail of them within the State.”

Consultant gynaecologist and Chair of the Institute of Obstetricians and Gynaecologists, Dr Cliona Murphy spoke about the importance of integrating contraception provision with the new abortion care service. “Both the Citizens’ Assembly and the Joint Oireachtas Committee on the Eighth Amendment understood the importance of a holistic approach to unintended pregnancy,” she said. “They recommended reforms to contraception and sexuality education, but this is not reflected in State policy.”

The IFPA’s key recommendations include removing cost as a barrier to accessing all forms of contraception, and revising the relationships and sexuality education curriculum to ensure young people receive accurate, evidence-based information about contraception and how to access sexual and reproductive health services.