A women’s community is calling for more sensitivity and clear direction for those who want to buy the morning-after pill from pharmacies that choose to stock the emergency contraception. 

Almost three years have passed since the pill became available over the counter in some pharmacies in Malta. 

Yet, women are still facing issues when asking for the pill, with some feeling “shamed” and “judged” for asking for something that is their legal choice. Many vented their frustrations online in the 30,000-strong Facebook community Women for Women. 

Some spoke about the lack of sensitivity they felt when pharmacists asked personal questions in front of other customers. 

One woman questioned why she was asked for her ID details and had to reveal her identity in such a sensitive situation.

In light of this, Women for Women founder Francesca Fenech Conti wrote an open letter to the Chamber of Pharmacists asking for a clear procedure to be outlined.

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She said it would be very helpful if the public was made aware by the Chamber of Pharmacists of the correct procedure at law to dispense the over- the-counter medication.

Ms Fenech Conti went on to talk about the inconsistent way in which different pharmacists went about dispensing the medication and the type of questions they asked women.

“Should you insist on asking questions, these should be standardised for all pharmacies and they should be publicly announced to ensure no abusive or embarrassing questions are asked to people wanting to buy this pill and people should be taken aside to a private area while being asked these private and, for some people, very embarrassing questions,” she wrote.

When contacted and asked about the procedure, Chamber of Pharmacists president Mary Ann Sant Fournier told Times of Malta that the morning-after pill was dispensed in line with the relevant summary of product characteristics and patient information leaflet of products available together with guidelines and dispensing form issued by the chamber to its members. 

When Times of Malta asked the chamber for a copy of the guidelines issued to pharmacists, Ms Sant Fournier replied: “The Chamber as the national professional organisation reserves the right to maintain in confidence the professional tools issued to its members.

Should you insist on asking questions, these should be standardised for all pharmacies

“The raison d’être of the dispensing by pharmacists of the emergency contraceptive pill has been publicly and exhaustively explained.” 

She urged the public to approach the Pharmacy Council and the chamber with documented facts should they feel the need of redress. 

No questions asked? 

Ms Sant Fournier explained that the pharmacist is always obliged to ask questions when dispensing any medicinal product, even if it is classified as a non-prescription item. 

“In this case, the ECP must be dispensed by a pharmacist after consultation with the patient,” she said. 

“The minimum questions according to the dispensing form are to be asked in the best interest of the patient. Pharmacists are aware and advised to ensure discretion and confidentiality in engaging with their patients at all times.”

But what are the minimum questions? 

This is where it gets vague and where knowing what guidelines the pharmacists are following could help.

 As for requesting ID details, she said this could be necessary for a patient’s safety and for professional indemnity reasons.

Badge outside pharmacies?

The introduction of the morning-after pill in December 2016 had stirred up controversy with some pharmacists refusing to dispense it for moral reasons – since they deemed it to be abortive. 

As a result, only pharmacies that wanted to stock it started selling it. 

While a list of the pharmacies that stock the morning-after pill can be found online, women sometimes turn up at a pharmacy that does not stock it and ask what, to some, is a difficult and embarrassing question. While most are respectfully directed to a pharmacy that stocks it, others are not.

In the letter, Women for Women suggested having a sticker or badge affixed to the doors of those pharmacies that sold the pill to avoid embarrassing situations.

Replying to this, the chamber said: “This goes against pharmacy ethics. Pharmaceutical services must not be promoted or advertised in such a way as to draw direct or indirect comparison with other service providers or discredit others. 

“Also, this is tantamount to advertising of a medicinal product which is illegal and unethical.”

Still waiting for clear replies

Contacted for a reaction to the chamber’s replies to the points raised in her letter, Ms Fenech Conti said she still had not received direct answers from the chamber. 

“In my opinion, answers still remain vague and may not always protect a patient’s right to privacy besides also leaving scope for the current issues to persist,” she said.

She urged the public to write directly to the chamber with any problems encountered and to continue to share their stories anonymously and in confidence by private messaging me on Facebook or by sending an e-mail to womenforwomenmalta@gmail.com.”

Who can buy the morning-after pill?

Asked who could buy the pill and how many pills could be purchased at any one time, Chamber of Pharmacists president Mary Ann Sant Fournier said: “The Emergency Contraceptive Pill is dispensed by a pharmacist without a prescription to females above the age of 16 and on a doctor’s prescription for females under 16 years of age.” 

“It was not recommended to dispense more than one pill unless the patient vomited within three hours of taking it,” she said, adding: “Other safer alternative contraception methods (monthly hormonal contraception) exist”.

Dispensing to men was not recommended since this could be abused of by some men, imposing their will against a woman’s choice, she said.