By Marie-Amélie Trilliard
Dr. Angel M. Foster, PhD, Echo’s Endowed Chair in Women’s Health Research and associate professor in the Faculty of Health Sciences, has co-edited a new book, Emergency Contraception: The Story of a Global Reproductive Health Technology, published by Palgrave Macmillan. Emergency contraception (EC) can be defined as medication or devices that are used after sex to prevent pregnancy. Globally, the most widely used emergency contraceptive is the progestin-only pill. These emergency contraceptive pills (ECPs) have different brand names in different countries; in North America the best known ECP is Plan B.
Emergency Contraception is composed of sections written by different authors, examining emergency contraceptives in various countries. Many of the authors had been working on their research individually before the project started; overall, it took two years for research to be compiled for the book.
Dr. Foster authored one of the country-specific chapters of Emergency Contraception, entitled “Tunisia: A Global Leader in Reproductive Health and Rights.” The chapter focuses on the introduction of ECPs in Tunisia, which in 2001 became the first country in the Arab world to register a dedicated EC product. Dr. Foster explains that Tunisia can be considered a global leader because there is little opposition to EC, and the regulatory change of ECPs from a prescription to a non-prescription medication took place “seamlessly.”
Dr. Foster shows why these changes took place easily. Firstly, emergency contraceptives were introduced in Tunisia as an option for all women, not only rape victims as has been the case in other countries. Secondly, with regard to the medically incorrect common misconception that ECPs are a form of abortion, abortion has been legal in Tunisia since 1973 and Tunisia has very little abortion related politics; thus, controversy over the mechanism of action of ECPs has not been a factor. Finally, when ECPs were introduced as a behind the counter medication (meaning that the medication could be obtained directly from pharmacies without a prescription), different health care providers—nurses, doctors, and pharmacists—were all in agreement with the decision.
As for availability, if purchased directly from a pharmacy, ECPs in Tunisia cost approximately $9 USD, but they can also be obtained at a lower cost or for free from family planning clinics and emergency rooms.
Dr. Foster is currently continuing her research.