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Two Niagara area women have requested that the Regional Health Unit stop local birth control clinics from giving “morning-after” pills to teenagers. They say that the pills are being dispensed illegally, that they are dangerous to health, and that the clinics are undermining parents’ rights in counseling and treating under-age teens without parental consent.
Gerarda Savoie of Niagara Falls and Angela Braun of St. Catharines told the Niagara health services committee recently that they became concerned when they discovered that public health nurses, visiting schools to discuss birth control, were telling teens that “morning-after” pills were available for “emergency treatment” after unprotected sexual intercourse.
The pill handed out in the Niagara region is Ovral, manufactured by Wyeth, approved for use as a birth control pill. On calling Wyeth, Mrs. Savoie found out that the company does not recommend its use as a “morning-after” pill. The spokesman said that there are risks involved, since anyone taking the pill as “emergency” treatment would be subjected to four times as much estrogen within a 72-hour period than she would have normally over a month. Also, there are “incidences” of fetal abnormalities caused by the pill, he said, and anyone who suspects she may still be pregnant would be well advised to take a pregnancy test immediately and consult her doctor, since “she may wish to consider an abortion.”
Mrs. Savoie contacted the regional health department and asked for its policy on handing out Ovral. She was told that it was written in “technical language” and not available to the public. She was given a “fact sheet” explaining how to take Ovral and the effects of the drug.
The fact sheet, says Mrs. Savoie, minimizes the dangers of the drug, referring to the possibility of “mild nausea” and possible vomiting (in which case more pills must be taken “to make up for the ones lost in vomiting). Complications are “not likely,” the sheet goes on, but explains that “danger signals” include “abdominal pain (severe), chest pain (severe) or shortness of breath, headaches (severe), eye problems such as blurred vision or loss of vision, severe leg pain.”
Women taking Ovral to “decrease the likelihood of becoming pregnant…(after)a single unprotected act of sexual intercourse” must sign a form stating that they are aware that “the possibility of a resulting pregnancy still exists despite administration of the medication…the possible effects of the drug on the fetus are not fully known.”
“There are extreme life-threatening side effects to the drug, Mrs. Savoie told the health services committee. She supplied committee members with the extract from the Compendium of Pharmaceuticals and Specialties which details all the side effects of oral contraceptives, which include blood clots, stroke, heart attack, tumors and cancer. The Compendium, she pointed out states, “this produce (Ovral) is not recommended for post-coital interception (“morning-after), even though the formulation has been advocated in clinical publications.”
Possible side effects
However, Dr. Anne Carter the regional acting medical officer of health, says the procedure is legal. Under guidelines from the Ontario Minister of Health, doctors can give a “standing order” for issuing the drug. At the clinics, women are told of “the possible side effects and results” and the pill is issued.
This procedure is supposed to cover women between 16 and 35, women outside this age category have to see a doctor. Although, Dr. Carter said that “if we refuse to treat someone simply on the basis of age, we can be found liable.”
Wyn Kalagian, manager of the area’s family planning programme, has been instructed to write a report on the use of Ovral for the next health services committee meeting. She say that clinic personnel “urge” teens to tell their parents if they are going to use the pill, but added that parents will not be notified unless the teen gives permission.
Mrs. Braun and Ms. Savoie have asked that the policy of the health unit regarding Ovral be made available to anyone who requests it. They further ask that birth control clinics discontinue using Ovral as a “morning-after” pill on the grounds that it is dangerous and illegal. They also ask that the clinic’s role in the community to be re-evaluated. “It is our belief that they must be seen to reinforce the family unit as a source of communication,” they say. “They must not work in opposition to the family, or present themselves as an alternative. This portrays the family as uncaring, untrustworthy, disinterested in their child’s health.”
If the health services committee does not respond to their concerns, the two women say that they will file a complaint with the College of Physicians and Surgeon, on the grounds that the regional health unit is practicing medicine without a license.