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Column: Ireland's reproductive revolution – are women now in control?

Irish women have been actively demanding the freedom to choose when or if they become pregnant for over 40 years; a great deal has changed regarding contraception, but have we come far enough? asks Fiona Dunkin.

Fiona Dunkin

ON 22nd MAY1971, a band of 47 women marched brazenly and triumphantly into
Connolly station in Dublin, armed with various assortments of condoms, spermicides, jelly
and what appeared to be contraceptive pills (since few in Ireland could tell them apart, it
was in fact, as legend has it, simply aspirin).

To many onlookers in Connolly station that day, this was a perhaps scandalous, or at the
very least, farcical scene. After all, this was Ireland of the 1970s, a country still firmly
entrenched within the grips of the Catholic Church, a country in which women were forced
to leave public service upon marriage, and vitally, a country that had not yet legalised
contraception.

For these women, however, members of the Irish Women’s Liberation
Movement, this was a scene of defiance. A scene of freedom. A scene of rejection of the
societal and legislative shackles suppressing reproductive and sexual justice in Ireland.
These women were demanding equality. They were demanding the freedom to choose when
or if they became pregnant. They were demanding better lives.

Ireland’s reproductive revolution

Forty-two years later, however, how far have we come? Have the shackles finally
fractured? Undoubtedly, a great deal has changed since that day. In 1979, the Health
(Family Planning) Act legalised contraception. By 1993, though still required for the
contraceptive pill, restrictions regarding prescription for condoms had been lifted. Change
was incremental. As Ivana Bacik put it in her book of 2004, Ireland was certainly ‘dragged
kicking and screaming into the 21st century’.

However, it was the tweaking of legislation just two years ago, however, that perhaps heralded a real change of scene in terms of reproductive revolution in Ireland. Levonorgestrel, a form of emergency contraception, was made available over the counter in pharmacies. Boots announced plans in 2011 to begin sales of the drug without prescription, under something known as Patient Group Directions
(PGD), which meant that medical directors of pharmacies were in a position to authorise administration.

For the first time, women were, in effect, permitted to individually determine their reproduction in a retrospective manner. For the first time, such power seemed to have transferred from the doctor’s pen to the woman’s prerogative. And it was a success. Indeed, according to a recent study conducted by the Irish Pharmacy Union, the only brand of levonorgestrel available thus far, ‘NorLevo’, has been requested by women in 85 per cent of pharmacies in Ireland since its launch. Women had wanted this.

Are women really in control now?

But has this power truly been extricated from its previous beholders? Certainly, the
availability of emergency contraception over the counter has rendered the drug more
accessible, yet questions remain. Has the medical profession truly allowed women to grasp
hold of reproductive power in its entirety? Have deeply entrenched societal norms regarding
female sexuality truly dissipated? Has reproductive control truly become accessible for all
sectors of society?

Indeed, the phrase ‘over-the-counter’ could be said to be perhaps misleading in nature. Firstly, and perhaps most fundamentally, such access, is in fact, at the discretion of pharmacists. Under Principle One of the Pharmaceutical Society of Ireland’s (PSI) Code of Conduct for pharmacists, as outlined in the PSI’s Interim Guidance on the supply of NorLevo by pharmacists, pharmacists may refuse to dispense the morning after pill if it lies in contradiction with his or her moral standards; ‘if supply to a patient is likely to be affected by the personal moral standards of a pharmacist’ (PSI, 2011).

Though the pharmacist is required to refer women to another pharmacist, this is utterly irrelevant. Women are at the behest of potential humiliation, and even at the behest of a lack of access to the drug. Those of us from a small town will be well aware of the difficulty in finding a pharmacy open on Sunday. It is clear that women are not in control here.

The process of access

What about those pharmacists that do not object to dispensing emergency contraception, however? Surely in those cases, we can, with relative certainty, declare the drug to be accessible to all?

Perhaps not. Indeed, required as part of the process of access is a detailed, structured consultation process in order to ‘determine the appropriateness of the supply and provide an opportunity to meet the appropriate patient counselling requirements’ (PSI, 2011). Such a process is almost certainly very useful in terms of providing women with comprehensive information on the potential risks and effects
associated with the drug.

Nonetheless, with such a consultation largely based on a questioning approach, it may represent a source of intimidation, frustration or embarrassment for women. How about offering a variant approach, according the wishes of the individual woman? Would it be possible to provide women with accurate, comprehensive information on NorLevo, whilst also acknowledging the potentiality of such negative emotions within an information giving approach? Indeed, with NorLevo widely regarded as ‘safer than Aspirin’ (Grimes, 2002: 1536), it is necessary to ask; why does there exist such a discrepancy in terms of process of access?

Price varies wildly – is reproductive justice only for some?

None of these questions, however, are truly relevant unless we seek to encompass the experiences of all sectors of society, all kinds of woman. At present, there exists no standard price for over the counter emergency contraception. Prices can range from €10 to €45. Can we all afford that? I think not. Can we ever truly claim to have achieved reproductive justice if reproductive justice is only for some? Are some of us more equal than others? These are the questions Re(al)-Productive Health wish to ask.

We wish to learn from women’s real experiences in accessing emergency contraception. We wish to campaign, in a targeted manner, on specific issues preventing women from achieving full access to this vital drug, and seek to assist in the visioning of real alternatives.

Perhaps at the very root of such questions, however, is the sentiment proclaimed by Elizabeth Cady Stanton of the US Women’s Rights Movement in the 1880s, that; ‘The first great work to be accomplished for woman is to revolutionise the dogma that sex is a crime’ (Schneir in Shulman, 1980: 591).

Over 130 years later, has as this first great work yet been accomplished? And over 40 years after the events of May 22nd, 1971, have we yet reached our destination? Perhaps not. The contraceptive train trundles on – let’s stay on board.

Re(al)-Productive Health is made up of Aoife Campbell and Fiona Dunkin, two women in their twenties living in Dublin. Respectively, they are present and past students of Equality Studies in the School of Social Justice in UCD, with strong interests in women’s rights, equality and reproductive justice.

Re(al)-Productive Health hosts its official launch party on Wednesday, October 16th, at 7:45 p.m., in The Twisted Pepper on Middle Abbey Street, Dublin. Featuring on the night will be Dr. Ursula Barry of the UCD School of Social Justice, as well as a three-act DJ set. Entry is free and open to all.

Read: Boots to sell ‘morning after’ pill over the counter
Read: Average age of women requesting morning after pill is 23 years – survey
Read: Monday is the most common day women request the morning-after pill

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Fiona Dunkin

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