Germany May Set Easier Access to Morning-After Pill

If a measure recently put forth by Germany's committee on prescription drugs is adopted by the Ministry of Health, the currently obligatory doctors’ examination and prescription will no longer be needed – and hospital waiting rooms will likely be much emptier on Saturday and Sunday mornings.

For the recommendation to be adopted, the health ministry has to approve a statute that will then need to be passed by the Bundesrat, Germany’s upper legislative chamber.

The prescription drug committee, part of the Federal Institute for Drugs and Medical Devices (BfarM), is confident that the health ministry will adopt its recommendations concerning the over-the-counter sale of the "morning-after pill" as has been the case in previous drug-related recommendations. The pill would then be available without restrictions at pharmacies from January 2004, Ulrich Hagemann, chairman of the committee, told the Frankfurter Allgemeine Zeitung's weekly English newspaper.

The role of politics

But the health ministry nonetheless has remained noncommittal. “We are still looking into the matter,” a spokeswoman said. It wasn’t clear whether the ongoing negotiations between government and the opposition over health reform will play a role in the decision making.

Christoph Spindler, spokesman for the health ministry in the conservative southern state of Bavaria, denied a connection between health reform negotiations and the passage of the measure, speaking to the German liberal daily newspaper taz. But he added that Bavaria would naturally “want to have answers to a series of questions,” for example, whether the product can be used safely without physicians’ supervision.

Hagemann said the prescription committee had found no risks associated with selling the pill without a prescription. They also looked into the social advantages, he told the Frankfurter Allgemeine: “Reducing the number of abortions among teenagers is an important issue. Other countries have had positive experiences.”

Available in schools

The morning-after pill has been available without prescription in Britain for women over 16 years since the beginning of 2001. Other countries where the pill is sold without prescriptions are France (where it is handed out by school nurses), Portugal, Norway, Sweden, Finland, Belgium, Denmark and Switzerland.

The morning-after pill is based on the single hormone gestagen, and functions by preventing a fertilized egg from attaching to the uterus. It is not the same as the RU486 “abortion pill,” which causes a spontaneous miscarriage, and in fact will not terminate an already existent pregnancy.

Abortions among women between 15 and 18 years of age have risen in Germany over the past six years, from 33 to 50 per 10,000 women. Teenage pregnancies and the overall number of abortions have remained fairly stable. Britain has the highest percentage of teen pregnancies in Europe, 31 in 1,000 – more than twice as high as Germany. Only the United States ranks higher in industrial countries, with 52 in 1,000 women.

While it is unclear whether having the morning-after pill available over the counter will actually slow the rate of teenage pregnancies and abortions, women’s rights and family-planning groups welcome the decision.

“It’s a great advantage because taking the pill isn't delayed by the necessity of visiting a doctor. International studies show that the pill is more effective the earlier it is taken,” Regine Wlassitschau, of the German family-planning organization Profamilia, told the Frankfurter Allgemeine. “We strongly welcome the decision.”