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Emergency Contraception in the Caribbean
In Trinidad and Tobago, the rates of teenage pregnancy and HIV prevalence are quite high. The adolescent birth rate in the country is 33 births per 1,000 girls aged 15-19, and there were 15,000 people living with HIV in 2009. At the end of 2009, an estimated 240,000 people were living with HIV in the Caribbean, a rate exceeded only by Sub-Saharan Africa. Incidence of domestic violence and sexual assault are also shockingly commonplace. Because of these issues, emergency contraception (EC) is incredibly important to the lives of girls and women.
There are many myths and misconceptions about EC that we need to overcome. After unprotected or inadequately protected sex, EC works by disrupting ovulation; it does not end a pregnancy. EC does not appear to be harmful if inadvertently taken in pregnancy, and it does not prevent you from becoming pregnant in the future. EC has the same components as birth control pills, but in higher dosages. It significantly reduces pregnancy risk for one act of unprotected or inadequately protected intercourse. EC should be taken as soon as possible after the sex act, and it is effective if taken within 5 days after sex.
Caribbean counties, including Trinidad and Tobago, have signed onto international agreements such as the Convention on the Elimination Of All Forms of Discrimination Against Women (CEDAW), the International Conference on Population and Development (ICPD), and The Fourth World Conference on Women. To fulfill the commitments of these agreements, government should take further steps to have EC included in the National Health Formulary. In doing so, EC would be made available in public health institutions and would be made accessible to all people including the very poor, young people, victims of sexual violence, and people living in rural communities.
Contraception access is limited due to locality, cost, and availability, but we are still fortunate enough to be able to purchase EC over the counter without a medical prescription in Trinidad and Tobago. There have been significant efforts to restrict access to emergency contraception in several countries in Latin America and the Caribbean, such as Argentina, Chile, Ecuador, and Peru. In Honduras, for example, a person caught with EC can face a prison term of up to 6 years if found guilty.
EC can be used as often as needed. However, deliberate use of EC as a regular, routine contraceptive method is not recommended, and more effective methods of contraception exist for this purpose. EC should be used in incidences of unprotected intercourse or when routine contraception fails.
Although EC does not protect against HIV/AIDS, it is an important method in allowing girls and women to prevent unwanted pregnancies and avoid an unsafe abortion. It also empowers women because it provides them with an opportunity to exercise their sexual and reproductive rights by planning their pregnancies.
Ife Smith has been a member of the Youth Action Movement (YAM) at our local partner, the Family Planning Association Trinidad and Tobago,for eleven years. With the YAM, Smith has engaged in advocacy and peer education on sexual and reproductive health and rights issues.