A Pill for the Next Day

Women in Malta have been able to purchase the emergency contraception, or “plan B” under its popular moniker, since 14 December 2016. Our small country was one of the last EU countries to approve the next day pill as an over-the-counter birth control option. This article summarises how the morning after pill came to be sold in Malta, where to get the morning after pill, types of pill available and other considerations related to consumption of the day after pill.

After Pill versus Abortion Pill

The biggest disagreement regarding plan b contraception is whether or not the pill is abortive. Biologically, emergency contraception prevents an egg from being released into the ovaries. Sperm has no egg to fertilise so pregnancy cannot occur. On the other hand, if an egg is released into the ovaries and is then fertilised by sperm, taking plan b will not be effective. Hence the term, “next day pill”: the window in which an egg can be blocked from fertilisation is relatively short. This prohibition of an egg’s release is the reason that the morning after pill is not considered abortive. It only delays or inhibits egg release, rather than terminating an existing pregnancy.

In fact, there is a pregnancy termination pill called the abortion pill. It can be taken up to 70 days after a woman’s last period. This type of medical abortion is illegal in Malta (actually, Malta is the only EU country where abortion is illegal).

Background to Legal Approval

The morning after pill was first proposed to the Health Ministry and Civil Liberties Ministry by a group called Women’s Rights Foundation. One hundred and two women signed and filed a judicial protest against the public ministries. Their grounds? The Plan B pill allows women to properly plan the quantity, spacing, and timing childbirth.

After much deliberation, the Health Ministry and Civil Liberties Ministry decided that it was the Malta Medicines Authority to determine if the morning after pill could be licensed and distributed in Malta. Ultimately, the Malta Medicine’s Authority approved it, naming two types of plan b contraception for sale. One major aspect of the decision was Malta’s desire to be more in-line with other member EU member states.

On the Day After

The decision to take the morning after pill is not a light one. The morning after pill may be chosen for several reasons: if you’ve had unprotected sex without contraception; if a condom broke; if the partner failed to withdraw as intended; if a diaphragm moved out of place; or if you’ve missed taking your normal contraceptive pill. For more details regarding the types of pill, their requirements and effectiveness, continue reading.

Where to Get the Morning After Pill

Around a fourth of the 250 pharmacies in Malta carry the day after pill. There is no prescription required to purchase it. Even though the Medicine’s Authority approved the sale of the morning after pill, pharmacists have the right to choose whether or not to stock it. Many pharmacists believe the day after pill is abortive, citing their right to “conscientious objection based on their personal beliefs.” If a pharmacy doesn’t carry the emergency contraceptive pill, they are legally required to point you in the direction of a pharmacy that does. For a full list of Maltese pharmacies with the pill in stock, see this page. Keep in mind that many pharmacies in Malta are not open on Sunday; plan accordingly using this list of pharmacies and clinics open on Sundays and public holidays.

Types of Plan B Available

Two types of emergency contraception have been approved for the Maltese market. No matter the type you choose, it is important to speak with a clinician or pharmacist about health concerns before purchase. Although one pill offers a bit longer time period to be effective, it is important the emergency contraception be taken as soon as possible after intercourse. If you are also taking traditional contraceptive tablets, their effectiveness may be hampered by taking Plan B. Actually ingesting the morning after pill is simple: drink it with a glass of water! Here is a description of the two types of pill offered in Maltese pharmacies.

EllaOne. The greatest benefit to EllaOne is that it is effective up to five days after unprotected sex. The downside is that it may only be taken once during a menstrual cycle. Side effects are rare, but include irregular bleeding; headaches; nausea; and stomach pains. The active ingredient in EllaOne is ulipristal acetate.

Levonelle. A cheaper option than EllaOne, Levonelle is less potent with time. It is up to 95% effective within the first 24 hours; then only 85% effective in the next 48; then 58% in the final 72 hours. Levonelle cannot be taken more than 72 hours past the moment of ejaculation. Unlike EllaOne, Levonelle can be taken twice within a single menstrual cycle. The active ingredient in Levonelle is levonorgesterel.

Emergency Averted!

Regardless of the circumstances for taking it, emergency contraception is called such for a reason: it is largely believed to be less effective on emotional and physical levels than other methods of contraception. Still, Malta has aligned with the rest of the EU member states in supporting what is legally recognised as a woman’s right to choose when she has children, and to take the necessary actions to support her decision. If you’re a lady in an emergency, know that the next day pill is available to you in Malta!