Abortion

Colombian High Court Rules Emergency Contraception Is Not Abortion

The Colombian High Court has just ruled in favor of a governmental health agency's right to distribute emergency contraception pills within in public health care system.

Once again, emergency contraception is the focus of debate in Latin America, this time in Colombia, where the high court Consejo de Estado has just ratified the government health agency INVIMA‘s authorization of importation and distribution of emergency contraception pills.

INVIMA’s declaration had been taken to court by the citizen Carlos Humberto Gómez Arambula, who argued that the EC is “abortive” and violated the right to life for Colombian citizens. This was the same argument that the Constitutional Court of Chile used to ban the free distribution of emergency contraception in the public health system last April.

Contrary to what happened in Chile, the Colombian high court declared that EC is not abortive and does not fall afoul of the right to life. This is in line with the World Health Organization, which has unequivocally stated that “Levonorgestrel emergency contraceptive pills have been shown to prevent ovulation and they did not have any detectable effect on the endometrium (uterine lining) or progesterone levels when given after ovulation. Emergency contraception pills are not effective once the process of implantation has begun, and will not cause abortion.”

Progestin-only EC is available as a dedicated emergency contraceptive product under many names worldwide, and in Colombia under the name of Postinor-2.

In 2000, Postinor-2 received the Colombian sanitary registration from Invima, and therefore was authorized for importation and distribution with prescription by Profamilia, a sexual and reproductive health service provider. Profamilia demanded that Invima remove the prescription requirement, arguing that since 1996 the EC was internationally declared free of medical contraindications. Invima responded that the prescription was imposed as a way to make sure that women will receive medical counseling regarding it use and effects, particularly that it is not an appropriate contraception method for frequent use and that does not prevent sexually transmission diseases.

The prescription can be an obstacle to EC’s useful function, because EC can only be used up to 72 hours after sexual intercourse. But Profamilia offers counseling and prescription without appointment. And all women who seek contraception from Profamilia’s doctors are informed about EC pills and provided with prescription in case of need.

Since 2001, Profamilia has sold Postinor-2 through its health centers across Colombia. Other EC products are available in the market, although there are not authorized by Invima.

In addition, Profamilia has a website called Día Después (Morning After), where users can find useful information on how to use EC pills and chat with a “virtual gynecologist.”

In other Latin American countries there have been attempts to eliminate the access to EC. On April 4, the Constitutional Court of Chile banned the free distribution of EC in the public health system, which had been included in the National Norms on Fertility Regulation in 2006 through a Supreme Act of the Chilean President, Michelle Bachelet.

In Argentina, a 2006 sentence from the federal justice nearly halted EC’s distribution, but currently it is available without prescription and free of charge in public hospitals.

According to the Consorcio Latinoamericano de Anticoncepción de Emergencia, fifteen Latin American countries have EC products registered. In some other countries, like Mexico, Ecuador and Brazil, EC is included in the health public services. In some countries, including Dominican Republic, El Salvador and Bolivia, it is distributed without prescription. Next, there are countries where it is not distributed for free in public health services, but it is sold without prescription, as in Venezuela and Nicaragua. In addition, in countries such as Uruguay, Paraguay and Peru, some EC products are delivered for free in the public health services, but not all the EC products are offered.