Openness to other ways of looking at the world too often is cast aside.
I remember walking back from dance class in Paris and seeing graffiti on the wall: “France — love her or leave her.” I’ve heard a similar phrase in the States: “America –love it or leave it.” Narrow-mindedness is an international phenomenon and limits thoughtful domestic discussions, as no culture is above criticism.
U.S. discussions of hotly debated issues have often overlooked foreign experience. Just now, America is coming out of its shell and considering how other countries deal with major social issues. In discussing changes to American social security policies, experts are examining what other countries have done. Foreign experience heavily influenced the Supreme Court’s recent decision to declare unconstitutional juvenile capital punishment. This trend of comparing notes with other societies should continue. Perhaps it would guide American politicians as they establish reproductive rights.
The French were the first to make emergency contraception available without prescription in 2002.
What is the French approach and how has it worked?
I called Dr. Elizabeth Aubeny, a gynecologist and founder of the French Association of Birth Control. She told me Norlevo, a major emergency contraceptive, is available to all without prescription. The pill is free for minors and no parental consent or proof of age is required. Social security reimburses pharmacies for pills given out free. However, pharmacists must consult with customers and go over the medical facts of the pill before dispensing it. No prescription doesn’t mean you can run in and grab a 10 pack.
If a high school girl cannot reach a pharmacy, she can meet with her school nurse and get emergency contraception.
This contrasts greatly with the American situation. Here, young women need prescriptions for emergency contraception and it is certainly not available in high schools.
Every year, 800,000 boxes of Norlevo are delivered to France, according to the magazine L’Express. Ten to 15 thousand are delivered to high schools. Aubeny noted that these numbers haven’t changed in the three years since emergency contraception has been available without prescription, which leads her to conclude women are not using it as regular birth control. She told me in her experience, the young women asking for emergency contraception tend to be quite sexually responsible, as they are acknowledging a risk and dealing with it head on.
Since France made emergency contraception available, the rest of Western Europe has followed. Aubeny said only Germany and Italy still require prescriptions.
Aubeny and many other European health care providers view this system as an effective way of reducing the number of surgical abortions — something both pro-choice and pro-life activists see as desirable. New York Times columnist Nicholas Kristof recently reported that teenage girls in the United States are as sexually active as teenagers in Europe, but American teenagers are more likely to become pregnant and have abortions.
Jean Lamarche, a pharmacist in Paris, shared his views on the efficiency of the French system. He emphasized that young women must come to a pharmacy in person to get emergency contraception, and pharmacists must determine there is a real medical need for it. (Good pharmacists can use their medical knowledge to dispel teenage pregnancy myths.) So yes, Lamarche reflected, the system appears to be safe and effective.
France does have a right to life movement that views emergency contraception as abortion. The government views this as an extreme religious movement, however, and does not allow conscience clauses for health care providers. Aubeny noted that when pro-life pharmacists in France are met with requests for emergency contraception, many of them claim not to have it in stock. Of course, in France, snubbing authority is a national pastime.
As the Food and Drug Administration considers making emergency contraception available without prescription, I hope American medical experts will look at the experience Europe has already had. Hot button issues around the world are often the same; looking around and listening is a good thing.
Cynthia Martens ([email protected]) is a junior majoring in Italian and European Studies.
