We called 120 pharmacies: buying the morning-after pill on Sunday is an arduous task

Buying the morning-after pill in Gozo on Sunday can be very problematic, an exercise undertaken by MaltaToday has revealed.

On two of the six Sundays surveyed by this newspaper in November and December none of the two pharmacies open on the given days sell the emergency contraception.

Women in Gozo requiring the morning-after pill on those particular Sundays will have to travel to Malta.

The exercise showed that from the 120 pharmacies across Malta and Gozo contacted by a journalist posing as a client, an average of 64% sell the morning-after pill.

However, the rate ranges from 50% on one Sunday in November to 75% on another, making it an arduous task to source the emergency contraception.

The exercise covered the entire month of November, the first week of December and the 8 December, which is a public holiday.

On Sundays and public holidays, only 20 pharmacies across Malta and Gozo are open on a regional roster basis. Some will open on more than one Sunday.

This newspaper called up the individual pharmacies and posed as a client wanting to buy the morning-after pill.

The morning-after pill (MAP) is a type of emergency birth control which is used to prevent pregnancy for women who have had unprotected sex, or whose birth control method failed. It is recommended that the morning-after pill is taken within 72 hours of having intercourse and the earlier it is taken the more effective in can be in preventing an unwanted pregnancy.

MAP was introduced to Malta in 2016 and deemed as an OTC medication, meaning it could be sold over the counter in pharmacies without a doctor’s prescription as long as the person is over 18.

But MAP is also a contentious subject for pharmacists, who have the right not to dispense the pill on grounds of conscientious objection.

Some pharmacies have opted not to sell MAP outright, while in others individual pharmacists can decide not to sell it despite being available.

Women who request the morning-after pill over the counter are asked certain questions by pharmacists to ensure that it is taken correctly. But some women have complained that the questions are at times too personal or even unnecessary. They say they have felt “shamed” and “judged”.

The Chamber of Pharmacists has insisted that pharmacists should follow their guidelines, which are based on international standards. These guidelines tackle confidentiality and patient safety, among others.

From sympathy to conscientious objection: what we were told

During the data collection exercise, MaltaToday experienced a wide range of responses from the pharmacists who picked up the phone. Some were sympathetic, while others were cold, and borderline hostile.

Several pharmacies were upfront that only specific pharmacists employed there would sell the morning-after pill, directing us to come between certain hours.

One pharmacy, in particular, asked what had happened, and why MAP was necessary, and another downright refused to answer any questions over the phone and in a hostile tone said the person needed to come to the pharmacy and speak to the pharmacist in person.

However, apart from a few outliers the majority did not ask inappropriate questions or make the caller feel uncomfortable.

A handful of pharmacists went out of their way to try and protect the caller, asking the questions over the phone as to minimise the “embarrassment” or “shame” a person may feel by being asked private questions in front of other customers.

One pharmacist told the caller to come in and just say their name, and that nothing else needed to be said.

In a handful of instances, the caller was told that she had to sign a declaration form, and have her ID card number recorded.

What needs to be asked

Speaking to MaltaToday, Doctors for Choice member Dr Natalie Psaila said that because the guidelines issued regarding MAP were broad, it allowed pharmacies to create their own systems. However, Psaila argued that this should not be allowed.

She said that the only acceptable questions a pharmacist should be allowed to ask relate to age, the last time the client had intercourse, when was the last period and whether she suffered from any allergies. “Anything other than these questions is extra, and in our opinion unacceptable,” she said.

MAP at Mater Dei Hospital

A related aspect is the unavailability of MAP at Mater Dei Hospital, Psaila said. “Unfortunately, it’s still not available at Mater Dei Hospital, even against payment. Rape victims, who may be admitted to hospital, often cannot go to a pharmacy and buy it,” she said.

Psaila said that rape victims need to rely on relatives to buy it for them once shops outside the hospital open and not all of them had someone who could help.

She said that while some doctors and nurses may pool together, and provide MAP for victims, there is no policy in place. This all depends on the initiative of the staff on call at the time, she added. “We know that the longer the MAP is delayed, the less likely it is to work, and with abortion in Malta being illegal even in cases of rape, the MAP is the victims' only hope of avoiding an unwanted birth,” she said.

Additional reporting by Nicole Meilak