Emergency Contraception Emergency Contraception The Story of a Global Reproductive Health Technology Edited by Angel M. Foster and L. L. Wynn EMERGENCYCONTRACEPTION Copyright©AngelM.FosterandL.L.Wynn,2012 Allrightsreserved. Firstpublishedin2012by PALGRAVEMACMILLAN® intheUnitedStates—adivisionofSt.Martin’sPressLLC, 175FifthAvenue,NewYork,NY10010. WherethisbookisdistributedintheUK,Europeandtherestofthe World,thisisbyPalgraveMacmillan,adivisionofMacmillanPublishers Limited,registeredinEngland,companynumber785998,of Houndmills,Basingstoke,HampshireRG216XS. PalgraveMacmillanistheglobalacademicimprintoftheabove companiesandhascompaniesandrepresentativesthroughouttheworld. Palgrave®andMacmillan®areregisteredtrademarksintheUnited States,theUnitedKingdom,Europeandothercountries. ISBN 978-1-349-28727-7 ISBN 978-1-137-01648-5 (eBook) DOI10.1057/9781137016485 LibraryofCongressCataloging-in-PublicationData Emergencycontraception:thestoryofaglobalreproductivehealth technology/editedbyAngelM.Foster,LisaL.Wynn. p. cm. 1. Emergencycontraceptives. 2. Birthcontrol. 3. Human reproductivetechnology. I. Foster,A.M.(AngelinaMarguerite) II. Wynn,L.L.,1971– RG137.58.E432012 618.182—dc23 2011036206 AcataloguerecordofthebookisavailablefromtheBritishLibrary. DesignbyIntegraSoftwareServices Firstedition:March2012 Toaffordableandaccessible(emergency)contraceptionforall Contents ListofFigures ix ListofTables xi Acknowledgments xiii ListofAcronymsandAbbreviations xv Part I SettingtheContext 1 TheBirthofaGlobalReproductiveHealth Technology:AnIntroductiontotheJourneyof EmergencyContraception 3 L.L.WynnandAngelM.Foster 2 EmergencyContraception:HopesandRealities 19 JamesTrussell Part II CountryCaseStudies 3 UnitedStates:Activism,SexualArchetypes,andthe PoliticizationofScience 39 L.L.Wynn 4 Canada:CompetingFramesofAccessandAuthority 57 JoannaN.Erdman 5 Jamaica:ASuccessStoryinMovingto NonprescriptionStatus 79 DawnChin-Quee 6 Mexico:ExpandingAccessthroughPartnershipsand Persistence 91 RaffaelaSchiavonandElizabethWestley 7 Chile:OneStepForward,OneStepBack 107 VerónicaSchiappacasseandSoledadDíaz viii Contents 8 Britain:ContradictoryMessagesaboutSexual Responsibility 123 AnnFuredi 9 France:APioneerintheSwitchtoNonprescription Status 139 CarolineMoreauandErinGainer 10 Tunisia:AGlobalLeaderinReproductiveHealth andRights 153 AngelM.Foster 11 Lebanon:CanIntroductionBeTooQuiet? 169 FaysalEl-Kak 12 Morocco:APersonalAccountofthe IntroductionSaga 179 SaadHarti 13 Nigeria:CreatingDemandandIncreasingAvailability 191 DeborahApselLang,JillKeesbury,andAndrew S.Karlyn 14 Australia:OrganizedPhysicianOppositionto NonprescriptionStatus 207 HelenCalabretto 15 Bangladesh:AModelforNationalFamilyPlanning ProgramIntegration 221 SharifMohammedIsmailHossainandM.E.Khan 16 TheThailand-BurmaBorder:AddressingNeedsin Long-termConflictSettings 239 CariSietstra Part III Conclusion 17 TheFutureofEmergencyContraception:WhereAre WeGoingfromHere? 257 ElizabethWestley Resources 265 Bibliography 267 NotesonContributors 299 Index 303 List of Figures 1.1 MapoftheregistrationstatusofdedicatedECPs worldwide 16 9.1 Abriefchronologyoftheintroductionofadedicated ECPinFrance 140 13.1 Postinor-2®salesinNigeria,2002–2006 196 13.2 Postinor-2®coverageinNigeria,byregion,2006 198 List of Tables 10.1 Tunisianreproductivehealthindicatorsataglance 157 13.1 Awarenessofcontraceptivemethodsamongsexually activewomen,2005 200 15.1 SelectreproductivehealthindicatorsforBangladesh, 1993–2007 222 15.2 CorrectknowledgeofECPsreportedbyPhaseIand PhaseIItrainees 230 17.1 National-leveldataonECknowledgeanduse 258 Acknowledgments This book represents a collaborative project and we have been privileged to work with all of the amazing scholars, researchers, and activists who contributed chapters—we appreciate your enthu- siasmandanalyticalinsightsasmuchasyouractivismanddedication. We want to give a special shout out to James Trussell and Elizabeth Westley,whohavesupportedthisprojectsincethebeginningandwere invaluableinsketchingoutthebigpicture. We are especially grateful to the Pacific Institute for Women’s Health for providing the cover art for the book. We are also thank- fultoalloftheorganizationsandindividualswhogaveuspermission toreproducetheireducationalmaterialsandphotos,eventhoughwe were unable to use most of the images. We gratefully acknowledge the organizations and funders who supported the editors’ work on this book—the Richard & Rhoda Goldman Fund, the William and FloraHewlettFoundation,theAmericanInstituteforMaghribStud- ies,theUniversityofOttawa,MacquarieUniversity,andtheAustralian Research Council. And we thank the extraordinarily patient team at Palgrave Macmillan—Toby Wahl, Farideh Koohi-Kamali, Robyn Curtis,andSarahNathan. Completion of this book would not have been possible without the input and feedback we received along the way from a number of colleagues including Donna Lee Bowen, Mark DeLancey, Teresa Harrison, Courtney Jackson, Sameena Mulla, Kimala Price, Tracy Weitz, and Greg White. We also thank the fabulous interns and research assistants who helped with various phases of this project— Caroline Grillot, Julia Havard, Sarah Lewis, and Guy Threlfo. We deeply appreciate the support that we have received from Ibis ReproductiveHealththroughoutthis(verylong)journeyandwould especially like to thank Laurel Morrison for her sound advice and Megan Smith for her keen eye for detail. And we are extremely grateful to Flora Kenson for copyediting and typesetting this manuscript. Angel Foster wants to thank Nancy and Emad Mancy and Linda (aka Pruney) Lemmens for their gentle nudging (it is finally done!) andEddyNiestenfor...everything.