Doctors Warn of Rising ‘Morning-After Pill’ Use, Abuse in Burma

By Kyaw Hsu Mon 23 January 2014

RANGOON — Medical professionals in Burma have used a government report indicating a rise in sales of emergency contraceptive pills to highlight the health risks of the pharmaceuticals’ abuse.

A paper included in a recently held medical forum said use of pills to prevent pregnancy after sexual intercourse was increasing in Burma. The research, by the Ministry of Health’s Department of Medical Research, was small in scope, conducted over a year in 2012-13 in one central Burma town. Researchers asked 67 pharmaceutical shop owners in Mandalay Division’s Pyin Oo Lwin Township about customers and sales of the pills. According to the research, most users are teenagers, with sellers reporting that girls as young as 14 years old were purchasing the pill.

In Burma, the emergency contraceptives, also known commonly as “morning-after pills,” are legally imported by licensed pharmaceutical importers and there are no restrictions in place on sales of the pill. More than 80 percent of the pills in Pyin Oo Lwin were sold without doctor’s instructions and health warnings, the research said.

The pills contain hormones and are designed to disrupt the ovulation or fertilization that is required for impregnation to occur. Users are advised to take the pill within 72 hours of having unprotected sex, but the sooner a woman takes the pill, the more likely it is to work.

Because the pill is not 100 percent effective regardless of when it is taken, medical professionals stress the “emergency” aspect of its use, and say it should not be considered a regular form of contraception.

Dr. Ma Thida, a physician at Rangoon’s Thukha free clinic and editor of the People’s Image journal, said the rise in emergency contraceptives’ use should be an issue of national concern, representing a threat to both health and morality.

“It means there are a lot of users of these emergency pills, young girls are having sex dismissively, because they don’t know the side effects and only know these pills can protect against unexpected pregnancy,” Ma Thida said, adding that such sexual behavior marked a “deviation from tradition and custom.”

“These pills are for emergency cases, not for regular use. It’s a kind of hormone control, so if girls are regularly using it, it can have many side effects. For example, if they later want to have a baby after they are married, it can be harder to conceive. Another issue is the pill does not prevent the spread of HIV/AIDS and other infectious diseases,” she said.

Ma Thida said the government should tighten regulation of the pills’ sale, including requiring that warnings about their possible side effects and physicians’ instructions be included in the labeling of the product.

Dr. Than Htut, a Myanmar Medical Association central executive committee member, said Burmese people needed better sex education, but traditionally conservative mores often meant parents and teachers shied away from the subject with children.

“Parents and teachers are responsible for educating their children, and though we shouldn’t compare with other Western countries for extreme sex education, we need more awareness among our society,” he said.

Unlike many Western countries, abortion is illegal in Burma, upping the stakes for any girl or woman who finds herself pregnant unintentionally.

Than Htut said he was concerned that use of the pill was widely misunderstood to include protections that other contraception, such as condoms, does provide, namely preventing the spread of sexually transmitted diseases.

Echoing Ma Thida’s call for greater government regulation, Than Htut added that the Ministry of Health should embark on an awareness campaign to educate the public about emergency contraception.

Nandar, a drug store sales associate in Rangoon’s North Dagon Township, said most buyers were male but acknowledged that teenage girls would also sometimes purchase the emergency pills.

“There are at least three kinds of brands for emergency use, for one it costs under 1,000 kyats [US$1]. Ecee 2 and Postinor brands are in highest demand,” she said.