PLAN B

Plan B in Toronto.
Toronto women can now get morning-after pills without doctor's prescription By ROSS MAROWITS

TORONTO (CP) - A program aimed at reducing unwanted pregnancies and abortions is giving Toronto women access to the "morning-after pill" without a doctor's prescription.

Specially trained professionals at 40 pharmacies in three areas of the city are now dispensing the pills, but not before women are screened to determine if the medication is an effective option.

The one-year pilot program, which began Monday, allows pharmacists to prescribe one of two medications without prior consent from the patient's doctor. Pharmacists can prescribe the medication or consult with several doctors available to provide advice on the telephone, said Tom Brown, clinical co-ordinator of Sunnybrook and Women's College Sciences Centre.

"Emergency contraception can empower women to take control over their own health, prevent unwanted pregnancies, and thereby reduce the number of abortions," said Jane Pepino, chairwoman of the Ontario Women's Health Council, which is paying for the pilot.

The council believes many unwanted pregnancies are the result of a lack of awareness of emergency contraception. It will broadcast its views through radio ads and literature distributed in schools, doctor's offices and bars.

A study indicating the demand for the pills and the effect on the number of unwanted pregnancies and abortions will be presented to Ontario's Health Ministry. Results could determine if the program will be extended across Ontario, said Brown.

Although funded by the ministry, the women's health council has the authority to approve the project without government intervention, says a spokesman for Health Minister Tony Clement.

"It belongs with the women of the province to make those kinds of decisions and we'll look forward to the report after their study," said Gord Haugh.

The program is modelled after an initiative started in Washington. A similar effort was adopted in British Columbia by the outgoing NDP government in April.

"It makes sense that women have access to this," said Frances Lankin, Ontario's NDP health critic. "I think that there is some controversy about the nature of the actual pill itself and so it's probably good that it's being monitored."

It was unclear how many pills will be distributed. About 9,000 doses were handed out in Washington through 180 pharmacists.

Toronto women will be charged between $15 and $30 depending on which pill they receive. Physicians and pharmacists are voluntarily participating in the project.

Nearly 90,000 Ontario pregnancies are unwanted annually, with about half resulting in abortions, statistics suggest.

Preventing unplanned pregnancies through easy access to the morning-after pill would decrease the physical, emotional, social and economic costs of abortion or unplanned child-bearing, the council says.

Pharmacists will refer some women to counselling to ensure the pill isn't used as an ongoing method of contraception.

 The morning-after pill is used when birth control methods have failed or not been used at all. The pills contain higher doses of hormones that are commonly found in traditional birth control bills.

The emergency pill is 75 to 85 per cent effective if taken within 72 hours of intercourse.

The pill, also known as "Plan B," is legal in Canada.

But anti-abortion groups say the drug is the equivalent of an early abortion because it can prevent a fertilized egg from implanting in the walls of the uterus. Supporters argue that unlike RU-486, the so-called abortion pill, the morning-after pill works as a contraceptive because it prevents pregnancies but does not affect fertilized eggs already lodged in the uterine wall.

"I'm not sure that there is much to criticize. It is a contraceptive agent.  If you don't believe in contraception, you can criticize that," said Brown.

"It's not an abortion pill."

The prospects of providing the pill without prescriptions caused an ethical dilemma for some pharmacists last week in Alberta, even though 68 per cent of pharmacists voted they would be willing to dispense the pills.

A group called Concerned Pharmacists for Conscience argued that pharmacists must be given the right to refuse to dispense the pill - and any other drug with which they disagreed.