The morning after pill is to be available at high street chemists from the new year, but the second sexual revolution which will put women's fertility completely in their own hands is some distance off yet.
From January, those pharmacies with sufficient stocks of emergency contraception will be able to dispense pills to any woman who turns up without a prescription.
No longer will a woman who has had unprotected sex and fears she might become pregnant need to go to a GP.
The pills are safe and they work, provided they are taken within 72 hours.
The committee on the safety of medicines has recommended that pharmacists be permitted to dispense them. But the moral debate on contraception and abortion has tested efforts of the Department of Health and the Royal Pharmaceutical Society to make what some consider a simple medical matter acceptable to middle England.
Some women may find they have exchanged the interrogation of a GP for the cross-questioning of a pharmacist. Under political pressure from a government nervous of moral majorities, the Royal Pharmaceutical Society has agreed that its members will ask questions of the women who seek their help to establish, among other things, whether they have had unprotected sex.
The society insists that some questions are necessary. "There is a raft of information that the pharmacists will need to satisfy themselves of," a spokeswoman said.
The Department of Health has said pharmacists must not supply emergency contraception to under-16s or to women who are pregnant - even though the pill will not affect a pregnancy and certainly will not induce an abortion. But there might be women who wrongly think it will end a pregnancy, the spokeswoman for the Royal Pharmaceutical Society said, and so the question must be asked. The pills prevent a fertilised egg implanting - once that point is passed they have no effect. She added that it was not enough to inform women verbally or in writing because it might be appropriate to refer them to someone else if they were seeking a termination.
The conversations that will take place in pharmacies need not be embarrassing, she said. "You'd be surprised, the sorts of issues people are perfectly prepared to talk about in pharmacies," she said. "What we've got here is a sort of normalised, non-stigmatised healthcare intervention. I think pharmacies will manage this product sensibly and safely but sensitively as well."
Family planning experts wholeheartedly applauded the move to pharmacy sales, which all agree is a big step towards giving women complete control of their fertility. If the day when the emergency pill is as much a part of the family medical cabinet as aspirins and sticking plaster is not yet here, they believe it must still be the logical progression.
"That's really where we need to be, because if it is most effective when used 24 hours after unprotected sex (its effectiveness is reduced to 58% after 48 hours), we need women to have it to hand," said Ann Furedi of the British Pregnancy Advisory Service. "We're hoping it will come to be used as just another pharmacy product."
She believed there would be many women who asked the pharmacist for a packet in case they ever needed it, although most of those would be older, more affluent women since the cost will be £20 for the course of four pills, which are taken in pairs 12 hours apart. Under the guidelines being drawn up, unless women lie they are likely to be refused. She saw no place for interrogation of customers.
There have been two pilot projects, in Manchester and London, run by the Royal Pharmaceutical Society, in which demand for the pills was so great that the pharmacies were afraid to advertise their services in case they ran out of stocks. Exactly what the pharmacist will ask has still not been established. The society is setting up workshops for its members, and said they were likely to be told what information they needed to elicit, rather than what they should ask.
There was an immediate outcry yesterday to the revelation that pharmacists would be permitted to hand out the pill. "It does not at all sit in with my moral views as to what should happen," said Ann Widdecombe, the shadow home secretary. "There are also very good questions healthwise as to whether it will encourage ever more teenage sexual activity, whether it will encourage people into unprotected sexual activity."
The shadow health secretary, Liam Fox, said he was alarmed and appalled. "Making the morning after pill available to all girls over 16 in this way sends the wrong message about the need for responsible sexual activity," he said.
But Jenny Tong, the Liberal Democrat MP for Richmond Park, said the announcement was excellent news which was long overdue. "As a family planning doctor for over 20 years before I came in to parliament I have campaigned long and hard for women to be able to control their fertility in this safe and effective way.
"It is not an abortion. It is very safe, and I hope it will prevent many unplanned pregnancies in the future."
