Selling the morning-after pill over the counter has muddied the messages being sent to teenage girls about safer sex, nurses will warn this week.
A row over the issue has split the Royal College of Nursing, with staff divided over whether the measure to reduce unplanned pregnancies risks backfiring - or whether it has simply removed from thousands of women the trauma of unnecessary abortions.
Pharmacists have been trained to ask about the circumstances in which a woman thinks she has become pregnant, and health problems that may make the pill unsuitable. They are not supposed to sell it to girls under 16, although in practice teenagers who look older than their years may slip through the net.
However some members of the RCN's expert adolescent health team are concerned that quizzing young girls in a crowded pharmacy does not allow the time and privacy to go through preventative health messages about unprotected sex or risky behaviour.
'There are some people who think that selling the morning-after pill over the counter is not a good enough practice - that the advice isn't as good as a nurse would give,' said one RCN source.
'The assessments are supposed to be confidential and you can't really start going into the details of someone's sexual health in a shop.'
The morning-after pill is listed on the agenda for debate at the nursing union's annual conference in Harrogate this week, but meetings were continuing over the weekend over whether the discussion would be allowed amid internal protests.
A million courses of emergency contraception a year are taken in Britain, and until January 2001 they were only available from family planning clinics, GPs and Accident and Emergency departments.
But the Levonelle brand, which works by preventing a fertilised egg becoming implanted in the womb and can be taken up to 72 hours after unprotected sex, is now sold without a prescription in pharmacies, making it much more easily available.
The Family Planning Association, which along with the British Medical Association has strongly backed the move, said it appeared to be working well.
'We know that the majority of women use emergency contraception once in a year, regardless of where they get it from, and for them it's a wake-up call - it gives you a scare,' said a spokeswoman.
'Most women do assess what they are doing afterwards precisely because they don't want to be in that position again. We are all in favour of it remaining in pharmacies.'
A recent survey suggested almost one in five 16-year-olds had taken the morning after pill, with 3 per cent taking it more than once, suggesting one scare had not put them off.
But the Office of National Statistics also found last year that the number of 16- to 29-year-olds deliberately risking unprotected sex because they simply did not like using contraception had gone down, while the proportion of 16 and 17-year-old girls who had not had sex in the previous year had jumped by 9 per cent between 1999 and 2000. Those who did have sex had fewer partners, suggesting messages were getting through.
Members of the RCN's adolescent health team raised the issue for debate. But its sexual health team is understood to be firmly in favour of emergency contraception being sold over the counter believing it prevents unwanted pregnancies.
Official figures suggest only about a third of women taking emergency contraception get it from pharmacists, with the rest still going to a doctor. Superdrug, one of the largest chains selling it, found the greatest demand was from professional women aged 25 to 35, who may be too busy to go to a clinic or surgery with restricted opening hours.
