Beware the health risks of an over-the-counter morning-after drug

Other drugs that a woman might be taking need consideration before Levonorgestrel can be prescribed. The prescribing information also recommends further medical consultation in the event that a woman vomits, suffers nausea or other side-effects after taking Levonorgestrel and that there be a routine medical consultation three weeks later. It is less likely women will take such precautions if their doctor is not involved in prescribing the drug.

Pharmacists have no space for consultation other than their counter, which does not make it likely that a full and frank medical history can be taken. Many women would not feel comfortable sharing intimate personal information in so public a setting.

Pharmacists also are not qualified to undertake a medical examination, so women may not receive the full information they need in order to safely take the drug. A woman's GP is more likely than a pharmacist to be able to pick up whether a woman is using the drug regularly.

Pharmacists are also unlikely, from their position behind the counter, to notice signs of sexual abuse, which might be prolonged and facilitated by easier access to Postinor-2.

The World Health Organisation (WHO) has warned that "repeated use of emergency contraceptive pills in any month can expose women to higher doses of steroids than those recommended during one cycle" and that "there may be a higher percentage of ectopic pregnancies among emergency contraceptive pill failure cases than among a normal pregnant population".

Ectopic pregnancy is a serious, potentially life-threatening condition which can jeopardise a woman's ability to conceive and have a healthy pregnancy in the future. Further, the WHO says morning-after pills "are not recommended for routine use, because of the higher possibility of failure compared to regular contraceptives and the increased risk of side-effects".

Drug manufacturer Schering says morning-after pills can prevent or delay ovulation, or inhibit implantation of the embryo. Acting against the implantation of a human embryo happens after conception. It is not a contraceptive action. Use of misleading language like the description "emergency contraception" to describe this drug threatens women's informed consent.

Women need to know this upfront so they can give their full informed consent to use the drug.

Postinor-2's supporters claim that the pill disrupts the implantation of a fertilised egg or even just an egg. These descriptions are also misleading. When an egg and sperm meet, a new human embryo is conceived. Postinor-2 can prevent the implantation of this embryo, causing its death.

They also claim that until the embryo implants in a woman's uterus there is not a pregnancy and until there is a pregnancy there cannot be an abortion. Even accepting this argument, abortion is not a controversial procedure because it ends a pregnancy, but because it ends a human life. One of the actions of Postinor-2 can be to end a human embryo's life by preventing implantation.

More importantly, the convoluted arguments pursued by supporters of Postinor-2 to claim it does not cause an abortion are not the general community's understanding of abortion. The Macquarie Dictionary defines abortion as, among other things, "the arrested development of an embryo or an organ at its (more or less) early stage". Women need to be given clear information on the implications of using this drug.

Postinor-2 should not be available at all because of its abortion-causing effect. But if it is available, women should have the benefit of medical advice and not be kept in the dark about the effect of this powerful drug.