Aarti Krishnakumar, a Chennai local, entered the dating world after her mother’s efforts to arrange a marriage for her did not work out. Unsure of it all, Aarti went on a few dates and found herself in a panic after not getting her period.
When Aarti went looking for emergency contraceptive pills in Chennai, she took many avenues.
First, she visited three generic pharmacies, none of which carried the emergency contraceptive pill. At another pharmacy, Aarti recalls the pharmacist looking at her “as if I had just asked for an alien chip.”
Feeling more desperate, Aarti then visited a reputed hospital in the city, where she asked to see a gynaecologist. Here too, she did not receive the service she was expecting.
“The doctor started moral policing, saying you’re 32 what are you doing having sex with an unknown guy, questioning if I have a moral compass and wondering what my family will think,” says Aarti.
When Aarti brought up that she had visited the hospital to get help and not to be judged, the gynaecologist advised her to take a pregnancy test in a few weeks to find out if she was pregnant rather than prescribe her an emergency contraceptive pill.
A discouraged and increasingly worried Aarti then reached out to her family’s pharmacy as a last resort. She had avoided doing so earlier out of fear her family would find out.
“I literally had to beg them to help me find one of these pills. The pharmacist asked for some time to get back to me” says Aarti. “I think he took about 5 to 6 hours, and he sent me two tablets of Postpone-72, and never mentioned this to my family. I popped one and threw caution to the wind and said hopefully nothing is going to happen.”
After this experience, Aarti came to realize that Tamil Nadu was not best the place for women seeking emergency contraception.
Emergency contraceptive pills can be used within the first few days (ideally 72 hours) of unprotected intercourse or in the case of regular contraceptive failure during intercourse, in order to prevent unwanted pregnancy.
The pills can be taken at any time during the monthly cycle, are considered safe and effective and do not need a prescription and can be bought over the counter according to the existing policies on paper.
How emergency contraceptive pills turned taboo
Apoorva Mohan, a local activist, started advocating for the improvement of reproductive healthcare after going through a similar experience when helping one of her friends seek emergency contraceptive pills in Chennai years ago.
During this search, much like Aarti, Apoorva found that while emergency contraception is said to be completely legal and accessible on paper, it is anything but.
“There is kind of a shadow ban on it because there is a really misconstrued understanding of what emergency contraceptives are, predominantly by policymakers, politicians, and pharmacists,” says Apoorva.
No official ban was ever made of “I-pill,” a popular brand of emergency contraceptive pills, but public figures have over the years falsely declared this as equivalent to medical termination.
As a result, a popular misconception formed that has permanently damaged the state of accessing emergency contraceptive pills in Chennai.
“When it comes to the distinction between emergency contraception and abortion pills, there is definitely a very clear distinction, I am not sure where this misconception between the two comes from, but I am aware that there is a lot of confusion,” says Dr Vijayaprasad Gopichandran, Assistant Professor, Community Medicine at ESIC Medical College and PGIMSR. “There are some people who have cultural religious beliefs about abortion, and so they also tend to not adopt emergency contraception.”
Dr Vijay adds that in a lot of areas, healthcare workers themselves are unaware of the difference between emergency contraception and abortion.
Now, the pill is nearly impossible to find over the counter anywhere in Chennai, and a stigma surrounds those seeking it.
Few pharmacies stock emergency contraceptive pills
“I think largely if you went and talked to any pharmacist in the city, they are not aware of the need to stock it, so, therefore, they just don’t have it,” says Dr Vijay.
In July of 2022, Bharathy Singaravel, a journalist for The News Minute, visited 23 pharmacies around Chennai looking for emergency contraceptive pills. She found that 22 of them said they didn’t stock the pills, and one of them said they could give it only with a prescription. The only place she was able to find an I-pill, was through a citizen activist on Twitter, Archanaa Seker.
Citizen Matters went to a few neighbourhood pharmacies in Adyar that have been known to be more likely to carry these pills.
All the pharmacists met the request for emergency contraceptive pills with responses ranging from the sale being highly regulated/strict to saying none of the pharmacies in the city carry the pills.
Citizens turn suppliers of emergency contraceptive pills in Chennai
The second time Aarti sought out contraception, she didn’t waste her time looking around Chennai and ended up getting it from her friend travelling from Bangalore.
“That’s when I realized that whenever I am travelling next I am going to pick it up and stock it for myself or others,” says Aarti.
Aarti and Archanaa are not the only women in Chennai doing this, a few other Chennaiites like Apoorva have been stocking up on pills in their homes from other states, and having them readily available to those who need them.
Through Twitter, various other social media platforms, and word of mouth, these women have been able to successfully supply emergency contraceptive pills to many women, for a number of years, when pharmacies failed to do so.
Archanaa and similar activists have expanded the scope of the help they offer by not just carrying a stock of i-pills but also sharing lists of pharmacies that stock emergency contraceptive pills as well as a list of gynaecologists who are non-judgemental.
On top of this, these citizen activists have not only fundraised so that they can financially support women seeking help, but have emotionally supported women through finding contraception and even through medical terminations.
While these support networks have been incredibly impactful, Apoorva adds that one of their main challenges is that their audience is limited to only a small portion of the population that is in need of these services in Chennai.
“We are limited to people who have access to the internet, people who understand English, and people who know how to find people like me and Archanaa,” says Apoorva. “There are some people who have unprotected sex, who can’t get contraceptives because they don’t know that it exists.”
In recent years, Archanaa and Riya Gupta, another citizen activist, petitioned for the government of Tamil Nadu to reverse the shadow ban and make contraceptives available over the counter like they are supposed to be.
Along with this request, they asked that the government create a clearer understanding of the difference between something like an emergency contraceptive pill and a medical termination.
“The Drug Enforcement Agency of Tamil Nadu reached out to Riya Gupta and Archanaa and told them that they will ensure that pharmacies will start stocking up on emergency contraception and making it more accessible,” says Apoorva. “This, they did, for a short period of time. Of course, there has not been a lot of follow-through.”
Citizens like Apoorva, Archanaa, Riya and Aarti, despite taking many steps in the right direction, demand that much more has to be done by the government to get reproductive freedom where it needs to be.
“The biggest problem is lack of awareness and the second thing is access, the availability of emergency contraception pills is grossly overstated. It’s almost unavailable,” says Dr Vijay. “The government of India has guidelines about the use of emergency contraception, and while it is there on paper, it is there on policy, it is not really translated into availability.”
To help further the movement toward reproductive rights for all, consider donating, or reaching out to Apoorva, Archanaa, Riya and Aarti or various NGOs similar to the ones mentioned above who are working to change the state of reproductive rights in Chennai.