The Morning After Pill in Malta
The morning after pill (also known as Plan B or the day after pill) is a type of emergency contraception. It is a special type of contraceptive that is used after a woman has had sex to prevent pregnancy. It can be used after unprotected sex (no contraceptive was used at all) or after a regular contraceptive has failed (eg: a condom has torn or you missed more than one dose of the regular pill).
The EllaOne, a type of morning after pill that contains ulipristal, can be taken up to five days after sex. The other morning after pills contain the hormone levonorgestrel and can be taken up to three days after sex. However, the sooner a morning after pill is taken, the more likely it is to prevent pregnancy.
The morning after pill does not protect against sexually transmitted infections (STIs). If you believe you may be at risk of an STI, see your GP or attend your local health centre.
The morning after pill is available in Malta without the need of a doctor's prescription, but barriers to accessing it still exist.
Important facts about the morning after pill
The morning after pill is around 75% effective at preventing pregnancy. The sooner it is taken, the more effective it will be.
If you vomit in the first two hours after taking the morning after pill (three hours in the case of EllaOne), you should take another dose.
There is no limit to how many times you can take the morning after pill, although you should consider a regular contraceptive such as the regular pill if you wish to prevent pregnancy in the future and are not already on one. Regular contraceptives are generally cheaper than the morning after pill. Click here for more information about regular contraceptives in Malta.
Taking the morning after pill does not reduce your fertility in the future.
The morning after pill works by preventing pregnancy. It does not cause an abortion. It is not an abortion pill.
Cost and Types of Morning After Pill
Prices for emergency contraception in Malta vary from EUR 15 to EUR 40 per pill in most cases, with EllaOne being more expensive than the other morning after pills.
EllaOne contains the ingredient ulipristal acetate. It prevents pregnancy by modifying the action of the natural hormone progesterone. It should be taken as soon as possible after sex, although it can still work up to five days (120 hours) after sex. No dose adjustment is necessary for women in the overweight or obese BMI range. Women with severe asthma or severe liver disease should seek medical advice before taking EllaOne.
It is generally agreed that EllaOne is the most effective out of all morning after pills at preventing pregnancy.
For more information about EllaOne see the patient information leaflet here.
There is also more information on EllaOne's UK website: www.ellaone.co.uk
The other morning after pills contain the medication levonorgestrel, which is a type of hormone that prevents pregnancy. The pills that contain levonorgestrel can be taken up to three days (72 hours) after sex. Women who are obese may need to take a double dose of levonorgestrel-based pills. Levonelle and Escapelle are two morning after pills that contain levonorgestrel 1.5mg and are available in Malta.
Possible side effects
The side effects of morning after pills are usually mild and resolve in a few days. The most common side effects are headache, nausea, and abdominal pain. Spotting a few days after taking a morning after pill is also commonly seen.
If you have used a morning after pill, you next period may be later or earlier than usual, and it may be lighter or heavier than usual. You can use a high sensitivity pregnancy test like Clearblue from six days before your period is due to confirm whether the morning after pill has worked.
If you also take the regular contraceptive pill...
If you miss doses of your regular contraceptive pill, you can take a morning after pill to avoid getting pregnant. If you use Levonorgestrel-based pills (Escapelle or Levonelle), you can restart the regular contraceptive pill immediately after the morning after pill. If you use EllaOne, you should wait 5 days before restarting the regular contraceptive pill. This is because the active ingredient of EllaOne can interact with regular contraceptive pills.
If you take a morning after pill, you should not rely on the regular contraceptive pill until your next period. This is because the regular pills take time to work after missing doses. If you take a morning after pill you should use condoms until your next period.
Getting the Morning After Pill in Malta
The morning after pills are available over the counter (no doctor's prescription needed) from many pharmacies across Malta and Gozo. However, individual pharmacists are allowed to conscientiously object from dispensing it. This means that certain pharmacists may refuse to sell you the morning after pill, but they are obliged to inform you of other pharmacists who would be willing to dispense it. As professionals, all pharmacists must remain non-judgemental and maintain confidentiality.
The website pharmacy.com.mt has a list of pharmacies in Malta that stock the morning after pill. You can also refer to the map below. Even if your local pharmacy is not on the list or map, you may wish to call them to see if they stock the morning after pill.
If you are buying the morning after pill on a Sunday or public holiday, not all pharmacies will be open on the day. Check the roster of which pharmacies are open on Sundays and public holidays here.
You can find pharmacies that sell the morning after pill in your area on this map. This map is part of the I need MAP! initiative by Volt Malta. To report any inaccuracies or add more pharmacies to the map, email them here.
Know your rights
Pharmacists who refuse to dispense the morning after pill for moral reasons should tell you where you will be able to purchase it.
As professionals, all pharmacists must treat their clients in a non-judgemental and confidential manner. If you feel that this is not the case, you should make a complaint with the pharmacy or the authorities.
In Malta the morning after pill is available without the need for a doctor's prescription, and therefore a pharmacist should not ask for one. However, a pharmacist may ask you to see a doctor if you have a health condition that may make the morning after pill unsafe.
There is no limit to how many times you can purchase the morning after pill.
In Malta, people are generally deemed able to make decisions about their health when they reach the age of 16 years. The age of sexual consent is also 16 years. Therefore, there should be no barriers to 16 and 17 year olds accessing the morning after pill.
A significant disadvantage is that the morning after pill is not currently available at the public hospital. This is a problem for women who are admitted to hospital (eg: after a sexual assault) and wish to have the morning after pill. What usually happens in these situations is that a friend or relative is asked to purchase the morning after pill from an outside pharmacy. As doctors for choice, we believe this is less than ideal and we believe the morning after pill should be available in the public hospital to genuine cases.