Doctors have appealed to the minister for health, Simon Harris, to cut the cost of long-term contraception to reduce the number of crisis pregnancies in Ireland.
The Irish College of General Practitioners (ICGP) says options such as implants, injections, and intra-uterine devices (IUDs) — some of which can provide protection for years — are particularly suited to younger women, who may fail to take the pill daily, which they need to do if it is to be effective.
But they say the upfront cost of LARC (long-acting reversible contraception) is a deterrent to many younger women in full-time education or on low wages.
IUDs, such as the hormone-releasing Mirena and Kyleena coils, are subsidised under the Drug Payment Scheme for women without medical cards.
But, even then, they will still be charged for the first €144 of the cost, in addition to which they will have to pay for a GP’s consultation and prescription, a subsequent visit to have the device fitted, and a third visit for a check-up, after six weeks.
The ICGP calculates the total bill to be €364 — although some clinics charge more — a price they say puts off many women. “The financial barrier to LARC methods is significant,” it says.
Dr Nicola Cochrane, who is leading the push by the ICGP, said in a letter to Minister Harris: “We have, historically, had a low rate of IUD use in Ireland, particularly among younger women.
“There are cultural and educational barriers to considering these methods, which require a well-thought-out awareness campaign with all women’s health groups. However, the most significant barrier for young women is cost. If we can provide better contraceptive options, which are acceptable, safe, and long-lasting, to our younger population, then I suggest we could see a dramatic reduction in crisis pregnancies in Ireland.”
According to the ICGP, just 11% of women in Ireland use an IUD — a low rate that falls to 4% for the 18-35 age group — while only 4% use a hormone implant or injection.
The ICGP has suggested that LARC contraceptives be included in the Long Term Illness Scheme, which provides certain drugs free, regardless of a person’s income, or that a grant or voucher scheme be introduced to help with the cost.
The United Nations Population Fund shows that one in seven (14%) women in Ireland aged 15-49, and married or in a relationship, has an unmet need for contraception.
The figure is higher — one in five (20%) — when the unmet need for modern contraception is quantified, with significant numbers relying on withdrawal or the rhythm method.
The report was launched in conjunction with the Irish Family Planning Association, which has also long called for greater access to free and low-cost contraception, particularly for younger women.
So far, the minister has only acknowledged the ICGP’s letter and has not taken up Dr Cochrane’s suggestion of a meeting to discuss the issue.
His department said: “Access to long-acting, reversible contraception is currently covered under the medical card.”
In fact, not all LARC options are covered. The Department of Health did not comment on the ICGP’s suggestions for cutting costs for women who do not have a medical card.