The history of universal access to emergency contraception in Peru: a case of politics deepening inequalities.

According to UNFPA estimates, four girls under the age of 15 give birth each day in Peru. In 2010, 34% of adolescents who reported having suffered sexual violence became pregnant as a result of the assault, and 14% were aged 10–14 years. Adolescent pregnancy, sexual violence and forced motherhood (i.e. resulting from the lack of true choice young women may have in becoming pregnant and/or carrying the pregnancy to term) remain serious health and human rights concerns in Peru. Girls from marginalised or low-income populations are more likely to become pregnant and consequently to drop out of school, because of their limited access to information and health care services. Despite this serious public health problem, ensuring universal access to emergency contraception (EC) (the only contraceptive method that can prevent pregnancy after intercourse), has remained an object of political dispute, further deepening social inequalities in Peruvian society. Emergency contraceptive pills (ECPs) are a safe and effective contraceptive method that can prevent pregnancy up to five days after unprotected sexual intercourse. ECPs, also known as “the morning after pill” or “post-coital contraception”, work primarily by delaying ovulation and are more likely to be effective the sooner they are taken. Scientific evidence shows that ECPs do not prevent a fertilised egg from implanting in the uterus, and do not induce abortion. Ensuring universal access to a wide range of contraceptives, including EC, is associated with higher use and a decrease in the number of teen pregnancies. A number of international treaties (such as the Convention on the Elimination of All Forms of Discrimination Against Women, or the Convention against Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment) recommend that, in order to protect and promote the right to health, States make universally available a comprehensive range of good quality, modern and effective contraceptives, including EC. Furthermore, ECPs are included in theWorld Health Organization (WHO) Essential Medicines Model List, an inventory of the medicines considered most necessary and effective tomeet the needs of a country’s population. WHO recommends that ECPs be integrated into healthcare services and routinely offered to girls who have been raped.