Morocco: Difference between revisions

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[[File:Flag of Morocco.svg.png|300px | thumb|right|]]

'''OVERVIEW'''  

In Morocco, you can purchase birth control without a prescription. You can also access emergency contraception (the morning after pill), and ellaOne (which is currently considered the most effective EC) is available. There are no travel restrictions related to HIV or STD status, and you can get free anonymous HIV tests at certain facilities, which we list on this page. There is currently no HPV vaccination program. There also appears to be no PrEP in Morocco yet. You can find pads and tampons in Morocco, and there are some small-scale menstrual cup vendors.Abortion is legal under certain circumstances, and in recent years, these circumstances have been expanded. However, legal abortions are still not the norm and many women still seek out underground and unsafe abortions each year.

'''General Note:''' There are many types of contraceptives, also known as "birth control," including IUDs, oral contraceptives, patches, shots, and condoms, etc. If you would like to view a full list, click [https://www.plannedparenthood.org/learn/birth-control here].

In Morocco, birth control is informally available without a prescription. This means that it can be purchased over-the-counter at pharmacies. You can also access other forms of birth control, such as condoms, shots and IUDs. It is estimated that about 68% of Moroccan women use some form of contraception and that 48% use modern contraceptive methods. It was found in a 2015 UN report that 9.7% of Moroccan women have unmet family planning needs. The most common birth control methods were the pill (used by 49.6% of Moroccan women who are in marriages or in unions), IUD (4.3%), withdrawal (3.9%), rhythm (4.3%) and female sterilization (3.0%). Condom usage is rather low with only 1.2% using the male condom.<ref>[http://www.un.org/en/development/desa/population/publications/pdf/family/trendsContraceptiveUse2015Report.pdf Trends in Contraceptive Use Worldwide 2015]</ref>

According to a 2012 report from the Population Reference Bureau, "the country stands out among Arab countries for a rapid increase in modern contraceptive use by both rural and urban women and for relatively low levels of "unmet need" for family planning—defined as the share of women who wish to delay or avoid pregnancy but are not using contraception."<ref>[http://www.prb.org/Publications/Articles/2012/morocco-maternal-deaths.aspx In Morocco, More Modern Contraceptive Use Plays Key Role in Decreasing Maternal Deaths]</ref>

However, progress can still be made. For one, Moroccan family planning heavily emphasizes the pill, and it does not focus on condoms (which can prevent both pregnancy and STD infection). For this reason, it is recommended that Moroccan family planning dedicates more resources to emphasizing other contraceptive methods. Furthermore, as the report states, "Moroccan family planning and maternal health services tend to focus on the needs of married women. Single men and women may avoid family planning and reproductive health services because of a lack of confidentiality as well as judgment by providers. Roudi-Fahimi argued that these programs should be expanded to serve unmarried couples who are sexually active—a relationship that is usually kept secret because it is not acceptable socially or legally."<ref>[http://www.prb.org/Publications/Articles/2012/morocco-maternal-deaths.aspx In Morocco, More Modern Contraceptive Use Plays Key Role in Decreasing Maternal Deaths]</ref>

[[File:Moroccobirthcontrol.jpg|300px | thumb|left|frame|'''Birth control pills from Morocco''']]

* For a list of contraceptive options available in Morocco, click [http://contraceptive.ippf.org/search?search.searchtext=&search.component=&search.countrycode=MA here].

* In Moroccan cities, the neighborhood health clinics provide family planning services. However, at these clinics, there is often an expectation that, if you're being helped, you should be married. Clinic staff may not explicitly ask for marriage certificates, but they typically already know who is married and who is unmarried due to their neighborhood involvement. To avoid judgment and stigma, many unmarried Moroccan women choose to visit NGOs over neighborhood clinics for family planning services.

* For planned parenthood, (prescription/ shot or implant of hormonal contraceptives. + IUDs) there's the AMPF (Association Marocaine de Planning Familial). The fees are affordable (2 consultations: around 120dh, and the procedure and the device are free).

Some pills cost around 13 dh per month.

'''Important Notes:''' Emergency contraception may prevent pregnancy for three days (72 hours) and sometimes five days (120 hours) after unprotected sex. Take EC '''as soon as possible''' after unprotected sex. If you don't have access to dedicated EC, oral contraceptives can be used as replacement EC, but remember the following: 1) Only some contraceptives work as EC 2) Different contraceptives require different dosages and time schedules to work as EC 3) You must only use the first 21 pills in 28-day packs and 4) They may be less effective than dedicated EC. For general information on emergency contraceptives, click [https://www.plannedparenthood.org/learn/morning-after-pill-emergency-contraception here] and [http://ec.princeton.edu/info/ecp.html here].

Emergency contraception (the morning after pill) has been legal in Morocco since 2008.<ref>[https://en.wikipedia.org/wiki/Emergency_contraceptive_availability_by_country Emergency contraceptive availability by country]</ref> You can buy it at pharmacies without a prescription, according to locals. Technically, you may be required to have a prescription, according to Moroccan law,<ref>[http://www.cecinfo.org/country-by-country-information/status-availability-database/countries/morocco/ EC Status and Availability: Morocco]</ref> but this doesn't seem to be widely enforced.

* You can purchase dedicated emergency contraception at Moroccan pharmacies. Some brands you can expect to see are ellaOne, NorLevo 1.5mg and Postinor-2. For all of these pills, you should take one pill within 120 hours of unprotected sex to prevent pregnancy.<ref>[http://ec.princeton.edu/worldwide/ Princeton EC Website]</ref> Currently, ellaOne is considered the most effective EC on the market, since it can be effective for 5 days after unprotected sex, whereas the other pills are effective for 3-5 days after unprotected sex. For more information on ellaOne, check out the [http://www.ellaone.com/ ellaOne website].

* You can have an IUD inserted to prevent pregnancy for up to 5 days after unprotected sex.  

* If you can't access dedicated emergency contraception, you can use regular oral contraceptives (birth control pills) as emergency contraception. For progestin-only pills, you can take Microval (take 50 pills within 120 hours after unprotected sex). For combined pills (progestin-estrogen), you'll need to remember that, in 28-day packs, only the first 21 pills can be used. You can take Neogynon or Stediril (take 2 pills within 120 hours after unprotected sex and take 2 more pills 12 hours later). You can also take Microgynon, Microgynon-30 and Minidril (take 4 pills within 120 hours after unprotected sex and take 4 more pills 12 hours later).<ref>[http://ec.princeton.edu/worldwide/ Princeton EC Website]</ref>

'''Important Notes - Learn about PEP and PrEP:''' If you think that you've been recently exposed to HIV (i.e. within 72 hours), seek out PEP (Post-Exposure Prophylaxis). It's a month-long treatment to prevent HIV infection after exposure, and it may be available in your city. Take PEP as soon as possible. For more information, click [https://www.aids.gov/hiv-aids-basics/prevention/reduce-your-risk/post-exposure-prophylaxis/ here]. If you are at risk of HIV exposure, seek out PrEP (Pre-Exposure Prophylaxis). It's a daily oral pill that can prevent HIV infection before exposure. To learn more about PrEP, click [http://www.whatisprep.org/ here].

There are no travel restrictions related to HIV or STI status in Morocco. In the 1990s, some people were deported due to their HIV status, but that has stopped. Furthermore, while the US Consulate website claims that there are restrictions on HIV+ visitors to Morocco, this has been confirmed by numerous sources to be incorrect, and more information can be found online at [http://www.hivtravel.org/Default.aspx?PageId=143&CountryId=126 HIV Travel].

Please visit city pages, like the [[Casablanca]] page, for local recommendations.

* [http://www.alcs.ma/ Association de Lutte contre le Sida]: They offer treatment and education on HIV preventuin. Address: 17, Boulevard Al Massira Al Khadra, Casablanca. Phone: +212 2 994 242/43. Fax: +212 2 994 244.

* [http://www.opalsmaroc.com/ OPALS (Organisation Panafricaine de Lutte contre le SIDA or Pan-African Organization for the Fights Against AIDS)]: They offer support and education.

* If you have a yeast infection, you should ask the pharmacist for Fluconazole.

* There is no national HPV vaccination program in Morocco, despite the fact that cervical cancer is the second most common form of cancer among Moroccan women.<ref>[http://www.hpvcentre.net/statistics/reports/MAR_FS.pdf Morocco - Human Papillomavirus and Related Cancers, Fact Sheet 2016]</ref>

* There are no known providers of Pre-Exposure Prophylaxis (PrEP) in Morocco.<ref>[http://www.prepwatch.org/ PrEpWatch World Map]</ref>

'''Note:''' In addition to pads and tampons, you can also use menstrual cups and menstrual underwear for your period. To learn more about menstrual cups, click [https://en.wikipedia.org/wiki/Menstrual_cup here]. To learn more about menstrual underwear, click [http://menstrualcupreviews.net/best-period-panties-reviews/ here].

In Morocco, you can find pads, tampons and some menstrual cups. Pads are very common and easy to find. Tampons are sold in large stores, especially ones that are in tourist areas. You can also fine them in Marjane, a supermarket chain. Regarding menstrual cups, there are no official sellers of major brands, like DivaCup, MoonCup or Lunette. However, there are some women and small boutiques that may sell menstrual cups. Also, if you're using a menstrual cup, nearly all washrooms have some kind of water, so you'll be able to rinse it out.

Please visit city pages, like the [[Casablanca]] page, for local recommendations.

Please visit city pages, like the [[Casablanca]] page, for local recommendations.

'''Important Note:''' There are two main types of abortions: medical (also known as the "abortion pill") and surgical (also known as "in-clinic"). For medical abortions, you take a pill to induce abortion. For surgical abortions, a procedure is performed to induce abortion. For general information about medical and surgical abortions, click [https://www.plannedparenthood.org/learn/abortion here].

In Morocco, abortion is legal (for up to 6 weeks of pregnancy) under certain circumstances, which include: if the woman's life is endangered by the pregnancy, if the woman's physical or mental health is endangered by the pregnancy, and if the pregnancy is the result of rape or incest. In all other circumstances, such as risk of fetal impairment, social/economic reasons or upon request, are not permitted. If the woman's life is endangered by the pregnancy, spousal consent is not required. In all other cases, the spouse must generally approve of the abortion. If the husband refuses or cannot give consent, the physician is required to obtain the authorization of the chief medical officer of the province. This authorization will be a written notification, which will say that the intervention is the only way of safeguarding the health of the woman.<ref>[http://www.un.org/esa/population/publications/abortion/profiles.htm UN Profile - Abortion in Morocco]</ref>

In the future, Morocco may seek to further liberalize its abortion laws. In 2015, the government (by the king's decree) began to allow abortions in cases of rape or incest. Furthermore, the Moroccan Health Minister told the Associated Press, “Morocco’s penal code on abortion is very restrictive; the law is not fair to women. It doesn’t take into account the reality that Moroccans live in these days - there is an urgent need to revise this law."<ref>[http://www.middleeasteye.net/in-depth/features/delicate-debate-abortion-morocco-1032639837 Abortion in Morocco: A delicate debate]</ref> However, these are also conservative and religious groups in Morocco, which are actively and vocally opposed to abortion.

As reported in USA Today in 2015, "Doctors, activists, and professors say some Moroccan women try to induce an abortion by ingesting harmful herbal infusions or pills, laying on the sweltering floor of a hammam (bathhouse) or even inserting a sharp device into their vaginas. But women with money can usually find doctors willing to provide a safe abortion, according to Imane Khachani, a gynecologist in Rabat. These abortions typically cost over $1,000, a huge amount in a country where the minimum wage is just $300 a month."<ref>[http://www.usatoday.com/story/news/world/2015/08/12/morocco-moves-legalize-abortions-cases-rape-and-incest/31153009/ Morocco moves to legalize abortions in cases of rape and incest]</ref>

Abortions in Morocco generally cost 3000-9000 dirham.

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