Emergency Contraception (EC)
Awareness of, and access to, EC
Awareness and usage of EC:
The Alan Guttmacher Institute estimates that there are about 6.3 million unintended pregnancies each year
in the U.S. About half result in abortions. The FDA predicted that
if doctors and women adopt emergency contraception (EC) up to 2.3 million of these pregnancies
could be prevented; this could prevent up
to one million abortions. This change would reduce the level of abortions to a small fraction of their present levels.
There are many barriers preventing widespread
use of EC. An article in the Canadian Medical Association Journal (CMAJ) lists some barriers which are certainly
true in the U.S. as well:
"...lack of knowledge, reluctance of young women to request
medication from their physicians, denial of pregnancy risk, and lack of
timely access to physicians or family planning clinics." 1
The CMAJ concludes that: "As the
effectiveness of emergency contraception is time-dependent, convenient
prescription and dispensing mechanisms are crucial to enabling its use." 1
If unwanted pregnancies and abortions are going to be reduced through the use of emergency
contraceptives, then public health officials have an uphill battle educating the
public about the availability of the pills.
EC would be more frequently used if more women became aware of
it, and if more service
providers offered it. This is expected in the future as educational projects around the
world increase awareness and availability of the treatment. Lack of awareness of
EC appears to be widespread in the United States. A 1994 survey of
American women showed that only about 1% had used the method. This compares with 4% for
all ages of Finnish women and 25% for their women under 25. 1 In "South East Scotland, 93% of fourth year students (ages 14-15) knew of
the method, and 31% of girls had used it." 2,3
A 2000-NOV poll indicated that one out of four American women had never heard of
emergency contraceptives or morning-after pills. Nearly two-thirds of
women did not realize that the pills were available in the U.S. 4
Use of emergency contraception appears to be increasing
- A 2003-MAR news release by the Family Research Council cited an
unidentified poll by the New York Times. The poll found that
about 5% of all American women aged 18 to 44 had used emergency contraception. 5
- The New York Times reported in 2003 a recent Kaiser
Family Foundation Survey which found that 6% of American women have
used the morning-after pill. This is an increase from 2% in the year
- By 2010, among sexually active women aged 15 to 44, 11% had used EC. 23% of sexually experienced women aged 20 to 24 had used EC.
- Pharmacist awareness:
Planned Parenthood of New York City conducted a survey of 100 pharmacists in 1999. They found that few druggists
were able to provide their customers with reliable information about EC:
- 3% gave out accurate information.
- 37% knew nothing at all about EC.
- 60% offered incorrect information.
- 11% said that EC is an illegal drug!
Presumably, in the decade and a half since that survey, pharmacist knowledge has increased greatly.
Rejection of EC for religious reasons:
Many -- primarily conservative -- faith
groups define pregnancy as starting at conception. They also teach that EC sometimes prevents the implantation of a blastocyst -- a
pre-embryo -- in the uterus. Thus they have concluded that EC can be
abortifacient. Some groups state flatly that EC is an abortifacient. Further research has shown that EC only works as a contraceptive by delaying ovulation or preventing fertilization. Many of these groups still teach that EC is an abortifacient, in spite of evidence to the contrary.
these faith groups also teach that human personhood is achieved by the
pre-embryo at fertilization. They thus regard EC as a poison that murders babies.
||A voicemail service, the Emergency Contraception Hotline, provides
information on EC to callers from the US or Canada. Their number is
1-888-NOT-2-LATE (or 1-888-668-2528). The Hotline will list the nearest
health providers to your location. For callers from Canada, they will list
the nearest American providers. If you are far from the U.S. border you
might wish to phone the emergency room in the nearest non-Roman Catholic
hospital for information.
||An information web site: For those in the U.S., the Emergency Contraception Website has a search function to find an EC provider in your zip code. See: http://ec.princeton.edu/
Access to EC in the U.S.:
In the U.S.: Two brands of emergency contraceptives were originally
available in the U.S. only under a doctor's prescription. Unfortunately, they
have to be taken within a short time of intercourse. There often was
insufficient time for a woman to get an appointment, obtain a prescription, get
the pills and take them within the 72 hour limit.
Some states passed legislation allowing trained pharmacists to dispense EC
without a doctor's prescription.
After a major battle, and an unusual temporary personal veto by the Commissioner of
the FDA, the FDA switched many forms of EC to non prescription status. Kaiser Network's daily reports announced that:
"In 2006-AUG-24, the FDA approved Barr
Laboratories' Plan B for nonprescription sale to women and men 18 years and older throughout the
U.S. Barr agreed to send anonymous shoppers into pharmacies to test their
compliance with the age description. In addition, gas stations and
convenience stores are prohibited from selling the EC." 7
In practice, the age limit probably did not present a
significant barrier to sexually active young women under 18-years-of-age. Most
will be able to make an arrangement with an older woman or man who were able
to buy the pills for them.
In 2013-AUG, the FDA allowed Plan B, the most commonly used EC, to be available directly on pharmacy shelves for persons of all ages without prescription. However, "ella" still requires a prescription.
EC remains difficult to obtain in some areas of the U.S. in spite of the relaxed restrictions. There have been reports from rural areas, Native American reservations, and conservative regions of the country where pharmacists were not aware of the new rules, or were unwilling to implement them. 10 A study by the Journal of Adolescent Health was published in 2013-DEC. They sampled almost 1000 pharmacies across the U.S. and found that 20% percent of them believed that Plan B was only available to women 18 years and older. 11
Most newspapers' editorials and opinion pieces reacted positively to the
development on 2006-AUG-25. However some opinion pieces by conservative Christian groups disapproved:
Access to EC in Canada:
a popular EC, was approved for purchase without a prescription in Canada on
2005-APR-20. 8 They require only a consultation with a
pharmacist. The Society of Obstetricians and Gynaecologists of Canada, the Canadian Medical
Association, Planned Parenthood Federation of Canada, the Canadian
Pharmacists Association, the College of Physicians and Surgeons, the
Federation of Medical Women of Canada, the Canadian Women's Health Network, and the Canadian Nurses Association all approved of the move. The
medication is produced by Barr Pharmaceuticals' subsidiary Duramed
According to Medical News Today on 2005-APR-22:
"EC already was available without a doctor's prescription in the Canadian
provinces of British Columbia, Quebec and Saskatchewan, and provincial rules
say that pharmacists can refuse to dispense EC for moral or religious
reasons. ... The move makes Canada the 34th country worldwide to make
emergency contraception available without a doctor's prescription, according
to a Barr Pharmaceuticals representative." 8
Canadian Physicians for Life expressed opposition, as did numerous Canadian pro-life and
conservative religious groups.
A public opinion survey
by Leger & Leger during 2004-MAY found that 81% of adults in Quebec and
70% of adults in all of Canada agreed that EC should be available
without a prescription. More details.
Associated essay on this website:
The following information sources were used to prepare and update the above
essay. The hyperlinks are not necessarily still active today.
- Judith A. Soon, et al., "Effects of making emergency contraception
available without a physician's prescription: a population-based study,"
Canadian Medical Association Journal, 2005-MAR-29, Page 172-180. It is
online at: http://www.cmaj.ca/
- Reports on Britain and Finland were at: http://www.path.org/html/emergency_contraception_update_10_97.htm
- Anna Graham et al., "Teenagers' knowledge of emergency
contraception: questionnaire survey in south east Scotland," BMJ
Publishing Group, 1996-JUN-22, at: http://bmj.bmjjournals.com/
- Julie Severens Lyons, "Law makes morning-after pill available without
prescription: PHARMACIES WILL BE ABLE TO DISPENSE EMERGENCY CONTRACEPTIVES,"
The Mercury News, 2001-OCT-16, was at: http://www0.mercurycenter.com/premium/ No longer online.
- "Washington Update: Pill pushers," News release, Family Research
- Dann Denny, "More women using morning-after pill to prevent pregnancy," Herald-Times,
Bloomington IN, 2003-MAY-21, at: http://www.hoosiertimes.com/
- "Kaiser Daily Women's Health Policy Report Summarizes
Editorials on Approval of Nonprescription Plan B Sales to Women Over Age
18," KaiserNetwork, 2006-AUG-28, at: http://www.kaisernetwork.org/
- "Health Canada Approves Emergency Contraceptive Plan B as OTC Drug,"
Medical News Today, 2005-APR-22, at: http://www.medicalnewstoday.com/
- "Use of Emergency Contraception Among Women Aged 15–44: United States, 2006–2010," Centers for Disease Control and Prevention, 2013-FEB, at: http://www.cdc.gov/
- Robin Marty, "Mississippi Bill is the Latest Assault on Access to Emergency Contraception," Care2, 2014-JAN-09, at: http://www.care2.com/
- Mindy Townsend, "Pharmacies Are Giving Inaccurate Information About Plan B to Teens," Care2, 2013-DEC-28, at: http://www.care2.com/causes/
Copyright © 1999 to 2014 by Ontario Consultants on
Originally published on 1999-JAN-13
Latest update: 2014-FEB-21
Author: B.A. Robinson