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October 2002 Does Easy Accessibility of Emergency Contraception
Proper use of emergency contraception could prevent 1.7 million of the three million unintended pregnancies that occur every year in the United States. Women who have intercourse without contraception, experience contraceptive failure, or are victims of rape have two options to reduce their chances of pregnancy. Collectively known as emergency contraception, these treatments include taking high doses of birth control pills or having an intrauterine contraceptive device inserted. Emergency contraception has been known in the medical community for decades, but only recently has this information come to the attention of the general public, among whom greater awareness could make a dramatic difference. Emergency contraceptive pills are regular birth control pills, such as Ovral® or Ogestrel®, taken in higher doses than usual, or pills developed specifically for emergency contraceptive use. Preven®, which has been on the market since 1998, and Plan B® available since 1999, are the two emergency contraceptive products available in the United States. If the first dose of emergency contraceptive pills is taken within 72 hours of unprotected sex, followed by a second dose 12 hours later, the treatment will be effective in preventing pregnancy for at least 75 percent of the women who otherwise would have become pregnant. Taken within 24 hours of unprotected sex, the pills’ ability to interrupt ovulation, fertilization, or implantation of the egg increases significantly. The second method of emergency contraception is the insertion of an intrauterine device within seven days after unprotected intercourse. This procedure reduces the probability of pregnancy among 99 percent of the women who would have become pregnant without treatment. Cramping and bleeding are the most frequently noted side effects. Although millions of women worldwide have used emergency contraception, it is not as effective in preventing pregnancy as regular birth control methods. It is, as the name states, for emergencies. But emergency contraception does offer a safe way to reduce unintended pregnancy and, consequently, to reduce reliance on induced abortions. As part of its global portfolio of activities to improve women’s reproductive health, the Population Council staff has conducted research to improve awareness of and access to emergency contraception. In most countries a prescription is needed to obtain emergency contraception pills, but making emergency contraception accessible without a prescription would reduce the effort, time, and, in cases where a doctor’s fee is involved, cost associated with procuring the pills, making this type of contraceptive more useful for the emergencies for which it is intended. Long shown to be a safe method, the pill’s only side effects are nausea and vomiting. However, there is some fear that ease of access may encourage women to take chances with, or abandon, their current family planning methods. Population Council researchers asked, “What would happen if women were provided with pills during a routine doctor’s visit, given instructions, and asked to store the pills for use in an emergency?” To assess whether or not the incidence of unprotected sex would be higher if women had such access to emergency contraception, Council staff members conducted a study among 411 women from a family planning clinic in Pune, India. After agreeing to be part of the study, participants were either provided information on how to use and where to obtain emergency contraceptives or given three courses of the prescribed treatment for use if needed, in addition to instructions. The study results showed that women who received both information and pills were not significantly more likely to have unprotected sex than women receiving information only. But women with supplies were nearly two times as likely to use emergency contraception pills after unprotected intercourse as the other study participants. No one in the group used the pills more than once during the 12-month study, demonstrating that most women will not abandon their regular family planning methods in favor of emergency contraception. The vast majority of the women who used the regime did so properly, indicating that physicians need not explain the rules immediately before use. Interestingly, one-quarter of those who received pills and had unprotected sex during the study period did not use them. Researchers attributed this phenomenon to the study groups’ lack of familiarity with this method. Participants who had pills on hand liked having them available, but those who did not receive pills were unanimous in saying that they wished they had had them. This study, in combination with other Population Council efforts to examine the use and delivery of emergency contraception, is an important source of science-based information to help policymakers formulate choices based on research, rather than ideology, to better serve their female constituents. For further information about emergency contraception, visit http://ec.princeton.edu/questions/index.html. | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
