BACKGROUND:

Emergency contraceptive pills—a concentrated dose of the hormone found in many regular birth control pills—can prevent pregnancy by stopping or delaying ovulation, inhibiting fertilization or preventing implantation of a fertilized egg when taken shortly after unprotected intercourse (most effectively, within 72 hours).Although oral contraceptives have long been used for this purpose informally, it was not until the late 1990s that the Food and Drug Administration approved two products specifically packaged as emergency contraception (EC).

Since then, state policymakers have concentrated on two approaches to promoting access to EC.The first requires the provision of EC-related services in hospital emergency rooms to women who have been sexually assaulted. The second allows pharmacists to provide EC to customers without a prescription. Pharmacists providing the treatment must either have a specific collaborative practice agreement with a physician or be acting in accordance with a state-approved protocol that clearly spells out the circumstances under which pharmacists can provide EC.

HIGHLIGHTS:

6 states (California, Illinois, New Mexico, New York, South Carolina, Washington) require hospital emergency rooms to provide EC-related services to women who have been sexually assaulted. 5 states (California, Illinois, New Mexico, New York, Washington) require emergency rooms to provide information about EC to women who have been sexually assaulted. 5 states (California, New Mexico, New York, South Carolina, Washington) require emergency rooms to dispense EC to women who have been sexual assaulted upon request. 1 state (Ohio) requires health care providers that object to dispensing EC to refer patients to another health care provider. 5 states (Alaska, California, Hawaii, New Mexico, Washington) allow pharmacists to dispense EC without a prescription under certain conditions. 4 states (Alaska, California, Hawaii, Washington) allow pharmacists to distribute EC when acting within a collaborative practice agreement with a physician. 2 states, (California, New Mexico) including 1 that also gives pharmacists the collaborative practice option, allow pharmacists to distribute EC in accordance with a state-approved protocol.

FOR MORE INFORMATION:

Boonstra H, Emergency contraception: steps being taken to improve access, The Guttmacher Report on Public Policy, 2002, 5(5):10–13.

Boonstra H, Emergency contraception: the need to increase public awareness, The Guttmacher Report on Public Policy, 2002, 5(4):3–6.

Boggess J, How Can Pharmacies Improve Access To Emergency Contraception? Perspectives on Sexual and Reproductive Health, 2002, 34(3):162-165.

Gardner JS et al., Increasing access to emergency contraception through community pharmacies: lessons from Washington state, Family Planning Perspectives, 2001, 33(4):172–175.

Dailard C, Increased awareness needed to reach full potential of emergency contraception, The Guttmacher Report on Public Policy, 2001, 4(3):4–5 & 12.

Harvey SM et al., Women’s experience and satisfaction with emergency contraception, Family Planning Perspectives, 1999, 31(5):237–240 & 260.

Cohen SA, Objections, confusion among pharmacists threaten access to emergency contraception, The Guttmacher Report on Public Policy, 1999, 2(3):1–3.

Brown JW and Boulton ML, Provider attitudes toward dispensing emergency contraception in Michigan’s Title X programs, Family Planning Perspectives, 1999, 31(1):39–43.

Wells ES et al., Using pharmacies in Washington state to expand access to emergency contraception, Family Planning Perspectives, 1998, 30(6):288–290.