Getting 'Morning-After Pill' Not Always Easy
The cost of the emergency contraceptives included flat fees ranging from free to $220 and sliding scale systems that discounted fees for students and ranged from free to $54.
Trussell and colleagues say that wider access to emergency contraception services is needed, particularly on weekends and holidays when offices are closed. They suggest backup systems, such as information left on voice mail or with answering services, and collaboration with pharmacies. Washington state, for instance, allows pharmacists to prescribe emergency contraceptives to women without seeing a clinician. Trussell and colleagues say that providers themselves should consider over-the-phone prescribing. In the study, only 12 providers offered a telephone prescription.
"There are lots of ways to make access to contraceptives easier," Trussell says. "We ought to be eliminating as many barriers as possible."
A spokesperson for Planned Parenthood Federation of America tells WebMD that 47 of its 132 affiliates nationwide prescribe emergency contraception over the phone. When a woman calls asking about emergency contraception, she is asked questions that include when her last menstrual period was, whether she has ever had problems taking estrogen, and whether there is a history of blood clots in her family. Preven, the most common type of emergency contraceptive, contains estrogen, which can increase the risk of blood clots in some women. An alternative progestin-only pill, known as Plan B, can be prescribed if a woman cannot take estrogen. The caller is also asked for the name and phone number of a local pharmacy and pharmacist, and given information about potential side effects, such as nausea and severe headache.
About half of the Planned Parenthood affiliates offer a "standing" prescription for emergency contraception for established clients, meaning a woman who has already used emergency contraception is given a refillable prescription that allows her to get the pills without having to see her doctor. Some individual physicians offer this option, also. Another method is a preventive prescription for a supply of emergency contraception that a woman can keep at home or in her handbag.
- Emergency contraception, or the morning-after pill, can prevent pregnancy when taken within 72 hours of unprotected sex, but it may be difficult to obtain.
- In a recent study, 25% of attempts to get a prescription for emergency contraception failed.
- To make this treatment more available, physicians can prescribe the drug over the phone, prescribe it in advance, and establish back-up systems with answering services and pharmacies.