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Experts Call for Easier Access to Emergency Contraception


WebMD Health News

Nov. 20, 2000 (New York) -- Long touted by many reproductive health professionals as "America's best kept secret," emergency oral contraception may one day be completely out in the open and as easy to buy as aspirin -- but not before the regulatory process causes a few headaches along the way.

Speaking here Thursday at a media briefing sponsored by the Henry J. Kaiser Family Foundation, many experts say these pills, which are a higher-than-usual dose of standard birth control pills, may eventually be available over the counter, and that could be a good thing for women.

"Emergency contraception pills are still underused in this country. We are trying to increase access to these pills by making them more widely available," says Carolyn Westhoff, MD, an attending physician and professor of obstetrics, gynecology, and public health at Columbia Presbyterian Medical Center in New York. "We know that there is a need for emergency contraceptive pills and that women can easily identify for themselves whether or not they need it."

Westhoff and others at the briefing acknowledge, though, that there are still some major economic, bureaucratic and political hurdles to overcome before these pills make their way onto drugstore shelves. For example, insurance companies cover emergency contraception, but if these pills become available without a prescription, they will no longer cover the cost of these pills.

Emergency contraceptives act after intercourse by preventing the release of an egg from the ovaries or preventing a fertilized egg from implanting on the uterine wall. The first dose should be taken within 72 hours of unprotected intercourse and the second dose, 12 hours later.

There are two types of emergency oral contraception that are currently marketed for that purpose: Preven and Plan B. Preven is a combination of the hormones estrogen and protestin, and Plan B consists of progestin only.

In France, a progestin-only emergency contraceptive identical to Plan B is available "behind the counter," meaning that it is not on the shelf, but it is available without a prescription by asking a pharmacist. It is also available through high school or junior high school nurses. Emergency contraception is truly available over the counter in Norway.

Each year, millions of women worldwide get pregnant unintentionally -- most often because they forgot to use their birth control method or because of failure of the method they chose.

Likening emergency contraception to keeping a fire extinguisher in the kitchen, Westhoff says "the reason we have a fire extinguisher in our homes is because accidents do happen, not because people are planning to be careless. We use the same argument about emergency contraception."

Women need to have a back-up plan, she says.

But the way things stand now, she points out, even if a woman has unprotected or inadequately protected sex and knows that there is a solution available, she still has to see her health care provider, get a prescription, go to a pharmacy and get that prescription filled.

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