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>Emergency Contraception

EC Over-the-Counter




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  Taking EC Over-the-Counter

On February 14, 2001, CRLP petitioned the FDA, on behalf of more than 60 medical, public health, and other organizations, to change the status of emergency contraception (EC) from prescription to over-the-counter (OTC). By making emergency contraception available over-the-counter, the nearly 3 million unintended pregnancies that occur annually in this country could be reduced by half.

In September 2001, the FDA released a statement that it required more time before acting on the petition. Under FDA regulations, the agency is obligated to respond to the petition within 180 days, but there is no deadline for approving or rejecting the petition. On February 21, 2002, the FDA notified CRLP that the OTC petition was "being actively reviewed at this time."

Help Make EC OTC!

As part of CRLP's effort to have emergency contraception pills be made available over-the-counter (OTC), we wrote a letter to the Secretary of Health and Human Services Tommy Thompson. The letter is intended to give individuals concerned with women's reproductive health, the opportunity to show their support for making emergency contraception more easily obtainable for women. The letter can be immediately sent to Secretary Thompson by adding your personal information.

Click Here to Take Action!

State Trends in Emergency Contraception Legislation

Tired of inaction by the federal government, states take emergency contraception into their own hands.

It has been one year since CRLP petitioned the FDA to make emergency contraception available over the counter. It has been four years since the FDA approved a dedicated emergency contraception regime. In a poll released in November 2000 by the Kaiser Family Foundation, one-fourth of the women aged 18 to 44 surveyed said they had never heard of EC, and nearly two-thirds said they didn't realize it was available in the United States.1

Increasingly, states have become aware of the potential of emergency contraception for decreasing the number of unplanned pregnancies and therefore abortions, and are doing something about it.

In 1998, Washington became the first state to allow women access to EC through a pharmacist without a visit to the doctor. That pilot program was so successful it soon became law.

Increased access to emergency contraception pills is supported around the world: women in Albania, Belgium, Denmark, Finland, France, Israel, Morocco, Norway, Portugal, South Africa, Sweden, the United Kingdom, and other countries can get EC without a doctor’s prescription.

In 2001, California became the second state to enact a law that allows pharmacists to dispense EC directly to women without a visit to the doctor.2 As of February 2002, five states, Hawaii, Minnesota, New Hampshire, New York and Virginia, are considering similar bills.

This year, ten states, Arizona, Florida, Hawaii, Kansas, Minnesota, New Jersey, New York, South Dakota, Wisconsin and Washington are considering bills that require hospital emergency rooms or law enforcement agencies to provide emergency contraception or information about the treatment to rape survivors. In 2001, Illinois became the first state to enact a law that requires hospitals to provide sexual assault survivors with medically accurate written and oral information about EC.3

Short timeline of EC

  • Late 1970s - Doctors first begin to use doses of several regular birth control pills as emergency contraception

  • 1997 - FDA approves six common types of births control pills to be safe and effective for use as emergency contraception

  • 1998 - Preven, the first dedicated emergency contraception regime is approved by the FDA

  • 1999 - Plan B approved for sale by the FDA

  • February 14, 2001 - CRLP petitions the FDA to make EC over-the-counter
  • 1 Kaiser Family Foundation, http://www.kaisernetwork.org/Daily_reports/ rep_index.cfm?DR_ID=8923 (January 20002).
    2 In 2001, four other states: Minnesota, New Hampshire, Oregon, and Virginia, considered legislation that allows pharmacists to dispense EC directly to women without a visit to the doctor.
    3 In 2001, six other states: Hawaii, Kansas, Maryland, Minnesota, New Jersey, and New York, considered legislation that requires hospitals to provide sexual assault survivors with medically accurate written and oral information about EC.

    Statement of Val Smith
    Emergency Contraception Recipient

    "My real name isn't Val Smith, because who I am is not important, but what happened to me could, and does happen, to anyone. It could happen to your sister, friend, mother or cousin.

    "I was sexually assaulted. Since I wasn't sexually active at the time, I was not on any form of birth control. Immediately after the assault, my thoughts were on preventing a possible pregnancy. Because I didn't have any choice in the actions that could create a child, I didn't want to face an unwanted pregnancy. Also, although I am pro-choice, I never wanted to have to make a choice about abortion. Abortion wasn't an option because I wasn't going to become pregnant.

    "Approximately six hours after I was assaulted, I called my family doctor. Unfortunately, my doctor wasn’t available, and I had to discuss my assault and my fears of pregnancy with her answering service. The doctor's service wasn't equipped to handle my situation, so after the humiliation of being attacked, I was humiliated again by having an uninformed, insensitive person handle my call.

    "The service told me to call information for hospital names. The hospital I called then told me to try their emergency room, but the ER staff couldn't confirm whether they actually had emergency contraception available. Since the hospital wouldn't talk to me over the phone about my situation, I wouldn't know if they had the pills unless I drove there. The doctor's service eventually agreed to call in the prescription to a chain pharmacy because the hospital was three hours away. When I finally go the pills four hours later, the pharmacist was rude and condescending.

    "Unfortunately, because I couldn’t get EC myself over the counter, I relied on a health care provider who got the dosage wrong. I became pregnant and later had an abortion. This wasn't a question of my being irresponsible. I knew I needed emergency contraception, I knew how to get it, but I couldn't get it by myself. If I had been able to get it over-the-counter, I wouldn't have become pregnant or had an abortion.

    "I support the petition to make emergency contraception available over-the-counter so no one will ever have to go through what I went through."

    * Name has been changed.

    Interview with CRLP Staff Attorney, Bonnie Scott Jones

    On February 14, 2001, CRLP staff attorney
    Bonnie Scott Jones filed a petition with the U.S. Food and Drug Administration (FDA) on the behalf of more than 60 medical groups to make emergency contraception (EC) available over-the-counter. In the February 2002 issue of CRLP's Reproductive Freedom News, Jones discusses the developments in the petition, as well as her thoughts on what other obstacles lie ahead for women obtaining easier access to emergency contraception.

    CRLP Staff Attorney Bonnie Scott Jones announces the petition to the FDA to make EC available over-the-counter.

    Reproductive Freedom News (RFN): What is the status of our petition to the FDA?

    Bonnie Scott Jones (BSJ): The petition is pending before the FDA. They have not decided to rule on the petition yet. They are required to give some form of response within six months. They failed to do so, and we reminded them of that obligation. They wrote back and said that this raises complicated questions and we need more time. That is one of the responses they are allowed to give. And so we are now coming up on the anniversary, when they again are supposed to tell us the status. They can again tell us that they need more time. And I can virtually guarantee that is what they are going to do.

    RFN: Why is it important for women to have over-the-counter access to emergency contraception?

    BSJ: The most important reason is that, unlike other medical treatments, there is an extremely short window of time in which EC can be used effectively. EC has to be used within 72 hours of unprotected sex and it is more effective if used within the first 24 hours. It is not like getting a cold and you can wait around five days before you get your medicine. You need it extremely quickly, the sooner the better, and it will really make a difference. The other main reason is that the prescription requirements slow down the process of a woman getting emergency contraception. She has to get in touch with the doctor, find a doctor who will give her the prescription, and then call into a pharmacy that is willing to fill it. That takes a lot longer than a woman just going to her local drug store to pick up EC off the shelf next to other forms of contraception.

    RFN: Some critics of making emergency contraception available over-the-counter have charged that without a prescription there is an opportunity for the drug to be abused by women, specifically young women, instead of using other forms of contraception. What would you say to these critics?

    BSJ: I think it is both unreasonable and highly unlikely. If you look at the kind of factors that might play into a young woman's decision of what contraceptive to use, EC is not a desirable choice. It is very expensive compared to a condom. A condom is a matter of cents and I believe a package of EC is between $20 and $30 at the pharmacy. It makes women nauseous. It is not that pleasant. So it has unpleasant side effects that are much more uncomfortable than the side effects of a diaphragm or a condom.

    Although emergency contraception is a lot more effective than doing nothing, it reduces the chance of pregnancy in the neighborhood of 70%, but the pill is in the high nineties as well as condoms in terms of their effectiveness as a method of contraception. I don't think anyone is going to choose an expensive, not as effective, nausea-causing contraceptive over the contraception that is available for use on an ongoing basis.

    RFN: If the FDA said tomorrow that it was going to make EC available over-the-counter, what barriers still remain or could come up to prevent better access for women to EC?

    BSJ: There is the monetary barrier. If the FDA approves these drugs as over-the-counter, that does not mean that the two drug companies that sell EC have the money to make them available over-the-counter. It takes an enormous amount of money to put an over-the-counter drug on the shelves of stores. Unless you are going to be able to do a lot of advertising, get people to know about it and therefore develop a market for the drug, the store or pharmacists will not put it on their shelves.

    Then there are legal obstacles. States could try to pass laws that require parental consent before a teen could purchase EC. They would probably be unconstitutional, but that does not mean the legislatures would not try to pass them and the laws would still have to be challenged.

    Return to the main resource page on emergency contraception.

    Other Reproductive Freedom News articles:

  • October 2001 - Over-the-Counter is Cheap for Public and Private Insurers

  • July/August 2001 - FDA Should Grant OTC Status to Emergency Oral Contraception under Existing Law

  • March 2001 - EC Does It: Push for Over-the-Counter Dispensing

    March 18 - NPR Spotlights EC - Read the full story.

    CRLP is a co-sponsor of the campaign to Back Up Your Birth Control with EC. See the campaign's website for more details.

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