More women using ‘morning after’ pill

By Dr. Ananya Mandal, MDApr 29 2011

Figures have revealed that the rate of women using emergency contraception in 2006-08 more than doubled, compared with the rate in the previous four to six years, before the pills were approved for use without a prescription. This comes from a study from the Guttmacher Institute.

Morning after pill or emergency contraceptive is available over the counter for women who have had had unprotected sexual intercourse within the last 72 hours and wish to avoid pregnancy but the risk of pregnancy increases by 50% after the first 12 hours.

For the study the researchers reviewed data from the National Survey of Family Growth, found that 9.7% of women aged 15-44 had used emergency contraception (EC) in 2006-08, but that only 3% had talked to a doctor about it. Study author Megan L. Kavanaugh, a senior research associate at Guttmacher said the rate of use is still “relatively low, given that it's easy to access.” The researchers agree that “there's room for improvement”. Doctors could be better at getting the word out that emergency contraception exists and is available without a prescription, she said.

The team also noted that the percentage of women who had discussed EC with a doctor had not changed between the two study periods. Among the women who had received counseling from a medical professional in 2006-08, 43% said they had talked to a health-care provider at Planned Parenthood or another family planning clinic; 26% were counseled at a community health clinic; and about 16% said they had discussed EC at a private doctor's office.

The numbers are somewhat surprising, given that the average EC user tends to be financially well off, and high-income women tend to go to private doctors rather than community clinics. In fact, the study's authors found that women whose incomes were five times over the poverty line were more than twice as likely to use EC as those living in poverty. They write that the demographics of EC users are important because they can help inform decisions by public-health experts who aim to prevent national rates of unwanted pregnancies. Though experts had hoped the availability of the morning-after pill would reduce unplanned pregnancies, “so far there's no evidence that this is happening,” Kavanaugh added.

This study found that the average woman who has taken emergency contraceptives is college-educated, never married and aged 18-29. She began having sex in her teens, is slightly less likely than women in the general population to have ever had an abortion, is nearly twice as likely to have had a pelvic exam or Pap smear, and is nearly 10 times as likely to have talked to her doctor at least once about EC. She is also not likely to use the morning-after pill regularly: 61% of users had only done so once.

Experts suggest that these pills are not meant to be used regularly. The pills are not meant to replace regular birth control, but rather to be used as back-up when another method like a condom or diaphragm fails, or if a woman forgets to take her birth-control pill. The study's author also suggested that many people may still be unaware that EC is an option for them, or how to get it. The researchers think that the increase in its use is certainly related to the Food and Drug Administration's decision to make the drug available over the counter in 2006, but that it may have been the media publicity surrounding that decision that truly raised awareness of the drug's existence.

Along with the Plan B product One-Step, there is a generic equivalent called Next Choice available without a prescription. Side effects of both products include abdominal pain, fatigue, headache and nausea. The current study was funded by government and private grants, and the researchers report no financial conflicts of interest.