Compiled by Angie Stefaniak, MPA
Emergency contraception (EC) is a birth control method that works by preventing pregnancy after an act of unprotected intercourse. Currently, two forms of emergency contraception are available: pills containing hormones and copper-T intrauterine device (IUD). It is estimated that half of the 3.5 million unintended pregnancies that occur each year in the United States could be prevented if EC were easily accessible and used,  and the number of abortions each year could also be cut by as much as half.  The Department of Health and Human Services Healthy People 2010 goal is to increase the proportion of pregnancies that are intended to 70 percent.
For decades, EC has been prescribed for women following unanticipated sexual activity, contraceptive failure, or sexual assault to reduce the risk of pregnancy. In the mid-1960s physicians prescribed high dose estrogen to prevent pregnancy in a survivor of sexual assault. In the early 1990s, about one third of EC prescriptions were for rape survivors. By the end of the 1990s EC was recognized as a safe and effective method for all women at risk of unintended pregnancy.
Until the late 1990s EC was commonly known as the “morning after pill.” This term is a misnomer because treatment involves more than one pill, can be taken within five days after unprotected intercourse, and should not be confused with medication abortion because EC cannot terminate an established pregnancy. [4 ]
Before September 1998, no dedicated EC product had been approved, labeled and marketed in the U.S., and EC was available only through the “off-label” use of oral contraceptive pills. In September of 1998 the FDA approved the application to market the first dedicated EC product, the PREVEN ™ Emergency Contraceptive Kit. In 1999 the FDA approved the first progestin-only EC – Plan B®. Plan B® is the EC most widely used, and last year the FDA announced its approval of the sale of Plan B® over the counter to women and men 18 and older. 
National and Utah Data
According to a survey conducted by the Henry J. Kaiser Family Foundation and SELF Magazine in 2003, women’s awareness and use of EC remains low nationally, but is steadily increasing. They report roughly two-thirds of women “know that there is something they can do to prevent pregnancy” in the event of contraceptive failure or unprotected sex. Only about one in 20 women reported ever having used EC.  Table 1 shows the percentage of women who have ever used EC has increased annually from 1% in 1997 to 6% in 2003.
In Utah, data about EC use are harder to identify. The Utah Department of Health says it does not collect information on EC use. In addition, Barr Pharmaceuticals, Inc and Duramed Pharmaceuticals, Inc. the manufacturers and suppliers of Plan B, are unable to provide the total number of Plan B prescriptions distributed or written in the state of Utah.
To date, the most comprehensive data available for EC use in Utah comes from the state’s largest prescriber of EC – Planned Parenthood Association of Utah (PPAU). Chart 1 shows the total increase each year from 2000-2006. According to the data in Table 2, EC use has steadily increased annually (2003-2006) in all age groups. Women age 20-24 used EC more than any other age group. Age breakdowns are not available for years prior to 2003. These prescriptions represent those written for immediate consumption, and those written in advance of need. PPAU says that although they do provide EC prescriptions for future need, the majority of prescriptions provided are for immediate use.
Once called America’s “best-kept secret” the slow, but steady increase in EC prescriptions is most likely due to a combination of factors:
- The release of dedicated EC products: PREVEN™ and Plan B®;
- Organized education efforts by groups such as Planned Parenthood and the pharmaceutical manufacturers of EC; and
- Increased awareness of EC by providers and women. Enter more text and/or charts here as needed.
EC use has increased steadily both nationally and locally. However, although options for and information about EC have increased in the past decade, further efforts and research are needed to build a comprehensive picture of the number of women accessing emergency contraception, the reasons EC is used and what, if any, impact EC has on unintended pregnancy and abortion rates in Utah. As Plan B® becomes available without a prescription to women and men over 18 it is important to gather and analyze data on how over the counter access impacts unintended pregnancy rates as well.
Information about Plan B can be found at: www.Go2PlanB.com and www.plannedparenthood.org.
- Emergency contraception: What’s the Big Deal? American Medical Student Association. Available at: http://www.amsa.org/hp/ECD.ppt. Accessed January 9, 2007.
- Raine T, Harper C, Rocca C, Fischer R, Padian N, Klausner J, Darney P. Direct Access to Emergency Contraception Through Pharmacies and Effect on Unintended Pregnancy and STIs: A Randomized Control Trial. JAMA. 2005; 293(1):54 -62.
- Boonstra H. Emergency Contraception: The Need to Increase Public Awareness. The Guttmacher Report on Public Policy. October 2002.
- Weiss D, lead author. Golub D, revisions. A Brief History of Emergency Contraception. Planned Parenthood Federation of America Report. December 2006. Published by the Katharine Dexter McCormick Library.
- Kaiser Family Foundation and SELF Magazine Survey. 2003.Anational Survey of women about their sexual health. Take charge of your sexual health. Summer 2003. Available at: http://www.kff.org/womenshealth/loader.cfm?url=/commonspot/security/getfile.cfm&PageID=14298. Accessed on January 9, 2007.