Who’s Using the Morning-After Pill?

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The rate of women using emergency contraception in 2006-08 more than doubled, compared with the rate in the previous four to six years, according to a new study from the Guttmacher Institute. So who is taking the “morning-after” pill?

The researchers, who 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. The rate of use is still “relatively low, given that it’s easy to access,” study author Megan L. Kavanaugh, a senior research associate at Guttmacher, told Reuters, noting 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.

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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 — a standard measure of financial security — were more than twice as likely to use EC as those living in poverty.

The demographics of EC users are important because they can help inform decisions — or shape further study — 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 told Reuters.

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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.

Indeed, the pills are not meant to be used regularly. Known as Plan B or Next Choice, emergency contraception contains progestin, a synthetic form of progesterone, and is effective at preventing pregnancy if taken within 72 hours of sex, and most effective if taken within the first 12 hours. 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.

Emergency contraception is currently available behind the counter at drug stores for girls and boys age 17 or older, or with a prescription for younger teens.

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The study’s author 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.

Increasing doctors’ counsel about EC may make it more widely available to women who have had unprotected sex and do not wish to become pregnant.