Emergency contraception.(Guest Editorial)

As physicians with a special interest in women's health, we have a duty to advise our patients about their full range of contraceptive options, including emergency contraception.

Emergency contraception (EC) is safe and effective and should be a routine part of your contraceptive counseling. Timely use of these products could prevent more than 1 million abortions and as many as 2 million unintended childbirths in the United States each year.

Yet, according to a 1997 study conducted by the Henry J. Kaiser Family Foundation, only 9%-11% of the physicians surveyed made emergency contraception an integral part of their advice to patients. The same study revealed that 11% of the women asked had a basic understanding of the methods employed in EC but only 1% had actually used it. Many of the women who had heard about EC believed it was not safe and would have been reassured had their doctors discussed it with them. In fact, more than 40% of the women surveyed said they would have been more likely to use EC if it was on a doctor's recommendation, or if they had it at home when they needed it (J. Am. Med. Womens Assoc. 53[5 Suppl. 2]:242-46, 1998).

Another study has shown that only 1% of American women had ever used emergency contraception, while 2%-3% of women of childbearing age seek elective abortions each year (Ann. Intern. Med. 137[3]:180-89, 2002).

Many doctors worry that women who know about EC might be less likely to use their regular methods of contraception, especially if they are given a supply of the EC pills in advance. Yet the evidence suggests that women who are appropriately educated about EC and supplied with pills do indeed use them, but not at the expense of their usual contraceptives.

Since January 2002, pharmacists in California have been authorized, with special training, to dispense emergency contraceptive pills without a prescription. This program has been successful in some large urban areas, but elsewhere many pharmacists are not certified to participate. Many insurance plans do not cover the fees for the pharmacist ...