Association of Reproductive Health Professionals
Association of Reproductive Health Professionals
Reproductive Health Topics Publications & Resources Professional Education Newsroom Membership Policy & Advocacy About Us
Clinical Proceedings
Send To A Friend Send To A Friend Bookmark this Page Share this page
Update on Emergency Contraception

(Published March 2011)

Impact of EC on Risk Taking

One of the concerns expressed about making emergency contraception (EC) available over-the-counter (OTC) was that easy access would encourage women, particularly adolescents, to increase risky sexual behavior and reduce their routine use of regular methods of contraception. Reported evidence from studies conducted around the world demonstrated that making emergency contraception pills (ECPs) more widely available does not increase risk taking or adversely affect regular contraceptive use.1–13 In studies of ECP use and risk taking, women were randomized to receive either counseling and ECPs on demand or ECPs in advance for later use. Reanalysis of one of the randomized trials suggested that easier access to ECPs may have increased the frequency of coital acts with the potential to lead to pregnancy.14 Women in the increased-access group were significantly more likely to report that they had ever used ECPs because they did not want to use condoms or another contraceptive method.15

References:

  1. Glasier A, Baird D. The effects of self-administering emergency contraception. N Engl J Med. 1998;339:1–4.
  2. Jackson RA, Schwarz EB, Freedman L, et al. Advance supply of emergency contraception: effect on use and usual contraception: a randomized trial. Obstet Gynecol. 2003;102:8–16.
  3. Gold MA, Wolford JE, Smith KA, et al. The effects of advance provision of emergency contraception on adolescent women's sexual and contraceptive behaviors. J Pediatr Adolesc Gynecol. 2004;17:87–96.
  4. Lo SS, Fan SYS, Ho PC, et al. Effect of advanced provision of emergency contraception on women's contraceptive behavior: a randomized controlled trial. Hum Reprod. 2004;19:2404–10.
  5. Raine TR, Harper CC, Rocca CH, et al. Direct access to emergency contraception through pharmacies and effect on unintended pregnancy and STIs: a randomized controlled trial. JAMA. 2005;293:54–62.
  6. Hu X, Cheng L, Hua X, et al. Advanced provision of emergency contraception to postnatal women in China makes no difference in abortion rates: a randomized controlled trial. Contraception. 2005;72:111–6.
  7. Belzer M, Sanchez K, Olson J, et al. Advance supply of emergency contraception: a randomized trial in adolescent mothers. J Pediatr Adolesc Gynecol. 2005;18:347–54.
  8. Trussell J, Raymond E, Stewart FH. Re: advance supply of emergency contraception [Letter]. J Pediatr Adolesc Gynecol. 2006;19:251.
  9. Walsh TL, Frezieres RG. Patterns of emergency contraception use by age and ethnicity from a randomized trial comparing advance provision and information only. Contraception. 2006;74:110–7.
  10. Raymond EG, Stewart F, Weaver M, et al. Impact of increased access to emergency contraceptive pills: a randomized controlled trial. Obstet Gynecol. 2006;108:
    1098–1106.
  11. Hazari K. Use of emergency contraception by women as a back-up method. Health Popul. 2000;23:115-22.
  12. Ekstrand M, Larsson M, Darj E, et al. Advance provision of emergency contraceptive pills reduces treatment delay: a randomised controlled trial among Swedish teenage girls. Acta Obstet Gynecol Scand. 2008;87:354-9.
  13. Schwarz EB, Gerbert B, Gonzales R. Computer-assisted provision of emergency contraception: a randomized controlled trial. J Gen Intern Med. 2008;23:794-9.
  14. Raymond EG, Weaver MA. Effect of an emergency contraceptive pill intervention on pregnancy risk behavior. Contraception. 2008;77:333–6.
  15. Weaver MA, Raymond EG, Baecher L. Attitude and behavior effects in a randomized trial of increased access to access to emergency contraception. Obstet Gynecol. 2009;113:107–16.