SC Emergency Contraception InitiativeEducating and empowering women in South Carolina by increasing awareness of and access to emergency birth control
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The Facts

Emergency Birth Control Pills

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Reproductive health experts call emergency birth control pills (also known as emergency contraception, the ‘morning after pill,’ or Plan B®) the nation’s best kept secret because few American women are aware that they can do anything after sex to prevent pregnancy. Women can use emergency birth control pills to prevent pregnancy when they have had unprotected sex for any reason, such as: they have been sexually assaulted; they incorrectly use their regular contraceptive method; their regular method fails or they are on medications that interfere with their regular method’s proper action; or they have not yet initiated a regular method of contraception. No woman should have to face an unwanted pregnancy when a method exists to prevent it. Yet, South Carolina’s young women face significant barriers to receiving and using emergency birth control pills to prevent pregnancy.

Emergency Birth Control Pills Prevent Unintended or Unwanted Pregnancy.

  • Experts estimate that that nearly 40 percent of all pregnancies—and up to 85 percent of teen pregnancies—in the United States each year are unintended.[1,2] Moreover, experts estimate that timely use of emergency birth control pills could prevent up to 50 percent of these unintended pregnancies.[2,3]
  • Experts also estimate that timely use of emergency birth control pills could prevent up to 70 percent of all abortions among American women.[2]
  • Emergency birth control pills are the most commonly used method of emergency contraception. Emergency birth control pills contain the same hormonal medications that are in ordinary birth control pills.[2]
  • Emergency birth control pills are up to 89 percent effective in preventing a pregnancy, depending on the type of emergency birth control used, how quickly the pills are begun, and when during a woman’s menstrual cycle the sex occurred.[2] Emergency birth control pills are most effective when taken within the first 24 hours after sex. But they are still effective, although somewhat less so, when taken up to 120 hours after sex.[4,5,6]
  • Emergency birth control pills work like regular birth control pills: they delay ovulation and may inhibit fertilization. It is possible, though unproven, that emergency birth control pills may also prevent implantation.[7,8]
  • The medical community widely agrees that pregnancy begins when implantation is complete – so, even if emergency birth control pills prevent implantation, they do not end pregnancy. Emergency birth control pills prevent pregnancy.[2,7,8] Emergency birth control pills will not harm an already existing pregnancy.[2,6,8]
  • Emergency birth control pills, such as Plan B®, have been approved for use by the United States Food and Drug Administration (FDA).

Adolescent and Young Adult Women in South Carolina Need Access to Emergency Birth Control Pills.

  • According to the most recent data available, South Carolina’s adolescent pregnancy rate in 2000 (89 per 1,000 women ages 15 to 19) was slightly higher than the national rate (84 per 1,000).[9,10]
  • In 2003, there were an estimated 9500 pregnancies among teenagers in South Carolina.[26]
  • South Carolina’s non-Hispanic black and Latina teens had lower pregnancy rates (116 and 126 per 1,000, respectively) than their non-Hispanic black and Latina peers in the United States as a whole (153 and 138 per 1,000, respectively). White teens in South Carolina, by contrast, had a higher pregnancy rate (71 per 1,000) than did their white peers in the United States as a whole (55 per 1,000).[9]
  • Emergency birth control is particularly important for survivors of sexual assault or rape. Women ages 15 through 24 suffer the overwhelming majority of the approximately 300,000 rapes and sexual assaults that occur each year in the United States.[11,12] Experts estimate that in the United States, at least 25,000 pregnancies occur each year as a result of reported rapes and sexual assaults.13 Experts also estimate that 22,000 of these pregnancies could be prevented with the timely use of emergency birth control pills.[13]
  • In August 2006, the Food and Drug Administration (FDA) ruled that young women (and men) ages 18 and older can obtain Plan B®, the only prepackaged, dedicated emergency birth control pill product, without a prescription. Women under age 18 still need a prescription to obtain Plan B®.[25]
  • In South Carolina, the law requires that hospital emergency rooms provide emergency birth control pills to sexual assault survivors who ask for them.[14]

Respected Medical Organizations Support the Use of Emergency Birth Control Pills, But South Carolina’s Young Women Face Barriers to Getting Them

  • Worry about emergency birth control pills’ safety—Respected professional medical organizations, including the American College of Obstetricians and Gynecologists, American Academy of Pediatrics, Society for Adolescent Medicine, American Medical Association, American Medical Women’s Association, and World Health Organization, among others, support women’s access to emergency birth control pills because they are entirely safe and effective.[2,7,15.16,17,18]
  • Unnecessary tests—The American College of Obstetricians and Gynecologists, Society for Adolescent Medicine, and other respected medical organizations assert that, because emergency birth control pills are not dangerous under any known circumstances, routine screening is entirely unnecessary. This means that young women do not need a pelvic exam, pregnancy test, or other laboratory work before being provided with or given a prescription for emergency birth control pills.[2,7] Such tests constitute a major barrier to young women’s accessing the care they need.
  • Confidentiality—Fear that their confidentiality will be violated keeps many young women from accessing needed contraceptive services.[19,20]
  • Cost—Cost is a major barrier to young women’s using contraception, whether they live in South Carolina or elsewhere. One state’s health department noted that 64 percent of women ages 15 to 44 using some form of contraception had out-of-pocket health expenditures 68 percent higher than their male counterparts.[21] Experts attribute higher health costs for women to reproductive health services that are not covered by private health insurance.[21,22]
  • Shortage of affordable providers—Experts estimate that about 250,000 women in South Carolina are in need of publicly supported contraceptive services. At the same time, publicly funded family planning clinics in South Carolina have served as many as 139,000 people and averted more than 32,000 pregnancies across the state each year.[23] Yet, new reports indicate that almost one-third of the Department of Health and Environmental Control’s family planning clinics have closed, making it much harder for poor and very young women to find affordable and confidential contraceptive services, including emergency birth control pills.[24]

Conclusion

To reduce unintended and unwanted pregnancy, South Carolina’s young women need affordable access to contraceptive services, including emergency birth control pills. Pregnancy and childbirth are potentially serious health issues for any young woman. Increasing access to emergency birth control pills among South Carolina’s 16- to 24-year-old women can help to prevent unintended pregnancies (and abortions) in this age group. No young woman should have to choose between childbirth and abortion when remedies exist to prevent unintended and unwanted pregnancy.

Written by Sue Alford, MLS
New Morning Foundation and Advocates for Youth © 2006.

References:

  1. Abma JC et al. Fertility, Family Planning, and Women’s Health: New Data from the 1995 National Survey of Family Growth. [Vital and Health Statistics, Series 23, no.19]. Hyattsville, MD: NCHS, 1997.
  2. Society for Adolescent Medicine. Provision of emergency contraception to adolescents; position paper of the Society for Adolescent Medicine. Journal of Adolescent Health 2004; 35:66-70.
  3. Trussell J et al. Emergency Birth Control Pills: a simple proposal to reduce unintended pregnancies. Family Planning Perspectives 1992; 24:269-73.
  4. Trussell J, Stewart F, Raymond EG. Emergency Contraception: A Last Chance to Prevent Unintended Pregnancy. Princeton, NJ: Office of Population Research, Princeton University, February 2008 Available online at http://ec.princeton.edu/questions/ec-review.pdf
  5. Ellertson C et al. Extending the time limit for starting the Yuzpe regimen of emergency contraception to 120 hours. Obstetrics and Gynecology 2003; 101:1168-1171.
  6. Conard LAE, Gold MA. Emergency contraceptive pills: a review of the recent literature. Current Opinion in Obstetrics and Gynecology 2004; 16:389-395.
  7. American College of Obstetricians and Gynecologists. Emergency contraception. ACOG Practice Bulletin, December 2005 (#69).
  8. International Consortium for Emergency Contraception. Emergency Contraceptive Pills: Medical and Service Delivery Guidelines, 2nd edition. New York: Author, 2004.
  9. Alan Guttmacher Institute. Teenage Pregnancy: Overall Trends and State-by-State Information. New York: Author, 1999.
  10. Ventura SJ et al. Revised pregnancy rates, 1990-97, and new rates for 1998-99: United States. National Vital Statistics Reports 2003; 52(7):1-14.
  11. Rennison CM. Rape and Sexual Assault: Reporting to Police and Medical Attention, 1992-2000. [Selected Findings] Washington, DC: Bureau of Justice Statistics, 2002.
  12. Perkins C. Age Patterns of Victims of Serious Violent Crime [Special Report] Washington, DC: Bureau of Justice Statistics, 1997.
  13. Stewart FH, Trussell J. Prevention of pregnancy resulting from rape: a neglected preventive health measure. American Journal of Preventive Medicine 2000; 19:228-229.
  14. S.C. Code Ann. §16.-3-1350. Medicolegal examinations for victims of criminal sexual conduct or child sex abuse. Alexandria, VA: National Center for the Prosecution of Violence against Women. http://www.ndaa-apri.org; accessed 7/15/2006.
  15. Klein JD and the Committee on Adolescence. Adolescent pregnancy: current trends and issues. Pediatrics 2005; 116:281-286.
  16. American Medical Association. Access to Emergency Contraception [Report of the Council of Medical Service, CMS, Report 1-I-00] Chicago, IL: Author, 2000.
  17. American Medical Women’s Association. Position Statement on Emergency Contraception [Position Papers] Alexandria, VA: Author, 1996.
  18. World Health Organization. Medical Eligibility Criteria for Contraceptive Use. Geneva: Switzerland: WHO, 2004.
  19. Dailard C, Richardson CT. Teenagers’ access to confidential reproductive health services. Guttmacher Report on Public Policy 2005 (November):6-11.
  20. Boonstra H, Nash E. Minors and the right to consent to health care. Guttmacher Report on Public Policy 2000; 3(4):4-7.
  21. Kentucky Office of Women’s Physical and Mental Health. Kentucky Women’s Health 2002: Data, Development, and Decisions. Frankfort, KY: Author, 2002.
  22. National Campaign to Prevent Teen Pregnancy. General Facts and Stats. Washington, DC: Author, 2001; http://www.teenpregnancy.org/resources/data/genlfact.asp accessed 2/22/2006.
  23. Alan Guttmacher Institute. Contraception Counts: State by State Information. New York: Author, updated 2006; http://www.agi-usa.org/pubs/ib22.html; accessed 7/16/2006.
  24. Auer H. 2 steps forward, one step back. Post and Courier (3/4/2006); http://www.charleston.net/; accessed 3/16/2006.
  25. Food and Drug Administration. “Plan B®: Questions and Answers.” http://www.fda.gov/cder/drug/infopage/planB/planBQandA20060824.htm; accessed 08/28/2006.
  26. 2005 Fact Sheet: Adolescent Pregnancy Update. The South Carolina Campaign to Prevent Teen Pregnancy, 2005. http://www.teenpregnancysc.org/pdf/2005_Fact_Sheet.pdf, accessed 09/06/06.

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