Access to Emergency Contraception After Removal of Age Restrictions

Levonorgestrel emergency contraception (EC) is safe and effective for postcoital pregnancy prevention. Starting in 2013, the US Food and Drug Administration removed age restrictions, enabling EC to be sold over the counter to all consumers. We sought to compare the availability and access for female...

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Bibliographic Details
Published in:Pediatrics (Evanston) 2017-07, Vol.140 (1), p.1
Main Authors: Wilkinson, Tracey A, Clark, Porsche, Rafie, Sally, Carroll, Aaron E, Miller, Elizabeth
Format: Article
Language:English
Subjects:
Adolescent
Adolescents
Age
Age (Biology)
Age Factors
Census
Consumers
Contraception
Contraception, Postcoital
Contraceptives, Postcoital
Economic conditions
Economic forecasts
Economic indicators
Female
Health aspects
Health Services Accessibility - legislation & jurisprudence
Humans
Pediatrics
Postcoital contraceptives
Poverty
Pregnancy
Scripts
Social Control, Formal
Statistical data
Teenagers
United States
Youth
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Summary:Levonorgestrel emergency contraception (EC) is safe and effective for postcoital pregnancy prevention. Starting in 2013, the US Food and Drug Administration removed age restrictions, enabling EC to be sold over the counter to all consumers. We sought to compare the availability and access for female adolescents with the 2012 study, using the same study design. Female mystery callers posing as 17-year-old adolescents in need of EC used standardized scripts to telephone 979 pharmacies in 5 US cities. Using 2015 estimated census data and the federal poverty level, we characterized income levels of pharmacy neighborhoods. Of 979 pharmacies, 827 (83%) indicated that EC was available. This proportion did not vary by pharmacy neighborhood income level, nor was significantly different from the 2012 study ( = .78). When examining access, 8.3% of the pharmacies reported it was impossible to obtain EC under any circumstances, which occurred more often in low-income neighborhoods (10.3% vs 6.3%, adjusted odds ratio 1.5; 95% confidence interval 1.20-1.94). This was not significantly different from 2012 ( = .66). Correct information regarding over-the-counter access was conveyed only 51.6% of the time; accuracy did not differ by pharmacy's neighborhood income (47.9% vs 55.3%, adjusted odds ratio 0.89; 95% confidence interval 0.71-1.11) and was not significantly different from 2012 ( = .37). A majority of pharmacies have EC available; however, barriers to and disparities in access for adolescents persist and have not changed since the previous study despite regulatory changes that were designed to improve access to EC.
ISSN:0031-4005
1098-4275
DOI:10.1542/peds.2016-4262