Journal of Public Health Policy

, Volume 35, Issue 3, pp 292–310

Association between increased availability of emergency contraceptive pills and the sexual and contraceptive behaviors of women

  • Danielle N Atkins
Original Article

Abstract

In the United States (US), access to emergency contraceptive pills (ECPs) expanded to nationwide in 2006 when regulators allowed Plan B, a brand of emergency contraception, to be sold without prescription. Using data from the National Health and Nutrition Examination Survey from 2001 to 2010, I examined any association between increased access to these ECPs in the US and negative consequences. I found an association between increased access to ECPs and a 2.2 per cent higher probability of any sexual activity, a 5.2 per cent increase in the likelihood of reporting sex with multiple partners, an increase in the average number of partners by 0.35, and a −7.6 per cent decrease in the likelihood of injectable contraceptive use. These results suggest that policies in the US and other countries that expand access to ECPs should be paired with information on ECPs’ lack of protection against sexually transmitted infections and relatively lower efficacy compared to other forms of contraception.

Keywords

emergency contraception risky sexual behaviors contraceptive use public health women’s health 

References

  1. Trussell, J. and Raymond, E.G. (2011) Emergency Contraception: A Last Chance to Prevent Unintended Pregnancy. Office of Population Research at Princeton University.Google Scholar
  2. F.D.A. (2006) Plan B: Questions and answers. 14 December, http://www.fda.gov/Drugs/DrugSafety/PostmarketDrugSafetyInformationforPatientsandProviders/ucm109783.htm, accessed 7 December 2011.
  3. G.A.O. (2005) Decision Process to Deny Initial Application for Over-the-Counter Marketing of the Emergency Contraceptive Drug Plan B was Unusual. In: Office GA, (ed.). Washington DC: Government Accountability Office (G.A.O).Google Scholar
  4. Harris, G. (2011) Plan to widen availability of morning-after pill is rejected. New York Times 7 December.Google Scholar
  5. Rovner, J. (2013) FDA OKs prescription-free Plan B for all ages, ending battle. National Public Radio, 21 June, http://www.npr.org/blogs/health/2013/06/11/190684947/fda-oks-prescription-free-plan-b-for-all-ages-ending-battle, accessed 21 June 2013.
  6. Grimes, D.A. (2002) Switching emergency contraception to over-the-counter status. New England Journal of Medicine 347 (11): 846–849.CrossRefGoogle Scholar
  7. Wearn, A. and Gill, P. (1999) Hormonal emergency contraception: Moving over the counter? Journal of Clinical Pharmacy and Therapeutics 24 (5): 313–315.CrossRefGoogle Scholar
  8. Girma, S. and Paton, D. (2011) The impact of emergency birth control on teen pregnancy and STIs. Journal of Health Economics 30 (2): 373–380.CrossRefGoogle Scholar
  9. Moreau, C., Bajos, N. and Trussell, J. (2006) The impact of pharmacy access to emergency contraceptive pills in France. Contraception 73 (6): 602–608.CrossRefGoogle Scholar
  10. Wood, A.J.J., Drazen, J.M. and Greene, M.F. (2011) The politics of emergency contraception. New England Journal of Medicine 366 (2): 101–102.CrossRefGoogle Scholar
  11. Gold, M.A., Wolford, J.E., Smith, K.A. and Parker, A.M. (2004) The effects of advance provision of emergency contraception on adolescent women’s sexual and contraceptive behaviors. Journal of Pediatric and Adolescent Gynecology 17 (2): 87–96.CrossRefGoogle Scholar
  12. Ekstrand, M., Larsson, M., Darj, E. and Tyden, T. (2008) Advance provision of emergency contraceptive pills reduces treatment delay: A randomised controlled trial among Swedish teenage girls. Acta Obstetricia Et Gynecologica Scandinavica 87 (3): 354–359.CrossRefGoogle Scholar
  13. Jackson, R.A., Schwarz, E.B., Freedman, L. and Darney, P. (2003) Advance supply of emergency contraception: Effect on use and usual contraception – A randomized trial. Obstetrics & Gynecology 102 (1): 8.Google Scholar
  14. Polis, C.B., Grimes, D.A., Schaffer, K., Blanchard, K., Glasier, A. and Harper, C. (2007) Advance provision of emergency contraception for pregnancy prevention. Cochrane Database of Systematic Reviews: 2.Google Scholar
  15. Weaver, M.A., Raymond, E.G. and Baecher, L. (2009) Attitude and behavior effects in a randomized trial of increased access to emergency contraception. Obstetrics and Gynecology 113 (1): 107.CrossRefGoogle Scholar
  16. Marston, C., Meltzer, H. and Majeed, A. (2005) Impact on contraceptive practice of making emergency hormonal contraception available over the counter in Great Britain: Repeated cross sectional surveys. British Medical Journal 331 (7511): 271.CrossRefGoogle Scholar
  17. Durrance, C.P. (2012) The effects of increased access to emergency contraception on sexually transmitted disease and abortion rates. Economic Inquiry 51 (3): 1682–1695.CrossRefGoogle Scholar
  18. Hatcher, R.A., Trussell, J. and Nelson, A.L. (eds.) (2007) Contraceptive Technology. New York: Ardent Media.Google Scholar
  19. Boonstra, H. (2002) Emergency contraception: Steps being taken to improve access. Guttmacher Report on Public Policy 5 (5): 10–13.Google Scholar
  20. Hazell, K. (2012) Morning-after pill: ‘Contraceptive-by-courier’services launches. The Huffington Post UK 17 April, http://www.huffingtonpost.co.uk/2012/04/17/morning-after-pill-delivery_n_1430881.html, accessed 10 November 2013.

Copyright information

© Palgrave Macmillan, a division of Macmillan Publishers Ltd 2014

Authors and Affiliations

  • Danielle N Atkins
    • 1
  1. 1.Department of Political ScienceUniversity of TennesseeKnoxvilleUSA

Personalised recommendations