Access to Contraceptive Did Not Alter Practices, Study Says

By Marc Kaufman
Washington Post Staff Writer
Wednesday, July 13, 2005

Making emergency contraception available without a prescription in Britain did not lead women there to rely on it rather than other birth control methods or to an increase in unprotected sex, a new study has found.

The three-year study of more than 20,000 women found that over-the-counter availability had little effect. About the same percentage of women used the emergency contraceptive before and after it become more easily available in January 2001 -- about 8 percent annually.

The researchers concluded that fears that nonprescription emergency contraception would change contraceptive practices were unfounded, as were hopes it would reduce unwanted pregnancies.

The study was published on the online version of the British journal BMJ (formerly the British Medical Journal).

The question of whether emergency contraception should be available without a prescription has become a political issue in the United States, with social conservatives saying that it would encourage sexual promiscuity and reproductive rights advocates saying it would enable women to better protect themselves against unintended pregnancies.

In 2003, a Food and Drug Administration advisory panel voted 23 to 4 to recommend making the Plan B brand of emergency contraceptive available without prescription, but the agency rejected the proposal last May. The makers of Plan B, Barr Laboratories Inc., revised the application and resubmitted it, but the FDA missed its January deadline for acting on it.

The issue has now been raised in the confirmation of Lester M. Crawford, nominated by President Bush to become the commissioner of food and drugs. Sens. Hillary Rodham Clinton (D-N.Y.) and Patty Murray (D-Wash.) have accused the administration of politicizing the Plan B application and have placed a hold on Crawford's nomination until the FDA makes a decision.

The authors of the study, conducted by researchers at the Imperial College Faculty of Medicine in London and funded by the British Office of National Statistics, wrote that their work had "important policy implications."

They concluded that women prefer obtaining emergency contraception over the counter, that cost appears to be a barrier for some, and that the proportion of women using emergency contraception did not increase after the policy change.

"Given the apparent absence of negative consequences, and the fact that many women clearly prefer to buy [emergency contraception] over the counter, our study supports the case for lifting the ban on over-the-counter sales in the United States and other countries," the authors, led by professor of primary care Azeem Majeed, wrote.

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