The effects of self-administering emergency contraception

Area of Science:

• Reproductive Health
• Contraception Research
• Public Health Policy

Background:

• Emergency postcoital contraception currently requires a doctor's prescription and timely administration within 72 hours.
• A proposal suggests making emergency contraception available over-the-counter to improve accessibility.
• This study investigated women's behavior and outcomes when provided with a home supply of emergency contraceptive pills.

Purpose of the Study:

• To evaluate the impact of providing women with a readily available supply of emergency contraceptive pills at home.
• To compare the use of emergency contraception, other contraceptive methods, and pregnancy rates between women with and without home supplies.
• To assess the safety and effectiveness of self-administered emergency contraception.

Main Methods:

• A randomized controlled trial assigned 553 women to receive a replaceable supply of hormonal emergency contraceptive pills (treatment group) and 530 to obtain them via prescription (control group).
• Outcomes, including emergency contraception use, other contraceptive use, and unwanted pregnancy incidence, were assessed one year later.
• Data analysis included 549 women in the treatment group and 522 in the control group.

Main Results:

• 47% of women in the treatment group used emergency contraception at least once, compared to 27% in the control group (P<0.001).
• 98% of women who returned questionnaires in the treatment group used emergency contraception correctly, with no serious adverse effects reported.
• Unintended pregnancies occurred in 18 women in the treatment group and 25 in the control group (relative risk 0.7; 95% CI 0.4-1.2).

Conclusions:

• Increased accessibility of emergency contraception is safe and does not lead to increased repeated use or changes in other contraceptive methods.
• Providing emergency contraceptive pills for home use may potentially reduce the rate of unwanted pregnancies.
• The findings support policy changes to make emergency contraception more readily available to women.