ACOG Steps Up Efforts to Get Emergency Contraception to Women

May 8, 2006

Washington, DC -- From its Annual Clinical Meeting today, top leaders of The American College of Obstetricians and Gynecologists (ACOG)-the preeminent authority on women's health-launched a new national campaign, Ask me., aimed at educating women about emergency contraception (EC) and encouraging them to get an advance prescription from their ob-gyn. ACOG developed this campaign to help eliminate the logistical and political barriers that currently exist and make EC largely inaccessible to women.

At a news conference, ACOG President Michael T. Mennuti, MD, ACOG President Elect Douglas W. Laube, MD, MEd, ACOG Immediate Past President Vivian M. Dickerson, MD, and Iffath A. Hoskins, MD, representing ACOG's Committee on Health Care for Underserved Women, spoke of the critical need for all women of reproductive age to have unimpeded access to emergency contraception, an essential treatment method for protecting and safeguarding their reproductive health. It's been estimated that greater access to EC could cut unintended pregnancy and abortion rates in half.

"With the Ask me. campaign, ACOG is stepping up our efforts to address this country's high rate of unintended pregnancy. Nearly half (49%) of the more than 6 million pregnancies that occur each year are unplanned," Dr. Mennuti said. "Family planning is an important issue for our specialty, and EC is an excellent contraceptive option for millions of women who want to prevent an unintended pregnancy."

Emergency contraception, also called the morning-after pill, is a higher dosage of the same hormones found in ordinary birth control pills. It is highly effective in reducing a woman's chance of pregnancy after a contraceptive failure or unprotected sex. This can include rape. If taken within 72 hours of unprotected sex, EC prevents up to 89% of pregnancies; it is most effective if taken within 24 hours.

According to ACOG, over half (53%) of the women who have unplanned pregnancies are using some method of contraception. "Accidents happen. No form of contraception offers women 100% protection," noted Dr. Mennuti. "By getting women to ask about emergency contraception and by ob-gyns giving them an advance prescription for it, we hope to make EC a forethought, not an afterthought. We want women to be prepared-well before a contraceptive failure or unprotected sex occurs. Afterward may be too late."

The theme of the Ask me. campaign is "Accidents happen. Morning afters can be tough." Campaign materials include posters for physician examination and waiting rooms and the Ask me. button-a key element designed to promote dialogue between the patient and her ob-gyn about emergency contraception. (See attachments for educational materials on EC.)

Dr. Laube explained that currently EC is not available without a prescription, except in a handful of states (AK, CA, HI, ME, MA, NH, NM, VT, and WA). Because of the prescription requirement, many women have difficulty getting EC within the 72-hour efficacy window. "Even with a prescription, women can be denied EC because some pharmacists refuse to dispense it," he added.

In 2005, at least six states expanded access to emergency contraception. However, more than a dozen states tried to enact laws that would allow pharmacists to refuse to fill prescriptions for EC and other drugs that they say are against their beliefs-so-called "conscience clause" or "refusal" legislation. "Emergency contraception is a hot topic at the state level, and women's health is once again in the middle of this tug of war," Dr. Laube said.

In May 2004, the US Food and Drug Administration rejected the application from Barr Pharmaceuticals, Inc. to make Plan B®, the only dedicated emergency contraception product on the market, available without a prescription on the basis of insufficient data related to safety. Though now acknowledging that women age 17 and older can safely use Plan B® as an over-the-counter (OTC) drug, the FDA nonetheless has introduced new excuses to continue its delay in making a decision.

"The scientific evidence and medical consensus supporting non-prescription sales of emergency contraception is unparalleled in FDA history," Dr. Dickerson said. She reiterated ACOG's support for making EC available directly to women over the counter. "The FDA's failure to act amounts to a quintessential shell game, in which women are the losers. Not granting national OTC status to Plan B® goes against their mission of promoting public health and welfare. EC's safety and efficacy are backed by decades of research and are not debatable," she added. "As champions of women's health, ACOG endorses non-prescription sales of emergency contraception."

Studies also show that women are more likely to use EC if they have it readily available. It is estimated that making EC widely available OTC has the potential to prevent at least half of unintended pregnancies in the US (or about 3 million pregnancies annually) and reduce the number of abortions in the US by 50%.

"This is ACOG's way of standing up for our patients," noted Dr. Hoskins. "One of our goals is to make awareness of EC so widespread that it's no longer a best-kept secret in medicine. We're hopeful that the Ask me. campaign will accomplish that. This would have a profound impact on women's health."

Another aspect of the new ACOG initiative is to educate women about what emergency contraception is and how it works. Emergency contraception prevents pregnancy. It is, however, often confused with medical abortion. Emergency contraception and the abortion pill RU-486 are not the same thing. EC works before a pregnancy is established, not afterward. If a woman is already pregnant, EC will not work, nor will it terminate her pregnancy.

"Through the Ask me. campaign, we're optimistic that our specialty's proactive approach-by promoting advance prescriptions for EC-will improve wider access and greater usage of EC," stated Dr. Mennuti. He added, "Unplanned pregnancy is a major public health issue in the US. As ob-gyns, it's our mission to advocate for, protect, and advance women's health, and that's really what this campaign is about."

The American College of Obstetricians and Gynecologists is the national medical organization representing over 49,000 members who provide health care for women.