interesting article about this. one thing that surprised me was that people confuse morning after pills with RU-486 (or the abortion pill) which it is not.
as this is my local paper, the stats are all about minnesota and south dakota :)
http://startribune.com/stories/1556/1613282.html
Morning-after pill use is increasing
Josephine Marcotty
Star Tribune
Published Feb 11, 2002
Women who don't want to become pregnant are increasingly turning to emergency contraception after they have unprotected sex.
In the past three years the Planned Parenthood clinics in Minnesota and South Dakota have seen a fivefold increase in the use of emergency contraception pills, which usually prevent ovulation if taken within 72 hours after intercourse.
Family planning experts across the nation say more women are using the drugs as awareness spreads about two versions introduced in 1998 and 1999.
Yet in Minnesota, use of what is sometimes known as the morning-after pill is controversial. Some critics think that emergency contraception may be a form of abortion, and it's often confused with RU-486 or mifepristone, the abortion pill.
The medical community has been split over whether doctors have an obligation to offer the emergency contraception to women who want to avoid pregnancy. Hospitals don't always offer it to victims of sexual assault.
However, recent compromises among medical groups and women's health advocates may mean that more women will hear about the option.
Emergency contraception has been around since the 1970s. Some women knew they could ask a doctor or clinic for a high-dose birth control pill to avoid pregnancy after unprotected sex.
In 1998 and 1999, the Food and Drug Administration (FDA) approved two products for sale specifically as emergency contraception. Preven, made by Gynetics in Belle Meade, N.J., is a package of four hormone pills. Plan B, a two-pill package, was developed by the Women's Capital Corporation, a Washington, D.C., company financed primarily by nonprofit organizations.
Surge in use
Since then, the number of prescriptions sold has been rising. Across the nation, Planned Parenthood said, use of the drugs by its patients rose from 48,000 in 1998 to more than 310,000 in 2000, the most recent data available. The surge may stem partly from a three-year advertising campaign by the Planned Parenthood Federation of America that ended last summer.
The number of prescriptions by 23 Planned Parenthood clinics in Minnesota and South Dakota grew from 1,568 in 1998 to almost 8,500 in 2001. Minnesota's three largest health plans paid for 1,700 such prescriptions last year, but say that demand has been doubling or tripling every year. The drug manufacturers do not report sales figures but say sales are up.
"We still have a long way to go," said Dr. Sharon Camp, president of Women's Capital. "Many people still don't understand that the pills almost always work by delaying ovulation. They are often confused with mifepristone, which causes the abortion of a fertilized egg that's implanted in the lining of the uterus."
Reproductive health groups and many doctors now recommend that any sexually active woman who does not want to become pregnant keep emergency contraception pills in her medicine cabinet just in case. Planned Parenthood and other groups also plan to launch a marketing campaign this spring with the message, "Back up your birth control."
Most women call for it only when they need it.
Jen Elmers, who answers the phones at Planned Parenthood's south Minneapolis clinic, talks with the women who call asking about emergency contraception. "You need the morning-after pill," she said to one early morning caller on a recent Monday. "OK, I have to ask you some questions."
Like many callers, this one told her that the condom broke during sex over the weekend. After a series of friendly, matter-of-fact questions, Elmers says: "You're in the hot zone right now. You can come on in."
Elmers has seen women of all ages seeking emergency contraception.
"I remember one middle-aged woman who hadn't been sexually active in a long time," she said. "She was so embarrassed. I remember her standing here at the counter next to a 17-year-old with pink spiked hair."
Even when being responsible about birth control, embarrassment is inevitable, said Sarah McCulloch, 24, who works for Planned Parenthood. Twice during college she called the clinic when her boyfriend's condom broke during sex, she said.
"It's a hard feeling, walking into a clinic," she added.
Still widely unknown
Still, research shows that in the general population, awareness of emergency contraception remains low. According to the Kaiser Family Foundation, which researches reproductive issues, only 2 percent of women in the United States have used it, and less than half the population has heard of it.
According to the American College of Obstetrics and Gynecology, increased use of emergency contraception could prevent half of the approximately 3 million unintended pregnancies that occur in the United States each year, including as many as 700,000 that end in abortion.
"This pill is FDA-approved, it is not very expensive, it is very low-risk, easy to prescribe, easy to take, and it ought to be an over-the-counter medication," said Sarah Stoesz, executive director of Planned Parenthood Minnesota/South Dakota.
Women's Capital is conducting the research necessary to seek FDA approval to sell the drug without a prescription, Camp said.
Emergency contraception has been entangled in the abortion debate. Last fall, the Minnesota Medical Association was split on whether to support legislation requiring hospitals to offer emergency contraception to victims of sexual assault.
Some members objected to the proposed bill because they did not condone the possibility of harming a fertilized egg. Doctors say that 80 percent of the time, the pills act to delay ovulation, but they don't know why it works the rest of time. It's possible the hormones in the pills may prevent a fertilized egg from implanting into the uterine wall, they said.
"I believe life begins at conception," said Dr. Richard Mulder, a family practice physician from Ivanhoe, Minn., and a Republican state representative. If a woman takes emergency contraception, "was the sperm in contact with egg or not?" he asked. "How are you going to tell?"
Recently the association's board of trustees resolved the fight. Although it stopped short of recommending the legislation, it agreed that physicians have an ethical obligation to inform patients about emergency contraception, and it plans to do more to educate doctors and patients.
"A woman needs to know in order to make her own ethical choice," said Dr. Paul Sanders, executive director of the state Medical Association.
The debate was sparked partly by a 2001 survey of 137 Minnesota hospitals conducted by the Minnesota affiliate of the National Abortion Rights Action League. It found that only half of hospitals said they would provide emergency contraception to a rape victim. The survey used anonymous callers to emergency rooms pretending to be friends or counselors for rape victims.
The Minnesota Hospital and Health Care Partnership disputed the results, saying they don't reflect how emergency room workers would act with a real sexual assault victim. Nonetheless, the hospital group took steps to change.
It intends to include a packet of information on emergency contraception in the kits routinely given to rape victims. If the medication is not on hand at the hospital, women will be told where they can get it.
"It's direct patient education," said Dave Feinwachs, general counsel for the hospital group. "And it's a simple, elegant solution."