Barriers to EC access continue to fall
The roadblocks to emergency contraception (EC) continue to be removed, with more women now accessing the method. According to results from the 1997 Contraceptive Technology Update Pill Survey, more than half of family planning facilities now prescribe emergency contraceptive pills (ECPs) on site and provide them any time. Responses in this category jumped 10% over the 1996 level of 44% providing "full access" use.
With the U.S. Food and Drug Administration (FDA) affirmation of ECP safety, published in the Feb. 25, 1997, Federal Register, the push is on to increase awareness and access to EC methods. (For more information on the Federal Register notice, see CTU, May 1997, p. 53.)
The publicity surrounding the FDA’s move has led more women to seek ECPs, says Marilyn Joseph, MD, FACOG, the medical director for Boynton Health Service, the University of Minnesota student health center in Minneapolis.
"I’ve seen an increase in use this year, and I think it’s because there has been more press out here about it," notes Joseph, whose facility has been a longtime EC provider and one of the initial facilities included in the publication, Emergency Contraception: The Nation’s Best-Kept Secret. (See resource box, p. 143.) "All the patients who are on any kind of prescription birth control are required to go to a one-hour contraceptive class, and ECPs are discussed in that, as well as IUDs and every other method," she says.
A similar increase has been noted this year at the Knoxville (TN) Center for Reproductive Health, says family nurse practitioner Corinne Rovetti, RNC, MSN. The facility, which also offers abortion services, has been providing ECPs for about 23 years. "We have noticed an increase in usage this year with all the good media coverage and increased awareness about its availability. We have information available about ECPs and make mention to patients for future concerns."
While ECPs have been available at the University of Toledo (OH) Student Medical Center for a number of years, there has not been much call for them, says nurse practitioner Kris Sully, RNC, OGNP. However, that has changed over the last couple of years, she states, and requests for EC are growing.
The nonprofit Reproductive Health Technol-ogies Project (RHTP) in Washington, DC, kicked off a educational media campaign this summer about emergency contraception with good results. Billboards, bus placards, and public service announcements in print, radio, and television formats were rolled out in three cities: Seattle, Los Angeles, and San Diego. Media efforts were scheduled to kick off in Chicago at CTU press time, with similar activity to begin in Miami in January 1998, says Jennifer Bull, an assistant in Princeton (NJ) University’s Office of Population Research who has worked with the EC project. The ads, developed by Seattle communications firm Elgin DDB, also have appeared in national magazines such as Glamour, Cosmopolitan, and Buzz.
To illustrate the effectiveness of the media campaign, phone calls from Los Angeles to the toll-free Emergency Contraception Hotline (1-888-NOT-2-LATE) jumped from 138 in June to 536 in July, with calls in Seattle increasing from 43 in June to 104 in August and from 28 to 94 in San Diego during the same time period. The EC project’s home page (http://opr.princeton. edu/ec/) also has had visitors from the three cities, indicating interest in the EC method.
Emergency contraception is here to stay, so what are you doing to improve access? asks Linda Dominguez, OGNP, senior clinician with Planned Parenthood of New Mexico in Albuquerque and a member of RHTP’s EC project. Patients who come to Dominguez for ECPs have heard about the method from a friend, a sister, or a roommate. "Women are finding out about it the way they find out about everything else in their health, and that is woman-to-woman," she says. "That tells me that EC is coming in, it’s coming up from the grass roots, and that’s where it needs to be."
Facilities are going to have to take a look at how EC requests can be worked into the patient flow. At Planned Parenthood of New Mexico, ECPs can be prescribed over the telephone to any established, charted patient but cannot be prescribed over the phone for new patients.
One way to increase awareness is to discuss ECPs with patients as the best backup method of contraception, says Dominguez. Just as clinicians educate patients on how to use foam, condoms, and vaginal contraceptive film, they can discuss ECPs. "We’ve got to integrate EC into the messages we are telling patients and be ready to give EC on demand," Dominguez says.
You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
- Award-winning Medical Content
- Latest Advances & Development in Medicine
- Unbiased Content