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Emergency contraception (EC) is a safe, proven and effective way to prevent pregnancy after unprotected intercourse. EC contains a large dose of the same hormones found in the birth control pill and can be started up to five days (120 hours) after unprotected intercourse. The most commonly used form of EC, Plan B, reduces the risk of pregnancy by 89 percent when started within 72 hours — or three days — after unprotected intercourse. Despite the proven effectiveness of EC, barriers to access continue to be a problem across the United States. History of EC Over the Counter
Emergency contraception, once available only by prescription, was approved as an over-the-counter medication in 2006. There was a tough, 3-year-long battle to make EC quickly available to more women . In the end, over-the-counter access to EC was approved only for women older than 18. Although the FDA’s decision was a victory, access is still an issue for many women, regardless of their age.
Many women still report delays and refusals when attempting to obtain emergency contraception. Women face discrimination by pharmacists who refuse to dispense EC, and these women often have no viable alternative. The age limitation also places a burden on young women. The United States has one of the highest rates of teen pregnancy of any developed country. EC holds tremendous potential for dramatically reducing the number of unintended pregnancies among teens, which would mean fewer abortions – a goal on which everyone should be able to agree.
The battle over access to emergency contraception is complicated by widespread misunderstanding about what the drug actually is. In public debate, EC is confused -- often intentionally, by anti-choice proponents --with the early-abortion option, mifepristone. The distinction between the two is important. Emergency contraception is exactly what it sounds like – contraception. It prevents pregnancy, whereas Mifepristone terminates an existing pregnancy.
Planned Parenthood Affiliates of California (PPAC) has been fighting to gain broader access to EC since it first became available in the United States. California was one of the first states to allow pharmacists to dispense EC without a prescription , and PPAC is proud to have always been on the cutting edge of increasing women’s access to the most effective methods of affordable birth control. We have been a key supporter of the following state legislation to expand access to EC.
Sheila Kuehl authored Assembly Bill 525 which ensures that women have access to a full range of reproductive health services, including emergency contraception, through all state-managed health care plans and HMOs. PPAC noted that one of the trends in healthcare during that period involved non-profit hospitals being acquired by religious organizations that limited women’s access to certain reproductive healthcare options. PPAC was especially worried about survivors of rape who were being denied information and access to EC when taken to the emergency room. AB 525 was a first step to ensure that a full range of reproductive healthcare options, including EC, remain available to California’s women and men.
Carole Migden introduced AB 1860 in the 2001-2002 legislative session in response to serious concerns over how survivors of rape were being treated in emergency rooms across California. Despite the victory of AB 525 in the previous legislative session, women taken to emergency rooms after being raped were still being denied access and even basic information about emergency contraception. As Migden noted, about one in five American women will be raped at some point in their lives. Adding to the trauma of the assault, about one in ten women who are sexually assaulted will become pregnant by an attacker. As with other unintended pregnancies, about one-half of the pregnancies resulting from rape end in abortion. By strongly supporting AB 1860, PPAC ensured that all women in California, especially those who have survived sexual assault, get the care and support they need in the most effective and timely manner.
SB 1169, authored by Dede Alpert in the 2001-2002 legislative session, was a great victory for reproductive healthcare. After the success of a pilot program in Washington state, California took on the challenge to expand access to EC by allowing pharmacists to dispense the medication. (The FDA had not yet approved EC for over-the-counter status.) SB 1169 made California one of the first states to allow women access to EC without a prescription. This legislation made it possible for women to get the care they needed more quickly, especially on weekends and holidays when they might not be able to see a doctor to get a prescription.
Dede Alpert authored SB 490 in response to studies that showed only about 14 percent of pharmacists were actually dispensing EC without a prescription even though the passage of AB 1169 made it legal to do so. SB 490 made the process far less burdensome for pharmacists, and the legislation encouraged them to provide greater access to EC.
Jackie Speier authored SB 545 in the 2003-2004 legislative session to address another EC issue– the price. Although previous California legislation allowed women to get EC at a pharmacy without a prescription, women found that many pharmacists charged high counseling fess in addition to the price of the medication. The price-hike meant some women weren’t able to afford the medication or get it as quickly as they needed it, SB 545 prohibited pharmacists from charging the extra fee when dispensing EC without a prescription.
Sponsored by PPAC and authored by Deborah Ortiz, SB 644 established protocols for those pharmacists who claimed a religious or moral objection to dispensing medication such as EC
The legislation was inspired by a “mystery shopping project,” sponsored by Planned Parenthood, that sent women all over California to purchase EC -- including from pharmacists who would not dispense it because of their own religious objections . Not only were many of these women denied the medication, there was no legal responsibility for the pharmacist to tell them where they could get it or transfer the prescription to another pharmacy. This placed an undue hardship on women attempting to get EC within the time period it is most effective.
SB 644 ensures that women have access to EC without conflicting with the religious freedom of pharmacists. While it does not require the pharmacist to be willing to dispense EC, it does require that she or he arrange for the woman to get her medication from a different pharmacist in a timely manner.
The fight isn’t over! If you have been denied access to EC by your local pharmacy, we want to know about it. Contact your local organizer and tell us your story. As far as we’re concerned, the battle for EC won’t be over until every woman can get affordable emergency contraception within the 72 hours it is most effective!