Cochrane review of research on advance provision of emergency contraception
With colleagues at Family Health International, Johns Hopkins Bloomberg School of Public Health, the University of California at San Francisco, and the Center for Reproductive Biology at the University of Edinburgh, Ibis staff conducted a systematic review of randomized trials that have assessed the impact of providing emergency contraception (EC) to women in advance of need. Advance provision could increase the use of EC after unprotected sex, eliminating time needed to get a prescription or find a pharmacy and potentially reduce unintended pregnancy. EC has been shown to reduce the risk of pregnancy by up to 89% after unprotected sex, and some research suggests that it is more effective the sooner it is used. We found that advanced provision strategies did increase use of EC, but research conducted to date shows no effect on rates of unintended pregnancy. Women who received EC in advance did use it more frequently, but even with EC at home they often did not use it when they needed it. Advance provision of EC does not lead to increased unprotected sex or to reduced condom or regular contraceptive use as some opponents have charged.
Women deserve the chance to protect themselves from unintended pregnancy, and EC provides a safe, effective option to do so. Though EC has not had its hoped-for effects on reducing unintended pregnancy on a population level, more research is needed to determine new interventions to increase EC access and use.