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Direct Access to Emergency Contraception
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To the Editor: In their study of direct access to emergency contraception (EC),1 Dr Raine and colleagues provided information regarding EC use and its effects on rates of unprotected sex, unintended pregnancies, and sexually transmitted infections (STIs). However, based on data presented in the article, we disagree with their conclusion that "it seems unreasonable to restrict access to EC to clinics."
First, there was no observed benefit to having easier access to EC: pregnancy rates were similar across all 3 study groups. The only significant difference was in frequency of EC use, which was greater for women who had advance prescriptions than for those who had to go to the pharmacy or clinic to get EC. Promoting easier access because it increases the use of a medication without any improvement in its desired outcome seems counterintuitive. Medical interventions—in this case, enhanced access—carry risks, benefits, and costs. Without a demonstrated benefit, . . . [Full Text of this Article]
Allen R. Last, MD
lasta@upmc.edu
Stephen A. Wilson, MD
Department of Family Medicine
University of Pittsburgh Medical Center—St Margaret Hospital
Pittsburgh, Pa
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