In most countries, drugs are licensed either for prescription-only sales or for sale “over-the-counter” (OTC). (In reality, OTC access for emergency contraception pills (ECPs) usually means “behind the counter,” in that the buyer must request the product from a pharmacist rather than being able to pick it up straight from a convenience store shelf.) ICEC recommends that ECPs be available to women and adolescents without a prescription — and be truly over-the-counter — in order to increase access and minimize delay. This is especially significant given that ECPs are more effective the sooner they are taken after unprotected intercourse. Many other national and international agencies and bodies also recommend non-prescription access to EC. In countries where ECPs remain prescription-only, providers may consider offering advance prescription or provision.
When a woman must visit a doctor or other licensed health care provider prior to accessing ECPs, she often has to make two trips: one to a clinic to obtain a prescription and a second to a pharmacist to fill the prescription. This presents a significant barrier for many women, especially those who lack access to transportation methods or who live in rural areas without easy access to doctors or pharmacies. Moreover, requiring a prescription makes access to ECPs on weekends and at night (when many contraceptive mishaps occur) more difficult.
ECPs are safe for all women, including adolescents, for non-prescription use, with no contraindications and minimal side effects. ICEC has worked with manufacturers to ensure that product labeling is easy for consumers to understand. Studies show that women and teens can read and comprehend the label and understand when and how to take ECPs without advice from a health care provider. There are no clinical reasons suggesting that younger women and teens should not be able to use ECPs just as safely as adults. WHO, the American College of Emergency Physicians, the American College of Obstetricians and Gynecology, and other professional health groups support non-prescription access to ECPs.
Currently, more than 60 countries allow non-prescription sales of ECPs. However, in many countries, misguided fears have led to barriers to non-prescription access, including age restrictions (see our EC and Youth page). Those in favor of prescription and age restrictions often raise concerns about a possible link between increased access to emergency contraception (EC) and increases in high-risk sexual behavior, especially among adolescents. A large number of studies show, however, that women and adolescents with greater access to EC are not more likely to engage in unprotected intercourse, and are actually more likely to adopt an ongoing contraceptive method after EC use.