PMA2020 surveys provide valuable new information on knowledge and use of emergency contraception. This issue brief analyses the levels of knowledge, use of, and access to EC in seven different African countries. Results show that knowledge of EC varies by country but that use remains low in all areas surveyed.
This section contains fact sheets, blog posts, technical statements, clinical guidelines, journal articles and publications focusing on policies and access. Several publications focus on sexual assault and humanitarian settings. For more information on specific themes, please visit the EC Issues Pages. Many of our publications are available in multiple languages.
This review summarized evidence regarding current demand for on-demand oral contraception from 19 studies across 16 countries. In these studies, 9–97% of women in the analysis populations reported using the pills on demand as main method, although frequency and consistency of use varied. Reported reasons for interest in or use of this contraceptive approach included convenience, ease of remembering, ability to conceal use, lack of coital interruption, and infrequent sexual activity. Data from a variety of settings suggest that demand for an on-demand oral contraceptive may be widespread. The effectiveness of this potential method is not established, however. Authors: Elizabeth G. Raymond, Tara Shochet, Jennifer Kidwell Drake, and Elizabeth Westley
This article describes the methods of emergency contraception available in the United States, including efficacy, mode of action, safety, side effect profile, and availability. The most effective emergency contraceptive is the copper intrauterine device (IUD), followed by ulipristal acetate and levonorgestrel pills. Levonorgestrel is available for sale without restrictions, whereas ulipristal acetate is available with prescription only, and the copper IUD must be inserted by a clinician. Although EC pills have not been shown to reduce pregnancy or abortion rates at the population level, they are an important option for individual women seeking to prevent pregnancy after sex. Authors: Kelly Cleland, Elizabeth G. Raymond, Elizabeth Westley, and James Trussell
This paper reports the results of a review to synthesize the current evidence on service delivery strategies to improve access to ECP. Despite limited research of adequate quality, promising strategies to improve access were identified including: advance provision of ECP; task shifting and sharing; intersectoral collaboration for sexual assault; m-health for information provision; and scale up through national family planning programs. There are a number of gaps in the research concerning service delivery and ECP in LMIC. These include a lack of knowledge concerning private/commercial sector contributions to improving access, the needs of vulnerable groups of women, approaches to enhancing intersectoral collaboration, evidence for social marketing models, and investment cases for ECP. Authors: Angela Dawson, Nguyen-Toan Tran, Elizabeth Westley, Viviana Mangiaterra, and Mario Festin
Donors, particularly US-based private foundations, have played a key role in making emergency contraception available around the world, but the dynamics of donor funding have not been well-documented before now. This paper analyzes data on donor funding for EC-focused programs and donor spending for EC procurement.
When no products marketed specifically for emergency contraception are available, combined oral contraceptives – regular birth control pills – can also be used as EC. This is known as the “Yuzpe” method. The Yuzpe method offers critical EC access for women without access to dedicated ECPs.
Women’s access to ECPs is significantly influenced by the availability of EC products in their country. Many dedicated products – those that are packaged and labeled for EC use specifically – exist, but are only accessible to women if at least one product is registered and/or imported in their country. The ECP Registration Status fact sheet provides an overview of ECP availability by country based on three designations – at least one product registered, no registered product but current or previously imported product, and no registered or imported product.
For women wanting to prevent pregnancy, timely access to ECPs is crucial, since the sooner they are taken, the more likely they are to be effective. Regulatory limitations on the sale of ECPs (including prescription requirements and age restrictions) impede a woman’s ability to get ECPs when she needs them. This fact sheet addresses why unrestricted, over-the-counter (OTC) access to ECPs is essential and safe for women of all ages.
Although certain levonorgestrel-alone emergency contraceptive pills (LNG-ECPs) contain two 0.75 mg pills that are indicated to be taken 12 hours apart up to 72 hours after intercourse, labels for these ECPs do not reflect current scientific information. This short regimen update provides evidence-based conclusions for dosage and timing and recommends that women take LNG-ECPs in a single dose of 1.5 mg LNG — if the package contains two pills of 0.75 mg LNG, women should take both at the same time. Moreover, while ECPs are more effective the sooner they are used, they can provide some protection from unwanted pregnancy as many as five days (120 hours), not just up to 72 hours, after unprotected intercourse.
The clinical summary of emergency contraceptive pills (ECP) provides a one-page overview of ICEC’s Medical and Service Delivery Guidelines by briefly discussing how ECP regimens work, their efficacy and safety, guidelines on repeat use, and considerations for starting or resuming regular contraceptives following ECP regimens.
Unmet need for family planning remains high globally, and women and men face challenges accessing both accurate information about contraception and contraceptive supplies. Contraceptive social marketing programs offer creative, effective and successful strategies to provide reproductive health (RH) products and services. Yet, the peer-reviewed literature contains few evaluations of social marketing of contraceptives, particularly those focused on emergency contraception (EC). These programs have the potential to reach women with affordable, quality emergency contraceptive products when and where they need them, and they can contribute substantially to women’s ability to access a range of contraceptive options. Authors: Elizabeth Westley, Tara Shochet