Study: Sex Habits Unchanged by Emergency Pill

A study released today reports that females ages 15-24 who have easy access to the emergency contraceptive Plan B are not likely to abandon their usual birth control or engage in other risky behaviors.

The study's findings contradict one of the main objections to over-the-counter sales of emergency contraception, or "morning-after" pills. Last year, Barr Laboratories submitted a proposal to the Food and Drug Administration to sell Plan B without a prescription. But Steven Galson, acting director of FDA's drugs division, rejected that proposal, taking the unusual step of overruling an FDA advisory panel that had voted 23-4 in favor of selling Plan B over the counter. Galson, who acknowledged he was at odds with FDA scientists, cited a lack of data about whether Plan B could be safely used by girls ages 11-15 without a physician's supervision.

Barr Labs has since submitted another proposal to FDA to sell Plan B over the counter only to women age 16 and older; those 15 and under would still need a prescription. Barr spokesperson Carol Cox said Tuesday a decision is expected on its amended application by Jan. 20.

The study enrolled 2,117 females from California family-planning clinics. Participants were randomly assigned to one of three sources of emergency contraception: the clinic, over-the-counter access at nearby pharmacies, or an advance supply of three pill packages. STD and unprotected intercourse rates were similar in all three groups, though participants who received the emergency contraceptive in advance were almost twice as likely to use it than the other two groups. Lead author Tina Raine, a University of California-San Francisco obstetrician/gynecologist, noted that all three groups had similar pregnancy rates, perhaps because many women who reported having unprotected sex did not use the emergency contraception.

"Very few women used it more than once," said Raine. "They may not think they're going to get pregnant. They may not feel comfortable using it. They may not actually have it at the time they need it." This, she said, seems to show the "exact opposite" of critics' fears that women would come to depend on emergency contraception if it were easily obtainable.

It is "significant that no apparent downside of EC [emergency contraception] was demonstrated in the study," Stanford University's Iris Litt said in an accompanying editorial.

The full report, "Direct Access to Emergency Contraception Through Pharmacies and Effect on Unintended Pregnancy and STIs," and the editorial, "Placing Emergency Contraception in the Hands of Women," were published in the Journal of the American Medical Association (2005;293(1):54-62 and 98-99, respectively).

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