Scoping Review of Access to Emergency Contraception for Sexual Assault Victims in Emergency Departments in the United States

Wang, Michelle J.; Khodadadi, Alexandra B.; Turan, Janet M.; White, Kari

doi:10.1177/1524838019882023

Cited by 4 publications

(2 citation statements)

References 38 publications

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“…196 Other studies did not find a similar link, but it is currently recognized that even if there may not be an impact on the rate of abortions at the population level, access to EC lowers abortion rates at the individual level. 197 As part of reducing barriers to access, it is critical to safeguard the protection of special populations, including adolescents, 57,198 non-English speaking patients, 198 individuals at hospitals with religious affiliation, 199,200 sexual assault survivors, 201 women facing disaster situations, 202 patients from rural areas, 203 and military and veteran populations. 131,204…”

Section: Misinformationmentioning

confidence: 99%

Emergency Contraception: Access and Challenges at Times of Uncertainty

Stein¹,

Deverakonda²,

Katz

et al. 2022

American Journal of Therapeutics

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Background:The UN Commission on Life-Saving Commodities for Women and Children identified emergency contraceptive pills as 1 of the 13 essential underused, low-cost, and high-impact commodities that could save the lives of millions of women and children worldwide. In the US, 2 emergency contraceptive regimens are currently approved, and their most plausible mechanism of action involves delaying and/or inhibiting ovulation.Areas of uncertainty:Abortion and contraception are recognized as essential components of reproductive health care. In the US, in the wake of the Dobbs v. Jackson Women's Health Organization Supreme Court decision on June 24, 2022, 26 states began to or are expected to severely restrict abortion. It is anticipated that these restrictions will increase the demand for emergency contraception (EC). Several obstacles to EC access have been described, and these include cost, hurdles to over-the-counter purchase, low awareness, myths about their mechanisms of action, widespread misinformation, and barriers that special populations face in accessing them. The politicization of EC is a major factor limiting access. Improving sex education and health literacy, along with eHealth literacy, are important initiatives to improve EC uptake and access.Data Sources:PubMed, The Guttmacher Institute, Society of Family Planning, American College of Obstetricians and Gynecologists, the World Health Organization, The United Nations.Therapeutic Advances:A randomized noninferiority trial showed that the 52 mg levonorgestrel intrauterine device was noninferior to the copper intrauterine device when used as an EC method in the first 5 days after unprotected intercourse. This is a promising and highly effective emergency contraceptive option, particularly for overweight and obese patients, and a contraceptive option with a different bleeding profile than the copper intrauterine device.Conclusions:EC represents an important facet of medicine and public health. The 2 medical regimens currently approved in the US are very effective, have virtually no medical contraindications, and novel formulations are actively being investigated to make them more convenient and effective for all patient populations. Barriers to accessing EC, including the widespread presence of contraception deserts, threaten to broaden and accentuate the already existing inequities and disparities in society, at a time when they have reached the dimensions of a public health crisis.

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Section: Misinformationmentioning

confidence: 99%

Emergency Contraception: Access and Challenges at Times of Uncertainty

Stein¹,

Deverakonda²,

Katz

et al. 2022

American Journal of Therapeutics

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show abstract

“…Sexual assault survivors are at significant risk of unintended pregnancy. Many of these individuals present to emergency departments for care in the period that EC can be most effective in preventing unintended pregnancy; however, hospital policies concerning EC, staff misconceptions or objections, and/or state laws regarding EC can affect patient access 19 . Studies found inconsistency in hospital policies regarding access to EC.…”

Section: Barriers To Using Emergency Contraceptionmentioning

confidence: 99%

Facilitating Access to Emergency Contraception

Harrington

2020

J Midwife Womens Health

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Approximately 45% of pregnancies in the United States are unintended. 1 Healthy People  goals include universal access to family planning services with the purpose to decrease rates of unintended pregnancy and adolescent pregnancy. 2 Ensuring timely access to emergency contraception (EC) is essential to preventing unintended pregnancy. EC is very effective at reducing rates of pregnancy after unprotected sexual intercourse, contraceptive failure, and/or sexual assault. 3-5 Although numerous studies document safety and efficacy of EC, this contraceptive method remains underutilized. 1,4-6 This commentary describes EC methods, barriers to EC use, and the clinician's role in EC provision and access.

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Knowledge, attitudes, and practices of community pharmacists providing over-the-counter emergency hormonal contraception: a scoping review

Nona,

Ray,

Taylor

et al. 2024

International Journal of Pharmacy Practice

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Objectives Reducing the rate and impact of unintended pregnancy through effective contraception is a public health goal. Since deregulation, globally, ease of access to community pharmacists has enabled them to play a key role in the provision of emergency hormonal contraceptive pills (ECP). The aim of this scoping review is to explore pharmacists’ overall knowledge of and attitudes and practices towards the provision of emergency contraception. Methods A systematic literature search for the period from 1999 to 2023 was conducted using Scopus, Medline (Ovid), CINAHL, Emcare, Web of Science, and Google Scholar. Keywords such as emergency contraception, emergency contraceptive, morning after pill, plan B, pharmacist, community pharmacist, and pharmacy were applied. Articles published only in English that described the knowledge, attitudes, and practices of community pharmacists providing emergency contraception were included in this review. Key findings Twenty studies met the inclusion criteria. Despite positive attitudes towards the provision of ECP, there is a clear deficit in both the knowledge and counselling practices of pharmacists, with some pharmacists lacking an open attitude towards the supply of ECP to adolescents and third parties. Usage of a private counselling area ranged from 0% to 90% highlighting privacy for patients seeking ECPs is lacking during consultations. In countries where practice guidelines are available, these are often not being optimally utilized. Conclusions This review has highlighted gaps in pharmacists’ knowledge and counselling practices, demonstrating shortcomings in pharmacists’ education, training, and application of professional practice guidelines. Future research on ECP guidelines is recommended to improve implementation and usability in practice.

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Scoping Review of Access to Emergency Contraception for Sexual Assault Victims in Emergency Departments in the United States

Cited by 4 publications

References 38 publications

Emergency Contraception: Access and Challenges at Times of Uncertainty

Emergency Contraception: Access and Challenges at Times of Uncertainty

Facilitating Access to Emergency Contraception

Knowledge, attitudes, and practices of community pharmacists providing over-the-counter emergency hormonal contraception: a scoping review

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