THE EFFECTS OF SELF-ADMINISTERING EMERGENCY CONTRACEPTION

Background Emergency postcoital contraception prevents pregnancy, but it must be prescribed by a doctor and taken within 72 hours of interco urse. It has been proposed that emergency contraception be made availa ble without a prescription. We undertook a study to learn how women mi ght behave if given a supply of emergency contraceptive pills to keep at home. Methods We assigned 553 women to be given a replaceable suppl y of hormonal emergency contraceptive pills to take home (the treatmen t group) and 530 women to use emergency contraception obtained by visi ting a doctor (the control group). The frequency of use of emergency c ontraception, the use of other contraceptives, and the incidence of un wanted pregnancy were determined in both groups of women one year late r. Results The results for 549 women in the treatment group and 522 wo men in the control group were available for analysis. Three hundred se venty-nine of the women in the treatment group (69 percent) and 326 of the women in the control group (62 percent) contributed detailed info rmation at followup. One hundred eighty of the women in the treatment group (47 percent) used emergency contraception at least once. Among t hose who returned the study questionnaire, 98 percent used emergency c ontraception correctly. There were no serious adverse effects. Eighty- seven women in the control group (27 percent) used emergency contracep tion at least once (P<0.001 for the comparison with the treatment grou p). The women in the treatment group were not more likely to use emerg ency contraception repeatedly. Their use of other methods of contracep tion was no different from that of the women in the control group. The re were 18 unintended pregnancies in the treatment group and 25 in the control group (relative risk, 0.7; 95 percent confidence interval, 0. 4 to 1.2), Conclusions Making emergency contraception more easily obta inable does no harm and may reduce the rate of unwanted pregnancies. [ N Engl J Med 1998;339:1-4.) (C) 1998, Massachusetts Medical Society.