Emergency contraception over-the-counter: The medical and legal imperatives

Requiring a physician's prescription for hormonal emergency contraceptive p ills makes no sense. Unintended pregnancies remain endemic in the United St ates, and wider use of emergency contraceptive pills could substantially he lp. However, the prescription requirement poses an unnecessary barrier to p rompt, effective use of this preventive therapy. According to the Durham-Hu mphrey Amendment of 1951, the default option for all new drugs is, in princ iple, over-the-counter, unless a drug is addictive or dangerous when self-a dministered. Clearly, hormonal emergency contraception is neither of these. Emergency contraceptive pills meet all the customary criteria for over-the -counter use: low toxicity, no potential for overdose or addiction, no tera togenicity, no need for medical screening, self-identification of the need, uniform dosage, and no important drug interactions. The Food and Drug Admi nistration is authorized, and, by its own regulations, should be required t o switch hormonal emergency contraception to over-the-counter status withou t delay. The current prescription requirement is not only gratuitous but al so harmful to women's health because it impedes access to this important th erapy. (C) 2001 by the American College of Obstetricians and Gynecologists.