High hopes versus harsh realities: the population impact of emergency contraceptive pills

Abstract

Black et al. examine changes in the prevalence of emergency contraception (EC) use in Britain between 2000 and 2010; a period of major change in the availability of emergency contraceptive pills (ECPs). We find two findings in this paper striking. First, despite increased availability there was no meaningful increase in the proportion of sexually active women aged 16-44 not intending pregnancy who used any type of EC in the past year between 1999-2001 (2.3%) and 2010-2012 (3.6%). Second, there was a shift toward obtaining ECPs from retail outlets (mostly pharmacies). These twin findings replicate earlier results from Marston and colleagues (BMJ 2005 Jul 30;331(7511):271), who found no increase in use in the past year from 2000 (8.4%) to 2001 (7.9%) to 2002 (7.2%) but a shift towards obtaining ECPs from a pharmacist (a third in 2002). It is puzzling that Black et al. found much lower use (based on NATSAL 2&3) than did Marston et al. (based on the Omnibus Survey), particularly since the latter included all women in the denominator whereas the former included only sexually active women.