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Since 2006, when the \"morning-after pill\" Plan B was first sold over the counter, sales of emergency contraceptives have soared, becoming an $80-million industry in the United States and throughout the Western world. But emergency contraception is nothing new. It has a long and often contentious history as the subject of clashes not only between medical researchers and religious groups, but also between different factions of feminist health advocates. The Morning Aftertells the story of emergency contraception in America from the 1960s to the present day and, more importantly, it tells the story of the women who have used it. Side-stepping simplistic readings of these women as either radical feminist trailblazers or guinea pigs for the pharmaceutical industry, medical historian Heather Munro Prescott offers a portrait of how ordinary women participated in the development and popularization of emergency contraception, bringing a groundbreaking technology into the mainstream with the potential to alter radically reproductive health practices.

Abstract Infertility is perceived by many of those affected by it as one of the most stressful episodes in life. Assisted reproduction can help only some of the people with a desire for children to experience the birth of a biological child. Most people who remain involuntarily childless eventually come to terms with the situation; their psychological well-being is not lastingly affected. However, they should envisage a ‘plan B’ as early as possible. The prospect of permanent childlessness should not be an unmentionable topic, neither for couples themselves nor for the doctors treating them.

Emergency contraception is indicated in instances of unprotected sexual intercourse, including reproductive coercion, sexual assault, and contraceptive failure. It plays a role in averting unintended pregnancies due to inconsistent use or non-use of contraception. Options for emergency contraception vary by efficacy as well as accessibility within the U.S. This paper provides an overview of levonorgestrel (Plan B One-Step and generic counterparts), ulipristal acetate (sold as ella), and the copper intrauterine device (IUD, sold as ParaGard), including the mechanisms of action, administration, efficacy, drug interactions, safety, side effects, advantages, and drawbacks. It will also review current misconceptions about emergency contraception and access for subpopulations, including adolescents, immigrants, survivors of sexual assault, rural populations, and military/veteran women. This paper will address barriers such as gaps in knowledge, and financial, health systems, and practice barriers. Continuing areas of research, including the impact of body weight on the efficacy of emergency contraceptive pills and potential interactions between ulipristal acetate and ongoing hormonal contraceptives, are also addressed.

Nearly a half million infants in the United States are born preterm or with low birth weight each year. Providing women who have had a prior adverse birth outcome with access to family planning can help reduce the incidence of subsequent high-risk pregnancies and adverse outcomes. One effective option to prevent unintended pregnancy for women with a prior adverse birth outcome who either do not use contraception consistently or whose contraception fails is emergency contraception (EC). The purpose of our study was to understand willingness to use EC among African-American women who recently had an adverse birth outcome. The Healthy Births Healthy Communities (HBHC) Interconceptional Care Project (ICCP) targeted high-risk African-American women from two low-income Chicago neighborhoods who recently had an adverse birth outcome. The aim of HBHC ICCP was to improve participants’ future birth outcomes by providing medical and social services and helping women to clarify their reproductive life goals. Information about participants’ pregnancy intentions and willingness to use EC was measured in an interview shortly after enrollment into the study. Over 90 % of the 131 women in our study either did not want to become pregnant or did not know if they wanted to become pregnant within the next 2 years. These women had 4.4 times higher odds of reporting willingness to use EC as compared to women who reported a desire to become pregnant within the next 2 years (75.6 vs. 50.0 %, respectively; AOR: 4.4; 95 % CI 1.1, 17.6). EC is an essential part of the reproductive toolkit for women at high risk of adverse birth outcomes who are not intending pregnancy, along with reproductive life planning and use of effective contraception.

To determine pharmacy students' knowledge, attitudes, and behaviors regarding emergency contraception.OBJECTIVESTo determine pharmacy students' knowledge, attitudes, and behaviors regarding emergency contraception.A cross-sectional survey was conducted among a convenience sample of students prior to a regular class period. The 16-item survey instrument included both multiple-choice and true/false questions to assess knowledge and Likert-type scale questions regarding attitudes and behaviors. Frequency and descriptive statistics were calculated for all variables.METHODSA cross-sectional survey was conducted among a convenience sample of students prior to a regular class period. The 16-item survey instrument included both multiple-choice and true/false questions to assess knowledge and Likert-type scale questions regarding attitudes and behaviors. Frequency and descriptive statistics were calculated for all variables.Three hundred one pharmacy students were surveyed. Eighty-seven percent knew that Plan B had been approved by the Food and Drug Administration (FDA) for nonprescription use, yet 33% believed that it worked by disrupting a newly implanted ovum. On a scale from 1-5 on which 5 = strongly agree, the mean item score was 1.5 for whether nonprescription emergency contraception should be available without counseling by a pharmacist, yet only 26.7% believed they were competent instructing patients on the use of emergency contraception.RESULTSThree hundred one pharmacy students were surveyed. Eighty-seven percent knew that Plan B had been approved by the Food and Drug Administration (FDA) for nonprescription use, yet 33% believed that it worked by disrupting a newly implanted ovum. On a scale from 1-5 on which 5 = strongly agree, the mean item score was 1.5 for whether nonprescription emergency contraception should be available without counseling by a pharmacist, yet only 26.7% believed they were competent instructing patients on the use of emergency contraception.Additional education is needed to prepare pharmacy students to provide informed pharmaceutical care to patients seeking emergency contraception, especially given the passage of legislation making the pharmacy the point of access for some emergency contraception products.CONCLUSIONSAdditional education is needed to prepare pharmacy students to provide informed pharmaceutical care to patients seeking emergency contraception, especially given the passage of legislation making the pharmacy the point of access for some emergency contraception products.

On December 7, 2011, Secretary of Health and Human Services Kathleen Sebelius overruled a decision of the Food and Drug Administration (FDA) on the over-the-counter (OTC) status of emergency contraception. What will be the repercussions of Secretary Sebelius’s action? Why is the act itself of far greater long-term significance than the transitory regulatory action it impacts? By reversing an FDA decision, the Secretary has set a dangerous precedent for all-comers to lobby Congress, the Department of Health and Human Services (HHS) and the White House on any and all FDA decisions—directly inserting politics into what must be a scientifically driven process.

This manuscript covers Plan B, the brand name of emergency contraception that now has dual over the counter and prescriptive status. Although Plan B has been available over the counter since November 2006 to men and women older than 18, very few patients know about this option. In addition, many clinicians and patients believe myths about Plan B. This article describes the uses of Plan B, its potential to decrease unwanted pregnancies and abortions, current laws, indications and effectiveness, mechanism of action, and helpful hints.

This manuscript covers Plan B, the brand name of emergency contraception that now has dual over the counter and prescriptive status. Although Plan B has been available over the counter since November 2006 to men and women older than 18, very few patients know about this option. In addition, many clinicians and patients believe myths about Plan B. This article describes the uses of Plan B, its potential to decrease unwanted pregnancies and abortions, current laws, indications and effectiveness, mechanism of action, and helpful hints.