Advance provision of emergency contraception

Evidence Summaries

Level of Evidence = A

Advance provision of emergency contraception does not reduce pregnancy rates.

A Cochrane review 1 (abstract , review ) included 11 studies with a total of 7,695 subjects from the United States, China, India, and Sweden. Advance provision (provided in advance of need) compared to standard access situations (defined as routine contraceptive counseling, provision of information on emergency contraception, or emergency contraception on request) did not decrease pregnancy rates (OR 0.98, 95% CI 0.76 to 1.25 in studies for which we included twelve month follow-up data; OR 0.48, 95% CI 0.18 to 1.29 in a study with seven-month follow-up data; OR 0.92, 95% CI 0.70 to 1.20 in studies for which we included six month follow-up data; OR 0.49, 95% CI 0.09 to 2.74 in a study with three month follow up data), despite increased use (single use: OR 2.47, 95% CI 1.80 to 3.40; multiple use: OR 4.13, 95% CI 1.77 to 9.63) and faster use (WMD -12.98 hours, 95% CI -16.66 to -9.31 hours). Advance provision did not lead to increased rates of sexually transmitted infections (OR 1.01, 95% CI 0.75 to 1.37), increased frequency of unprotected intercourse, nor changes in contraceptive methods. Women who received emergency contraception in advance were equally likely to use condoms as other women.

References

1. Polis CB, Schaffer K, Blanchard K, Glasier A, Harper CC, Grimes DA. Advance provision of emergency contraception for pregnancy prevention (full review). Cochrane Database Syst Rev 2007;(2):CD005497 [Review content assessed as up-to-date: 9 November 2009].  [PMID:17443596]


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