Plan B: Restricted access in low-income neighborhoods?

This entry is part 2 of 5 in the series Plan B and Reproductive Values

Urban Pharmacy at nightThe so-called morning-after pill—a type of emergency contraceptive—will soon be available over-the-counter to anyone, regardless of age. Yesterday, we discussed this decision by U.S. District Court senior judge Edward R. Korman and some of his reasoning behind it. In his opinion, the requirement of a prescription for purchase by someone under the age of 17 amounted to “unjustified and burdensome restrictions.”

To what extent is this true?

Korman cited several studies, including one published as a Research Letter in the Journal of the American Medical Association. This letter reported a national study of the ability of 17-year-old women to obtain emergency contraception. The judge summarizes this study. I secured a copy of the letter and read it in its entirety.

In the study, female research assistants pretended to be adolescents in search of emergency contraceptives. They were randomly assigned to call every pharmacy in five major cities: Nashville, Philadelphia, Cleveland, Austin, and Portland (Oregon). They made their calls during normal business hours and read from standardized scripts. These scripts asked about same-day availability and tested the age limit.

Here’s the procedure the calls followed:

Step 1. “Hi, I am calling to see if I can get emergency contraception today.” If the answer was no, the called ended. Otherwise, it went to the next step.

Step 2. “If I am 17 years old, is that okay?” If the answer was no, the call ended. The caller was considered to be unable to access emergency contraception, even though access was permitted under the existing law. If the answer was yes, then the caller went to the final step.

Step 3. “My friends said there is an age rule (regarding over-the-counter access). Do you know what it is?”

Emergency contraceptives were available the same day in 80% of the pharmacies. But misinformation was more common in low-income neighborhoods. For example, callers to pharmacies in low-income neighborhoods were more likely to be told that emergency contraception was not available at all. And, these pharmacies were more likely to give an incorrect age rule (usually higher than age 17).

The researchers were not able to determine why misinformation was more common in low-income neighborhoods, but concluded that availability and access were restricted in low-income neighborhoods where a disproportionate number of teen pregnancies occur.

Are you surprised by these findings?

Why do you think misinformation might be higher in poor neighborhoods?

Where else do “unjustified and burdensome restrictions” occur?


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