This NARAL Pro-Choice Massachusetts survey reveals that young women seeking to prevent unwanted pregnancies still face significant barriers in obtaining the Plan B^® emergency contraceptive, often called the "morning-after pill" because it is used in the few days after sex. Mystery clients posing as 17-year-old women called 275 pharmacies — one-quarter of these facilities statewide — to ask about Plan B^®'s availability, cost, and options to get it. (In August 2006, the FDA approved non-prescription sales to adults, but kept the Rx requirement for teenagers.)

We found that most pharmacists want to help, but they may not have all the resources needed to do so. Initially, just over half (56%) of pharmacists surveyed correctly told the caller that she could get Plan B^® with a prescription from a health care provider or specially trained pharmacist; after prompting, an additional 30% said so. While most of those asked were able to provide a referral for a prescription, often to a family planning provider or community health center, one in ten (11%) had no recommendation and a sizeable proportion (18%) suggested the costly, time-consuming option of going to the ER or hospital.

Knowledge of how Plan B^® works was also mixed: Although three-quarters (76%) of pharmacists queried provided at least partially accurate information, virtually no one was able to offer a full explanation — and a third focused on the contraceptive's least-likely mechanism of action (that it might prevent implantation). Four percent (4%) still confused Plan B^® with the early abortion pill, Mifeprex.

The survey also found that emergency contraception is quite costly everywhere, averaging just over $44 for a single-dose package. Prices — and availability — varied considerably by county, with Berkshire County offering the most affordable Plan B^® ($38), and Dukes and Nantucket Counties tied for providing the most ($55) costly. And, while eighty-nine percent (89%) of pharmacies had Plan B^® in stock, it was unavailable in one in five pharmacies in Hampshire and Hampden Counties.

The report — The Morning After: Can Your Pharmacist Help? — makes a series of recommendations to improve access for teens and other women with limited resources and less access to reproductive health care. In light of the survey findings, the Commonwealth's two professional organizations -- the Massachusetts Pharmacists Association and the Massachusetts Independent Pharmacists Association — have already indicated that they are willing to work with NARAL Pro-Choice Massachusetts and other women's health advocates to educate their memberships about emergency contraception, training opportunities, and informational resources to enable women to obtain timely and affordable care.

In addition to educating pharmacists, NARAL Pro-Choice Massachusetts urges government officials and women's health advocates to pursue changes to the Medicaid program and other strategies to reduce Plan B^®'s cost burden. The report also encourages community members to report pharmacies that fail to stock it and recommends broader public awareness efforts to improve women's knowledge of this birth control method.

Click here to view the full report (pdf).

Under a 2005 law, hospital emergency rooms must offer emergency contraception to sexual assault survivors, and women of any age can receive this birth control method directly from a specially trained pharmacist without having to visit another provider to obtain a prescription. The NARAL Pro-Choice Massachusetts survey found that pharmacists participating in this program were better informed and more interactive with callers, but only a handful are actively doing so. In addition, in 2006, the Massachusetts Board of Pharmacy interpreted state regulations requiring pharmacies to stock all "commonly prescribed" medications to encompass Plan B^® in response to a lawsuit against Wal-Mart for failing to do so.

Emergency contraception is a progestin-only birth control method that can be taken to prevent pregnancy up to five days after unprotected sex, contraceptive failure, or sexual assault. EC works like other hormonal contraceptives — like the Pill — primarily by preventing ovulation; it may also prevent fertilization or inhibit implantation of a fertilized egg. EC does not work if a woman is already pregnant and will not harm an existing pregnancy. Plan B^® reduces the risk of pregnancy by up to 89%, but it is even more effective if taken within 24 hours of sex.