General Articles

New Study Reports Adolescent Females Can Use Over-The-Counter Emergency Contraception

Source: Elizabeth G. Raymond, Kelly Ladin L’Engle, Elizabeth E. Tolley, Nancy Ricciotti, Martha V. Arnold, Sola Park, “Comprehension of a Prototype Emergency Contraception Package Label by Female Adolescents,” Contraception (Mar 2009): 199-205.
This study sought to identify whether young women can understand the proper use for over-the-counter emergency contraception (EC) based solely on the information on the package label. The researchers interviewed 335 volunteers ages 12–17. The volunteers were drawn from six large cities in the United States and were recruited in shopping malls and family planning clinics. Of the young women, 140 had a seventh grade (or lower) reading level, 70 were Latina and 88 were black. 
Researchers gave the young women an empty package of a prototype EC brand labeled “Levo 1.5.” Despite the name, the package was almost identical to that of “Plan B,” the current EC product sold in pharmacies. The interviewers asked the volunteers to read the package as if they were “thinking about whether to buy it.” Interviewers then asked participants to answer a series of 20 questions about the product. The researchers sought to determine whether the young women understood the six key concepts necessary for the proper use of emergency contraception. The six concepts are:
  1. EC prevents pregnancy after unprotected sex
  2. EC should be taken as soon as possible after sex
  3. EC does not protect against sexually transmitted diseases (STDs) or HIV/AIDS
  4. EC should not be used in place of regular contraception
  5. EC should be taken within 72 hours after sex
  6. EC should not be used by women who are pregnant
Key Findings:

  • 82% of teens understood each of the six key concepts for safe and effective use.

  • 92% understood concepts one, three, four, and six.

  • 96% understood either concept two or concept five.

  • The survey questions that confused most participants were related to key concept number two.

  • The difference in understanding between young women ages 12–14 and those ages 15–17 was no more than 10 percentage points for any one concept.

SIECUS Analysis:

When the Food and Drug Administration (FDA) first approved emergency contraception (EC) to be sold as an over-the-counter drug, its sale was restricted to women ages 18 and older. At the time, the FDA argued that there was insufficient research on younger adolescents’ ability to use EC without a doctor’s oversight. This research suggests that that the FDA’s fears are unsubstantiated, and that women as young as twelve would in fact be able to use EC properly over-the-counter. 
The study does suggest, however, that EC manufacturers may need to come up with improved language to convey the fact that “EC should be taken within 72 hours” and “EC should be taken as soon after sex as possible.” Still, of the young women in the study, 95 percent understood that EC must be taken within 72 hours and 82 percent understood the phrase “as soon as possible.” The researchers were able to confidently state, “Female adolescents aged 17 years and younger can obtain sufficient information from the…label to enable safe and effective use…without assistance from a clinician.”
In April 2009, a U.S. district judge ordered the FDA to lower the restriction on EC to allow young people 17 and older to purchase it. This was partly in accordance with the fact that “the agency’s own medical reviewers had initially recommended that the contraceptive be made available without any age restrictions.”[1] The authors of the study conclude their report by stating that the FDA should eliminate all age restrictions. SIECUS agrees, as we believe that all people, regardless of age, should have access to all FDA-approved methods of contraception in order to ensure that they have the ability to maintain their own health and wellbeing. Since EC is a time-sensitive drug, the current restrictions limit adolescents’ ability to prevent unintended pregnancy.[2]
Moreover, SIECUS believes that all young people should receive comprehensive sexuality education in order to help them understand Emergency Contraception as well as all other methods of preventing both unintended pregnancy and STDs.  

[1] Associated Press, “FDA expands access to Plan B for 17-year-olds”, 22 April 2009, accessed 3 June 2009, <>.

[2] Susheela Singh and Jacqueline E. Darroch, “Adolescent pregnancy and childbearing: levels and trends in developed countries,” Family Planning Perspectives 30.2 (2000): 14-23.