Correspondence

Plan B — The FDA and Emergency Contraception

N Engl J Med 2004; 351:1031-1032September 2, 2004

Article

To the Editor:

Dr. Steinbrook (June 3 issue)1 joins the American College of Obstetricians and Gynecologists in urging “all obstetrician-gynecologists to provide advance prescriptions for emergency contraception to all women of reproductive age at every office visit.” It should be noted, however, that all physicians who care for women of reproductive age have the ability to contribute to this effort. Multiple well-designed studies have shown that advance provision of emergency contraception increases timely, appropriate use without adversely affecting routine contraception and sexual risk-taking behavior.2-4 Any physician who recommends that a patient use condoms should ensure with a prescription that the patient will have rapid access to Plan B should the condom break. In addition, physicians (such as internists, family practitioners, dermatologists, psychiatrists, and neurologists) who prescribe teratogenic medications to women of reproductive age have a particular responsibility to ensure that their patients are prepared for contraceptive emergencies, by routinely discussing and providing prescriptions for Plan B.

Eleanor B. Schwarz, M.D.
University of California, San Francisco, San Francisco, CA 94121
schwarz@medicine.ucsf.edu

4 References

1. 1

   Steinbrook R. Waiting for Plan B -- the FDA and nonprescription use of emergency contraception. N Engl J Med 2004;350:2327-2329
   Full Text | Web of Science | Medline

2. 2

   Glasier A, Baird D. The effects of self-administering emergency contraception. N Engl J Med 1998;339:1-4
   Full Text | Web of Science | Medline

3. 3

   Jackson RA, Bimla Schwarz E, Freedman L, Darney P. Advance supply of emergency contraception: effect on use and usual contraception -- a randomized trial. Obstet Gynecol 2003;102:8-16
   CrossRef | Web of Science | Medline

4. 4

   Raine T, Harper C, Leon K, Darney P. Emergency contraception: advance provision in a young, high-risk clinic population. Obstet Gynecol 2000;96:1-7
   CrossRef | Web of Science | Medline