NEW YORK (WOMENSENEWS)--Women living and working in the nation's most urban and urbane region nevertheless encounter significant obstacles to accessing emergency contraception, according to the results of a survey of pharmacies undertaken by an investigative division of New York City Council, the first study of its kind conducted by a city government.
The study, released last week, looked at access to Preven and Plan B, the two approved emergency contraception or "morning-after" pills. Almost half of the 170 pharmacies contacted by test callers in June and July said they did not have any emergency contraception products in stock. Of the total surveyed, 30 percent said they would not be ordering it.
Fifty-five percent of the pharmacies contacted in all five of the city's boroughs said that they stocked one of the two emergency contraception products, with chain stores only slightly more likely to carry the items than smaller independent stores.
"Although people think of New York City as a pro-choice city, women still do not have the full array of options that science provides and that they should have to prevent pregnancy, prevent abortion, or respond to being the victim of sexual assault or rape," said Council Member Christine Quinn, chair of the health committee and initiator of the study.
Emergency contraception prevents the beginning of a pregnancy by impeding ovulation, inhibiting fertilization or blocking the implantation of a fertilized egg, at which point a pregnancy begins. Emergency contraception has been approved by the U.S. Food and Drug Administration for public sale and distribution for five years and can be taken within 72 hours of unprotected sex to prevent pregnancy, although both types of pills on the market are more effective if taken earlier. Both require a doctor's prescription in New York State.
"Imagine the pain of a woman going to her pharmacy and having her pharmacist saying, 'Oh, we don't carry that,'" said Kelli Conlin, executive director of the New York State affiliate of the National Abortion and Reproductive Rights Action League.
Conlin attributed the failure of pharmacists to carry emergency contraception to ignorance about the use or shelf life of emergency contraception. Other pharmacists, she said, buckle to the demands of anti-choice groups such as Pharmacists for Life International that urge drugstores to refuse to provide emergency contraception, equating the high-dose birth control pills with abortion.
"That's the kind of attitude that we can't let get in the way of women who need health care," said Conlin.
Proposed Legislation Designed to Increase Access to Emergency Contraception
Women's access is blocked in other ways, as well. Investigators contacted 10 of the city-run health care clinics that provide information about sexually transmitted diseases. All told the inspectors that they did not offer information or access to emergency contraception.
"Not one of those clinics tells women that it is an option. They obviously provide other services that are very related," said Quinn. No explanation was offered by the study or the clinics themselves as to why these clinics do not offer emergency contraception.
New York City Council members are introducing a package of remedial legislation. One would require pharmacists to post conspicuous notices if they do not carry emergency contraception. Other legislation would require city clinics to make emergency contraception available if they offer services related to sexually transmitted diseases.
"This goes beyond women. It is a community issue," said City Council Member Yvette Clarke, one of the co-sponsors.
A third piece of legislation would require hospitals that receive funding or maintain contracts with the city to make emergency contraception information and products available to rape victims.
"Currently, whether or not a rape victim is informed, offered or supplied with emergency contraception is dependent on what hospital she goes to," said Harriet Lessel, executive director of the New York City Alliance Against Sexual Assault. Over one-third of the non-Catholic private hospitals and 80 percent of the Catholic hospitals in New York City did not provide emergency contraception, according to a New York-NARAL study conducted in 1999.
State Lacks Resources to Enforce Emergency Contraception Protocol
In May, the New York State Department of Health adopted a little-publicized protocol that requires hospitals to inform rape victims about the emergency contraception and to make the pills available, if requested. The New York state Protocol for the Acute Care of the Adult Patient Reporting Sexual Assault has requirements similar to laws passed in the past year in two other states, California and Washington, and is stronger than a law that took effect in this year in Illinois, requiring hospitals to provide emergency contraception information and referral to rape victims.
But New York State does not have the resources to enforce the protocol, said Lessel, and the proposed legislation would ensure that hospitals take the steps necessary to protect rape survivors from having to face a pregnancy.
The studies in New York City follow similar analyses of access to emergency contraception elsewhere in the United States. A report published last month in the Journal of American College Health reported that nearly half of the 358 university clinics surveyed (48 percent) did not provide emergency contraception. The research was conducted in 1999, but a newspaper follow-up in Rhode Island this month found only four of the 11 colleges in that state provided students with emergency contraception.
Although Pharmacists for Life International sent out an emergency e-mail notifying its constituents about the New York study, Bogomir H. Kuhar, the organization's head, declined to comment. The group, part of the Pro-Life Net, is an associate of the American Life League, which opposes all birth control pills, as well as abortion.
Cynthia L. Cooper is an independent journalist in New York City who often writes about reproductive rights.
For more information:
"Emergency Contraception: available at a pharmacy near you?"
The Council of the City of New York, October 2002:
NARAL/NY: National Abortion and Reproductive
Rights Action League of New York:
NOT-2-LATE.com: The Emergency Contraception Website: