Study reveals dramatic decreases in emergency contraception related ER visits over 14 year period

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After federal approval of over-the-counter emergency contraception in 2006, emergency department visits and medical charges across the United States dropped dramatically, a new study suggests.

Emergency room visits related to emergency contraception fell 96%, from 17,019 to 659, while total related hospital costs fell by $7.2 million — from $7.6 million to $385,946 — between 2006 and 2020. The most significant decline was for humans between 2006–2007. Seen for emergency contraception.

Results of research led by Michigan Medicine are showing JAMA Network Open.

“Emergency departments are important sites for emergency contraceptive access because of their 24-hour access and high acuity of care,” said senior author Erica Marsh, MD, professor of obstetrics and gynecology at the University of Michigan Medical School and chief of reproductive endocrinology. and infertility at UM Health Von Voigtlander Women’s Hospital of Michigan Medicine.

“We believe this is the first study to specifically examine the relationship between relevant policy changes, disparities, and trends in emergency department visits related to emergency contraceptive use.”

Younger, lower-income, black, Hispanic and Medicaid insured patients were also seen for emergency contraceptive visits at a disproportionate rate compared to other emergency department services, the researchers found.

We found an overrepresentation of certain population groups using emergency departments for emergency contraception. This aligns with previous outpatient research that suggests ongoing barriers to emergency contraceptive access and/or emergency department use for other reasons, including sexual assault.”

Erica Marsh, MD, professor of obstetrics and gynecology at the University of Michigan Medical School

Previous research led by Marsh and colleagues found that ER visits related to sexual assault have increased more than tenfold in the past decade.

Emergency contraception traditionally includes methods of contraception used to prevent pregnancy in the first few days after unprotected intercourse, sexual assault or contraceptive failure.

Although the FDA approved the first dedicated product for emergency contraception in 1998, over-the-counter approval for adults did not come until 2006, followed by minors in 2013. The Patient Protection and Affordable Care Act mandated emergency contraception insurance coverage in 2012.

Although emergency contraceptive ER visits may have started before 2006, the steep decline between 2006-2007 suggests an association, the authors said.

The barrier is still in place

Researchers analyzed national data on more than 2 million emergency department visits among female-identified patients ages 15-44 over a 14-year period.

Contraception-related emergency room visits comprised 44 to 59% of Northeast hospitals, despite only 17–19% of other ER visits.

Meanwhile, Southern hospitals made 4.5 to 17% of emergency contraception visits in 2006, despite an average of more than 40% of other types of emergency department visits.

“Our analysis suggests ongoing barriers to over-the-counter emergency contraception and disparities in use for certain populations,” Marsh said.

“Future policies must reduce barriers to making emergency contraception safe and affordable for all.”


Journal Reference:

Vogt, E. L., etc. (2024). Trends in Encounters for Emergency Contraception in US Emergency Departments, 2006–2020. JAMA Network Open.

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