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Emergency contraception, efficacy and public health impact

Broekhuizen, Fredrik F

Current Opinion in Obstetrics and Gynecology: August 2009 - Volume 21 - Issue 4 - p 309–312
doi: 10.1097/GCO.0b013e32832e0772
Reproductive endocrinology: Edited by David L. Olive

Purpose of review Emergency contraception in the past two decades had been proven to be effective and well tolerated. Counseling and advance provision and prescription of emergency contraception have been embraced by professional organizations in practice guidelines for its potential to reduce the number of unintended pregnancies and abortions. Has emergency contraception lived up to that promise?

Recent findings Mifepristone (not available in the USA) is the agent of choice. Emergency contraception has not reduced the number of unintended pregnancies. Acceptance by healthcare providers and the public has not been optimal, and multiple financial and healthcare system barriers to use emergency contraception continue to exist. The public health impact of emergency contraception has been disappointing.

Summary Although emergency contraception may continue to be an important component of contraceptive practice, only increased access to more effective methods of contraception will change unintended pregnancy rates. The use of mifepristone for emergency contraception in the USA must be considered.

Department of Obstetrics and Gynecology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA

Correspondence to Fredrik F. Broekhuizen, Department of Obstetrics and Gynecology, Medical College of Wisconsin, 9200 W. Wisconsin Avenue, Milwaukee, WI 53226, USA Tel: +1 414 805 6624; e-mail:

© 2009 Lippincott Williams & Wilkins, Inc.