Survey of Women Who Ordered Plan B Online

An article in the journal Obstetrics and Gynecology reports the results of a survey of women who obtained emergency contraception (Plan B) via a web-based service. The women were asked why they were requesting emergency contraception, how long they waited before calling the service, who else they may have contacted first to try to get the drug, why they weren’t successful in getting it on that first attempt, and why they looked online instead of contacting a doctor or clinic.

The survey calls were conducted in 2006 prior to Plan B being made available over-the-counter to adult women. At the time, the website featured a directory of providers who would be willing to prescribe emergency contraception. The authors seem to have surveyed women who called the Reproductive Health Fellows at the University of Rochester, which served as a designated New York State provider. 65% of callers during the study period met eligibility requirements and completed the survey. Women were not eligible to complete the survey if they were minors, already received EC from a local providers, had language barriers, were follow-up calls, or were repeat callers who were already enrolled in the study. The majority of participants were 18-24, white, college-educated, of high socioeconomic status, urban, insured, single, and had access to high-speed internet access. 68% had no children, and 25% had obtained a prior elective abortion.

Among the results:
-55% reported condom breakage, slippage or incorrect use as the reason for needing emergency contraception. Only 38% reported failing to use any contraception method.
-For 56%, this service was their first call. For 26%, another doctor’s office or clinic was contacted first.
-When asked why that first contact failed, 45% reported a closed clinic or unreturned phone call, 19% reported that their provider refused to prescribe EC, and 14% reported no immediately available appointments.
-The most common reason cited (by 39% of women) for using the online service was “convenience/avoid anticipated barriers.”
-71% fully supported advance prescription of EC for future use, but only 43% fully supported over-the-counter access. Post-college education was associated with being more likely to approve of OTC access.

Strangely, although these women were seeking emergency contraception for their own use, women who didn’t fully support OTC access most frequently expressed concern that, “increasing ECP availability could promote risky sexual behavior and poor contraceptive practice.” At least one of the comments betrays an attitude of women finding themselves different or above other users seeking the same service –

I’d like to think I am on the good side of it being…that I’m not out there using it instead of like condoms and just going, “oh well, I can just do this later….” Some people are extremely, extremely irresponsible.

The authors note that “In several randomized controlled studies, women (including teenagers) who received advance supplies of ECPs did not report higher rates of unprotected intercourse…” They also note that their results may not be generalizable to the overall population of EC users.

Citation: Wu J, Gipson T, Chin N, Wynn LL, Cleland K, Morrison C, Trussell J. Women Seeking Emergency Contraceptive Pills by Using the Internet. Obstet Gynecol. 2007 Jul;110(1):44-52.