No matter your politics, we should all be able to agree on this: When a sexual assault survivor walks into an emergency room seeking care, it is crucial she has all the support and resources she needs. That includes the ability to prevent the added trauma of an unwanted pregnancy by using emergency contraception. Unfortunately, too many women are unfamiliar with this highly effective prevention method. And, in many cases, hospitals simply do not provide access to it. Or, if they do, it is not offered in a timely manner — despite the fact that the morning-after pill is readily available at the drugstore counter down the street. The last thing survivors of sexual assault want or need is a murky and confusing process to get necessary help.
When women are not given full counseling about — and access to — emergency contraception, a major health decision is taken out of their hands. Every year, over three million pregnancies (one half of all pregnancies in the United States) are unintended. In the 1960s, researchers began testing the effectiveness of concentrated, high doses of oral estrogen to prevent unintended pregnancy. In 1973, putting science and medical evidence first, the U.S. Food and Drug Administration (FDA) approved this form of contraception only as an emergency measure. In the time since (and not without significant resistance from critics), the FDA has declared emergency contraception, a.k.a. the morning-after pill, to be safe and effective in preventing unintended pregnancy after unprotected sex, birth control failure, or sexual assault. In addition, the FDA has approved the sale of some forms of this pill to women of all ages — over the counter, without prescription.
However, despite this increased access — and the number of options now available to women — emergency contraceptive use in the United States remains low. In fact, only half of OB/GYNs offer emergency contraception to all of their patients, and one third of reproductive-age women don’t know it exists.
This lack of information effectively cuts off access and can have a major impact on a woman’s life, especially for the nearly one in five who are survivors of rape — women like Rachelle. Rachelle, who asked us not to use her last name, grew up in a home where sexual health was not openly discussed. Therefore, she had little information about what to do if she found herself faced with an unwanted pregnancy.
During Rachelle’s freshman year of college, she was date-raped. She was “mortified when I woke up the next morning and found out that I had unprotected sex,” she says. Thankfully, her friends knew the options and support available to her during this traumatic experience. That afternoon, Rachelle decided to visit a nearby clinic, where she learned about emergency contraception. She was presented with this preventive method before she left the appointment.
Unfortunately, not everyone has friends like Rachelle’s. If used correctly, emergency contraception in conjunction with prompt medical treatment could help many survivors avoid the additional trauma of an unintended pregnancy. Yet, only 13 states and the District of Columbia require hospital emergency rooms to provide emergency contraception upon request to survivors of sexual assault. Additionally, nine states have proactively put into place restrictions on emergency contraception, and six states allow pharmacists to refuse to dispense it.
Whether it is intentional obstruction or inadvertent negligence, the fact remains that women deserve to have full knowledge of their healthcare options. And, providers need the training to fully deliver this care. By raising awareness of emergency contraception through unbiased and medically accurate information — and by requiring its distribution with no exceptions and regardless of a woman’s ability to pay — we will enable women to become more informed about the reproductive-health options available to them. This will also help reduce the risk of unintended pregnancies and will support survivors of sexual assault when they need it the most.
Access to emergency contraception isn’t just good health policy; it’s also good economic policy. Research has shown a link between a reduction in pregnancies and an increase of employment among women. In fact, by 1980, 65.5% of women age 25-34 were in the workforce, compared to just 34% during the 1950s, before contraception became widely available.
When women feel empowered and are given every opportunity to succeed, we all succeed. And, when we remove the unnecessary and archaic roadblocks to reproductive freedom, we are putting these deeply personal decisions back in the hands of American women — where they belong.
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Patty Murray, a Democratic Senator from the state of Washington, is a long-time advocate for reproductive rights. Last week, she introduced legislation that would provide increased access to and education about emergency contraception. She argues this access is both a necessity for assault survivors and a basic reproductive right for women.
Unsure if emergency rooms in your state are required to offer or provide sexual assault survivors with emergency contraception? The Kaiser Family Foundation has you covered.
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