Contraceptives Hotline Starts Off Hot
A telephone hotline set up to help anxious women who have just had unprotected sex obtain emergency contraceptives has logged an astounding 5,000 calls in its first few weeks of operation, according to its founders.
The popularity of the nationwide hotline suggests that emergency contraceptives--which usually consist of a regimen of birth control pills taken within a few days of having unprotected sex--may be of greater interest to women than previously thought.
The method is not new. For more than a decade, doctors have known that the right combination of ordinary birth control pills could prevent a pregnancy if taken within 72 hours of sexual intercourse.
Emergency contraceptives are “the nation’s best-kept secret,” says James Trussell, director of the Office of Population Research at Princeton University and a leading proponent. “Emergency oral contraceptives save in psychological costs, medical costs and social costs by preventing unintended pregnancies. But these are only potential savings. Achieving them will require educating the public.”
Besides the hotline, launched Feb. 14, a directory listing health professionals who provide emergency contraceptives has been published and the list put on the World Wide Web.
While college women seem to be aware of emergency pills--student health clinics have long been the most willing to promote the method--the hotline and Web site are designed to reach men and women of all ages.
“The only ones who know about this are college kids,” says Jo Ann Woodward, a nurse practitioner who operates the Special Health Care for Women clinic in Manhattan Beach. “We’re not reaching women in their 30s and 40s who could use it just as much.”
Before the hotline, Woodward says, she got about four or five calls a month from women seeking emergency contraceptives. But after a recent radio ad on the hotline began airing, the calls picked up.
The hotline is operated by the Washington, D.C.-based Assn. of Reproductive Health Professionals and Bridging the Gap Communications, a publishing house in Decatur, Ga., specializing in family planning and sex education.
“We’ve been very, very pleased with the response to the hotline,” says Marie Bass, director of the Reproductive Health Technologies Project in Washington, D.C., and member of the Assn. of Reproductive Health Professionals. “We really didn’t know quite what to expect.”
Bass says calls to the hotline, which is funded with private donations, are coming in so fast that additional financial support may be needed to cover the big phone bills.
But no one is complaining, she adds.
“This is not unlike other issues surrounding women’s health care. We need to be better consumers and ask [for emergency contraceptives]. Doctors are notoriously bad about discussing matters of sexuality and birth control with women. I think that women will have enough information from the hotline to be able to ask questions.”
According to a survey taken last year by the Kaiser Family Foundation, more than two-thirds of obstetricians and gynecologists said they were very familiar with emergency contraceptives and view the method as safe and effective. But the majority said they had prescribed the pills fewer than five times in the previous year.
In a 1994 Kaiser survey, only about 1% of American women said they had ever used emergency contraceptives.
“I think what we’ve all known, and the Kaiser Foundation documented, is doctors know about the method but they don’t very often tell women about it and women still really don’t know about it,” Bass says. “I’m still amazed by the number who are incredulous that this kind of method exists. Some react almost personally, ‘You mean to tell me that I didn’t have to go through what I went through!’ ”
What most of these women “went through” is either the anxiety of wondering if they are pregnant or an abortion. If emergency contraceptives were widely used, as many as 1.7 million unintended pregnancies and 800,000 abortions could be prevented, say its supporters.
This method is not RU486, the French abortion pill that is being tested in the United States. RU486 can be taken as many as nine weeks after a pregnancy is established and causes abortion. Emergency contraceptives do not cause abortion, Trussell says, because pregnancy is defined--in medical terms--as implantation of the fertilized egg. Emergency contraceptives are thought to work primarily by altering the lining of the uterus to prevent implantation.
The Kaiser study showed that a majority of doctors who do not perform abortions have no qualms about prescribing emergency contraceptives. Antiabortion groups, however, have expressed concern about the method.
“Our position is it’s an abortifacient,” says Teri Reisser, executive director of the Right to Life League of Southern California. “It carries the ability to cause abortion if it flushes out a fertilized egg.”
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The hotline, which operates around the clock, is completely automated in both English and Spanish. The caller listens to a brief explanation of emergency contraceptives and is advised to contact her own health-care provider, clinic or HMO, if she has one.
The caller is also given the names of three health-care providers in her area who will prescribe emergency contraceptives. About half of the providers are Planned Parenthood clinics. Other providers include women’s health clinics, college health clinics and private physicians.
Typically, emergency contraceptives consist of ordinary oral contraceptives containing estrogen and progestin. Six brands have been shown to have the right combination of hormones to prevent a fertilized egg from implanting in the uterus. The first dose, usually two pills, should be taken within 72 hours of intercourse. A second dose, usually two pills, is taken 12 hours after the first dose.
Other forms of emergency contraceptives include taking progestin-only mini-pills or insertion of the copper-T intrauterine device. The IUD can be inserted up to seven days after unprotected sex to prevent pregnancy.
Studies show there are no long-term or serious side effects to taking emergency pills. About half of the women who take the combination estrogen and progestin pills experience nausea and about one in five vomit.
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For More Information
* Emergency Contraception Hotline: (800) 584-9911.
* To find providers on the World Wide Web:
https://opr.princeton.edu/ec/ec.html.
