<< back to memos

MEMORANDUM IN SUPPORT 
The Unintended Pregnancy Prevention Act

A.5569 – Paulin / S.3579 – Winner

The New York State Chapter of the National Association of Social Workers supports every woman’s right to exercise reproductive choice, and to access Emergency Contraception (EC) as a safe and effective means of preventing an unintended pregnancy and as such, urges passage of A.5569/S.3579, the Unintended Pregnancy Prevention Act, which seeks to give women in New York State a second-chance to prevent unintended pregnancy by permitting trained pharmacists and registered nurses to dispense emergency contraception (EC) directly to all women. 

To reduce rates of unintended pregnancy and abortion in New York State, we need to do more to help all women understand and reduce their risk of unintended pregnancy. We need to do more to help women understand what puts them at risk, how to use regular contraception to reduce that risk, and what to do if contraception fails.  As members of the Emergency Contraception Access Campaign, a coalition of public health advocates, medical and health professionals, and community organizations across New York State promoting widespread knowledge of and access to EC, we understand the need to make it possible for all women to access EC, by providing effective knowledge of and resources to emergency contraception.

Emergency contraception is an extremely safe and effective method of back-up birth control.  EC is 75 to 89 percent effective in reducing unintended pregnancies resulting from contraceptive failure, unprotected intercourse, or sexual assault.  EC is a higher dosage of standard birth control pills that must be taken within 120 hours of unprotected sexual activity to be effective.  EC should not be confused with mifepristone (RU-486) as EC does not terminate an existing pregnancy, but rather prevents pregnancy by inhibiting or delaying ovulation, stopping fertilization, or preventing implantation.  If a woman takes EC after she is already pregnant, the pills will not disrupt the pregnancy or harm the fetus in any way. 

Making EC available through direct distribution by pharmacists and registered nurses eliminates a medically unwarranted barrier to EC access. Direct access to EC at the pharmacy counter will allow all women to get emergency contraception in time for it to work – without increasing the chances she will have unprotected sex or increasing STD rates.  Leading medical groups, including the American College of Obstetricians and Gynecologists and the American College of Nurse-Midwives, believe that EC is safe enough for use by woman of all ages without a prescription. They also stress the need for “unimpeded access to EC for all women of reproductive age.” 

In August of 2006, the Federal Food and Drug Administration approved the sales of over-the-counter (OTC) emergency contraception for adult women only, upon the presentation of a government issued form of identification. The time sensitive nature of the medication makes it imperative that women of all ages are afforded the most expedient access to EC possible. The FDA’s decision severely limits the ability of minors and women without identification to access EC. Providing direct pharmacy access to EC for women of all ages, especially young women, will increase the chances that they will receive appropriate and timely professional attention, support, and pregnancy prevention assistance.

In this new “dual label” EC environment, women under the age of 18, or those who do not have proper identification, are required to obtain a prescription for EC from a licensed health care provider, such as a physician, licensed midwife, or nurse practitioner.  Requiring prescriptions from these professionals creates numerous onerous barriers to obtaining EC in New York State. For example, appointments may not be immediately available; health care providers may not be readily accessible to women living in rural areas; and, many women without health insurance have no regular health care provider.  Despite the fact that women over 18 can now access EC without a prescription, the ‘dual-label’ environment in fact excludes a significant number of women at risk for unintended pregnancy and severely limits the number of women that are able to obtain emergency contraception within the critical time period in which it is effective as a method of pregnancy prevention. 

A.5569/S.3579 seeks to alleviate current barriers to emergency contraception in New York State by permitting pharmacists and registered nurses to dispense EC regardless of age and documentation.  Pharmacies in New York State are often open twenty-four hours a day, seven days a week and are located in most urban and rural areas.  By having direct pharmacy access to EC, women could also avoid incurring the expenses associated with medical visits and travel, thereby distinctly benefiting uninsured women and those who live in rural and urban medically underserved communities. A.5569/S.3579 also seeks to ensure that women do not lose insurance coverage for EC solely because it has become available without a prescription; losing insurance coverage amounts to an additional obstacle to EC access.

In light of the FDA’s decision to allow over-the-counter (OTC) sales of emergency contraception to adult women only, increased efforts are needed to promote knowledge and use of this safe, effective method of birth control.  A. 5569 addresses the need for improved EC education by initiating an EC education and outreach program for consumers, patients, and health care providers through the Department of Health, which will include information about EC’s safety, efficacy, appropriate use and availability.

Emergency contraception is one of the most powerful tools available for reducing the risk of unintended pregnancy and, thereby, the need for abortion.  Barriers that currently interfere with timely access to EC have eliminated emergency contraception as an option for many women in our state. 

The National Association of Social Workers position on reproductive health services and family planning is based on self-determination, and self-determination is what social work is all about — helping people make choices; assisting them in realizing the power within themselves, through decision making based on an understanding of their own strengths; and helping people navigate and choose from among the complex health care, mental health care and social services systems that are in place to support them during times of crisis.

Social work is based on the principle that each individual has a right to quality of life, to self-determination and to make his or her own decisions about how to meet the challenges, overcome the obstacles and grasp the opportunities that are so much a part of life.

It is for the above stated reasons, the National Association of Social Workers – New York State Chapter, urges the New York State Legislature to pass the Unintended Pregnancy Prevention Act.