title: Emergency contraception in Iowa pharmacies before and after over-the-counter approval.
abstract: OBJECTIVE
  To compare availability of emergency contraception in Iowa pharmacies, before and after the U.S. Food and Drug Administration (FDA) approved over-the-counter sales and identify reasons why over-the-counter, emergency contraception might still not be available in some Iowa pharmacies.
  
  
  METHODS
  Secondary analysis of data collected for an existing, descriptive study. A total of 906 pharmacies were identified; 405 (56.8%) pharmacies participated before, and 308 (43.2%) after the FDA policy change.
  
  
  METHODS
  Data collected via a scripted telephone survey.
  
  
  RESULTS
  After the FDA changed its policy and allowed over-the-counter sales of emergency contraception, the percentage of Iowa pharmacies offering emergency contraception increased from 57.8% to 70%. In the before sampling, 67.5% reported a perceived lack of demand as the primary reason for not carrying emergency contraception 66.7% reported this rationale in the after group. Other reasons included store policy, and moral, religious, or personal reasons. Pharmacists were surprisingly uninformed about the action of emergency contraception; before the FDA approved over-the-counter sales 53% believed the drugs primarily worked by blocking implantation of a fertilized egg. Indeed, even after FDA approved over-the-counter sales, 38% of pharmacists still believed that emergency contraception was comparable to an abortifacient. In addition, before the policy changed, 43.8% of pharmacists accepted emergency contraception as safe for teenagers; this percentage fell to 27.9% after the policy change.
  
  
  CONCLUSIONS
  Significant increases in the carrying of emergency contraception suggest the policy did succeed in increasing access. Despite this, barriers to access exist. Further research should explore why pharmacies might not carry emergency contraception.
authors: College of Nursing, University of Iowa, Iowa City, Iowa 52242-1121, USA. melissalehan@uiowa.edu
authors: Melissa Lehan
authors: ML
authors: Mackin
authors: Kathleen
authors: K
authors: Clark
mesh_terms: D000293:Adolescent; D044363:Contraception, Postcoital / Q000706:statistics & numerical data*; D005260:Female; D006291:Health Policy / Q000331:legislation & jurisprudence; D006297:Health Services Accessibility / Q000331:legislation & jurisprudence*; D006801:Humans; D007484:Iowa; D004366:Nonprescription Drugs / Q000627:therapeutic use; D010594:Pharmacies / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data*; D014481:United States
chemical_list: D004366:Nonprescription Drugs