title: Impact of emergency contraception status on unintended pregnancy: observational data from a women's health practice.
abstract: OBJECTIVE
  This study aimed to determine if nonprescription emergency contraception (EC) availability impacted self-reported unintended pregnancy rates and to assess women's knowledge and awareness of EC prior to and after nonprescription availability.
  
  
  METHODS
  A survey regarding contraception use and knowledge was verbally administered to a cross-sectional, convenience sample of 272 pregnant women receiving prenatal care at a large urban community women's clinic between August 2003 and October 2008. Statistical analyses determined the differences between two groups (before [BA] and after, [AA] non-prescription EC availability in the U.S. drug market) in terms of self-reported unintended pregnancy rates, knowledge and awareness of EC.
  
  
  RESULTS
  The AA group reported higher incidence of unintended pregnancy when compared to the BA group (90.7% vs. 72.7%, P = 0.0172). The majority of both groups reported that they were not using any contraception at the time of conception (BA-84.4%; AA-83.3%). There was no significant difference in the participants' awareness of EC between the two groups (BA-46.8% vs. AA-43.0%) nor was there a significant difference between the two groups in the self-reported willingness to use EC in the future (BA-53.1% vs. AA-63.4%). However, among participants who were unaware of EC, 61% reported they would consider using it in the future after receiving brief EC counseling from a pharmacist or student pharmacist. Neither age nor pregnancy intention was associated with self-reported EC awareness but there was an association with income (P = 0.0410) and education (P = 0.0021).
  
  
  CONCLUSIONS
  The change from prescription-only to non-prescription status of EC in the U.S. drug market did not impact the unintended pregnancy rate in this patient population. Lack of knowledge and awareness is still a major barrier to widespread EC use.
authors.affiliation: Division of a Pharmaceutical Evaluation and Policy, Department of Pharmacy Practice. College of Pharmacy, University of Arkansas for Medical Sciences . Little Rock, AR ( United States ).
authors.forename: Nalin
authors.initials: N
authors.lastname: Payakachat
authors.affiliation: Department of Pharmacy Practice. College of Pharmacy, University of Arkansas for Medical Sciences . Little Rock, AR ( United States ).
authors.forename: Denise
authors.initials: D
authors.lastname: Ragland
authors.affiliation: College of Pharmacy, University of Arkansas for Medical Sciences . Little Rock, AR ( United States ).
authors.forename: Cherri
authors.initials: C
authors.lastname: Houston
keywords: Attitudes; Behind-the-Counter Drugs; Contraception; Health Knowledge; Postcoital; Practice; United States