Reproductive outcomes of women who obtain emergency contraception without a clinic visit in an integrated health care system
Awarded 2012
Large Research Grants
Tina Raine-Bennett, MD, MPH
Kaiser Permanente Northern California

Objectives: Women have several timely options to obtain emergency contraception (EC) by prescription to increase their chances of preventing pregnancy. Little is known about population-based EC utilization and reproductive health outcomes. Methods: Data was abstracted from electronic health records to compare characteristics and reproductive health outcomes of 24,547 women age 15-44 who obtained at least one prescription for EC through the 24-hour call center (AACC) and other clinical routes (in-person or telephone visits or email) at Kaiser Permanente Northern California in 2010-2011. Results: Fifty-six percent of prescriptions were accessed through the AACC. The mean age of women was 26; adolescents were less likely than older women to access EC through the AACC than other clinical routes. Hispanic and African-American women were more likely than Asian and White women to access EC and to access EC through the AACC. STD rates were modest at 8% both in the 12 months before and after accessing EC. Nine percent of women adopted IUD or implants in the 12 months after accessing EC; women who accessed EC through the AACC were more likely to adopt IUDs than women who accessed EC through an in-person visit. 5.5% and 4.5% of women experienced a pregnancy within 3 months and 4-6 months respectively; 64% of live births were reported as unintended at the time of conception or at all. Conclusions: Women who access EC are high risk and benefit from having several options to access EC; they do not appear to be compromised by accessing EC without an in-person visit.