Emergency contraception (EC) can prevent pregnancy when taken shortly after unprotected sex. Four EC products have been approved by the U.S. Food and Drug Administration (FDA). Three of these products were approved for preventing pregnancy when taken within 72 hours after unprotected sex. One of these products, Plan B One-Step, was approved for over-the-counter sale by the FDA in 2013.
Since the late 1990s, state legislatures have taken different paths to expand access to emergency contraception. First, some states have mandated that hospitals provide emergency contraception–related services to people who have been sexually assaulted. Second, some states permit a person to obtain the medication without having to obtain a physician’s prescription. Third, one state has limited pharmacists’ ability to refuse to dispense emergency contraception on moral or ethical grounds. Finally, in some states, regulations discourage pharmacists from refusing to fill prescriptions for contraceptives, with one state having gone so far as to require pharmacies that stock contraceptives to dispense all contraceptive methods. At the same time, other states have attempted to restrict access by excluding emergency contraception from state Medicaid family planning eligibility expansions or contraceptive coverage mandates, or by allowing pharmacists and potentially some pharmacies to refuse to provide contraceptive services (see Refusing to Provide Medical Services).