To the Editor: In their study of direct access to emergency contraception (EC),1 Dr Raine and colleagues provided information regarding EC use and its effects on rates of unprotected sex, unintended pregnancies, and sexually transmitted infections (STIs). However, based on data presented in the article, we disagree with their conclusion that “it seems unreasonable to restrict access to EC to clinics.”
First, there was no observed benefit to having easier access to EC: pregnancy rates were similar across all 3 study groups. The only significant difference was in frequency of EC use, which was greater for women who had advance prescriptions than for those who had to go to the pharmacy or clinic to get EC. Promoting easier access because it increases the use of a medication without any improvement in its desired outcome seems counterintuitive. Medical interventions—in this case, enhanced access—carry risks, benefits, and costs. Without a demonstrated benefit, only risk and cost remain.
Second, even though study participants were drawn only from family planning clinics (which differentiates them from the general public), increased access did not lead to decreased pregnancy rates among this select group. Use of these data to steer public health policy toward increased unsupervised access to EC does not seem appropriate.
Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature
Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal
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