Duke Medical Ethics Journal
Breaking the Barriers: College Students and Emergency Contraceptives
by Mariana Bouchan
After the Supreme Court overturned Roe v. Wade on June 24, 2022, individual states gained the ultimate power to decide on the legality of abortion. Many states have since banned or restricted the procedure, spreading confusion and uncertainty around reproductive health and contraceptive access (Forbes). Right after the overturn, sales for emergency contraceptives skyrocketed, mainly due to fear and anxiety about the future of reproductive health. Before such an overturn, misinformation about emergency contraceptives has been spread across populations, sometimes influenced by religious beliefs. There is an ongoing misunderstanding on whether plan B, an emergency contraceptive, acts as an “abortion pill” (Forbes). For instance, U.S. Rep. Marjorie Taylor Greene argued, "The Plan B pill kills a baby in the womb once a woman is already pregnant” (Varney). However, plan b aims to prevent ovulation, preventing sperm from fertilizing the egg (Varney). The drug facts specifically state:
“EZ EC provides an inspirational example of how adolescents can substantially impact the advancement of reproductive rights (Kahn).”
“Plan B One-Step works before the release of an egg from the ovary. As a result, Plan B One-Step usually stops or delays the release of an egg from the ovary. Plan B One-Step is one tablet that contains a higher dose of levonorgestrel than birth control pills and works similarly to prevent pregnancy” (McGinley).
Due to such controversy, it is essential to clarify how plan B functions - this can be accomplished through clear communication with the public with familiar terminology. Although plan B attempts to be transparent with its methodology, misinformation still lingers, putting the accessibility of emergency contraceptives at risk.
In the United States, the rate of unexpected pregnancies among teenagers ages 15 to 19 years old is 75% (Dao). Although birth control and emergency contraceptives are currently legal in the United States, there are barriers such as misinformation, economic, and accessibility. Due to the high percentages of unexpected adolescent pregnancies, young adults need to be educated on how to gain access to emergency contraceptives and safe sex measures. However, such access was only hindered by the overturn of Roe v. Wade in 2022. To combat such barriers, some college students have created ways to have the peer-to-peer emergency contraceptive ability, decreasing stress and accessibility issues. These measures provide a hopeful opportunity for teenagers to face fewer barriers when addressing their reproductive health.
At Loyola University, there is a student-led effort to provide effortless access to emergency contraceptives: EZ EC. Entirely led by volunteers, the team delivers 4 to 5 orders of emergency contraceptives every week. This project inspired college students nationwide, providing a new approach to addressing the barriers to getting access to plan B, which is often an economic strain for college students. To encourage healthy sex measures, the team also met past campus boundaries to pass out condoms to students. Most importantly, EZ EC does not charge at all for the pills - the group made a discounted deal with a generic maker. Fundraisers and donations contribute to the cost. It is truly inspirational how the team has resolved the economic barrier toward emergency contraceptives. In an interview, a volunteer commented, “A lot of the girls who order EC from us — it’s like we give them an example in the demo of what to tell us, and people will just have that text copied and pasted.” (Kahn) The organization prides itself on providing a judgment-free environment, welcoming any student with open arms. EZ EC provides an inspirational example of how adolescents can substantially impact the advancement of reproductive rights (Kahn). Although emergency contraceptives are currently legal, it has been challenging to address the economic barrier. Nevertheless, EZ EC defies such borders, providing college students with the equitable access they deserve.
Similarly, after the Supreme Court overturned, Nikita Kakkad at UT Austin did a similar intervention project. Like many other students across the country, Nikita has contributed to the Emergency Contraception for Every Campus (EC4EC), similar to the Loyola University project. Unlike EZ EC, EC4EC comes with a price but successfully addresses transportation and accessibility barriers. Access to contraceptives is more urgent in Texas than ever, where abortion options are dramatically regressing. The prevalence of disinformation places a dire threat on access to Plan B in Texas. Kakkad states, “I remember in high school just constantly feeling scared and like I had no idea what I was doing when it came to having safe sex” (Washington). To address misinformation, Kakkad promptly delivers kits to students on campus. To respect anonymity, students can pick up kits in a pick-up spot, often being provided for free (Washington).
Similarly to interventions such as EZ EC and EC4EC, vending machines on college campuses facilitate access to the pill; however, cost remains a substantial issue. However, price remains a significant issue, as Plan B often ranges from $45 to $68 (Washington). Plan B is sometimes out of stock on college campuses, making access still difficult and unreliable. Affordability and stigma will continue to hinder access to such contraceptives. Nevertheless, college students incite hope towards making access effortless and equitable for all. Such access will allow students to continue pursuing their dreams without the anxiety of a possible pregnancy. Hundreds of students have already been touched by such measures. It is essential for society to address inaccurate claims about how emergency contraceptives work. The impact of college students on contraceptive access brings us one step closer to more equity in terms of reproductive rights, only providing hope for the future.
Review Editor: Reena Kagan
Design Editor: Sofia DiFulvio
Ashley Dao, PharmD Candidate 2024 St. John’s University College of Pharmacy and Health Sciences Queens. “Addressing Barriers to Emergency-Contraceptive Access.” U.S. Pharmacist – The Leading Journal in Pharmacy, 17 Sept. 2021, https://www.uspharmacist.com/article/addressing-barriers-to-emergencycontraceptive-access.
Forbes. “Roe v. Wade Reversal: Will It Affect Access to Plan B and Contraception?” Forbes, Forbes Magazine, 24 Aug. 2022, https://www.forbes.com/health/family/roe-v-wade-contraception-access/.
Kahn, Mattie. “The Students Quietly Distributing Emergency Birth Control on Campus.” The Washington Post, WP Company, 30 Nov. 2022, https://www.washingtonpost.com/magazine/interactive/2022/birth-control-distribution-ec4ec/.
McGinley, Laurie, and Lenny Bernstein. “'Morning after' Pill Label Changed to Clarify It Does Not Cause Abortion.” The Washington Post, WP Company, 23 Dec. 2022, https://www.washingtonpost.com/health/2022/12/23/morning-after-pill-label-change-fda/.
Varney, Sarah. “Misinformation Clouds America's Most Popular Emergency Contraception.” Kaiser Health News, 8 Dec. 2022, https://khn.org/news/article/emergency-contraception-plan-b-private-equity-abortion-debate/.
Washington, Jessica. “How a Network of College Students Is Preparing for Post-Roe Campuses.” The Fuller Project, 15 Nov. 2022, https://fullerproject.org/story/how-a-network-of-college-students-is-preparing-for-post-roe-campuses/.