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Emergency Contraception for Sexual Assault Victims

Every year, approximately 300,000 women are raped and about 25,000 women become pregnant as the result of a sexual assault.1
About one in six American women will be raped at some point in their lives. Adding to the trauma of the assault, each year about 25,000 women who are raped will become pregnant by an attacker. As with other unintended pregnancies, about half of the pregnancies resulting from rape end in abortion.2
Emergency contraception provides women with a safe and effective method to prevent unintended pregnancies.
Among the types of emergency contraception currently available are special doses of regular birth control pills, commonly known as “morning after pills,” and the use of a copper-T intrauterine device (IUD). Unlike Mifeprex, commonly called the “abortion pill,” emergency contraception does not induce abortion. Instead, it inhibits ovulation, fertilization or implantation before a pregnancy occurs. Emergency contraceptive options have been available for more than 25 years, and can be used safely by most women, even those who cannot use oral contraceptives for the long term. Although it is most effective within 24 hours, if taken within 120 hours after intercourse, emergency contraceptive pills substantially reduce the risk of pregnancy. Copper-bearing IUDs used as emergency contraception have an even higher success rate.
Despite its benefits, a large percentage of women do not know that emergency contraception is available.
Only 14 percent of women aged 18 to 44 have ever discussed emergency contraception with a doctor or nurse.3 A 2003 California survey found that just one in four reproductive age women know that emergency contraception is different from Mifeprex.4 Further, women who may need emergency contraception the most know the least. A survey of New York City youth found that 95 percent of those aged 14 to 18 had never heard of emergency contraception.5
Most hospitals do not provide emergency contraception­­—even to victims of sexual assault.
Local studies show that a large proportion of hospitals do not offer emergency contraception—nor referrals or counseling about emergency contraception—to victims of sexual assault. According to seven years of data from the Centers for Disease Control, fewer than half of all women who visited an emergency room after a sexual assault and who were not otherwise protected from pregnancy received emergency contraception.6 In a recent investigation, 35 percent of Catholic hospitals in states that require emergency contraception to be available to sexual assault victims reported that emergency contraception is not available under any circumstances—despite the fact that the church does not prohibit its use.7
Leading medical associations agree that emergency contraception should be offered to all victims of sexual assault.
The American Medical Association, American Nurses Association, American Public Health Association, American College of Emergency Physicians, American College of Obstetricians and Gynecologists, and American Academy of Pediatrics have publicly declared their official support for policies that require hospitals to offer emergency contraception to all victims of sexual assault.
The public supports increased availability of emergency contraception.
According to a national survey, over 80 percent of Americans believe that hospitals should not be allowed to deny emergency contraception to rape victims.8 Additionally, voters overwhelmingly oppose so-called “conscience clauses” that permit pharmacists to refuse to fill prescriptions—85 percent of Democrats and 70 percent of Republicans oppose pharmacist refusals.9
Eleven states have laws that help provide emergency contraception for sexual assault victims.
Eleven states (CA, IL, MA, NJ, NM, NY, OH, OR, SC, TX, WA) have laws that facilitate the availability of emergency contraception to women who have been sexually assaulted. The Massachusetts and New Jersey laws, enacted in 2005, require hospital emergency rooms to provide sexual assault victims with both information about and access to emergency contraception. Texas enacted a law in 2005 that requires hospitals to provide sexual assault victims with information about emergency contraception, but hospitals are not required to provide the medication. South Carolina law requires that emergency contraception be provided to women who request it, but does not require the hospital to inform them of the option. A California court ruled that a hospital could be held liable for failing to give a sexual assault victim information about, and access to, emergency contraception.10

This policy summary relies in large part on information from the Alan Guttmacher Institute and NARAL Pro-Choice America.

Endnotes
  1. Felicia Stewart and James Trussell, “Prevention of Pregnancy Resulting from Rape: A Neglected Preventive Health Measure,” American Journal of Preventive Medicine, November 2000.
  2. Stanley Henshaw, “Unintended Pregnancy in the United States,” Family Planning Perspectives, January/February 1998.
  3. Henry J. Kaiser Family Foundation, “2004 Kaiser Women’s Health Survey,” July 2005.
  4. Kaiser Family Foundation, “Emergency Contraception in California,” February 2004.
  5. Kaiser Daily Reproductive Health Report, “Adolescents Unaware of Emergency Contraception, According to Survey,” November 19, 2003.
  6. Annettee Amey and David Bishel, “Measuring the Quality of Medical Care for Women who Experience Sexual Assault with Data from the National Hospital Ambulatory Medical Care Survey,” Annals of Emergency Medicine, June 2002.
  7. Catholics for a Free Choice, “Complying with the Law?,” January 2006.
  8. American Civil Liberties Union Reproductive Freedom Project, “Religious and Reproductive Rights,” 2002.
  9. CBS News/New York Times poll, November 2004.
  10. Brownfield v. Daniel Freeman Marina Hospital, 208 Cal.App.3d 405 (Ct.App. 1989).
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