Our Reproductive Health Advocacy Fellow Dr. Lin-Fan Wang responds to the recent news reports on weight and its impact on emergency contraception efficacy:
As doctors committed to improving access to reproductive health care, we support women in having planned pregnancies. Working to make highly effective birth control methods (such as IUDs and implants) more widely accessible is an important step. However, there will always be a need for emergency contraception.
Several news outlets this week have reported on recent research about emergency contraception efficacy. This research indicates that levonorgestrel-based emergency contraception, like Plan B, may be much less effective at preventing pregnancy in women whose BMI is 25 or higher or women who weigh over 176 pounds. This is concerning because many women fall into those categories.
The good news is that there are other options for emergency contraception. Ulipristal acetate, known by the brand name ella, is more effective than Plan B for women with a BMI over 25. However, it too might lose its effectiveness past a certain weight or BMI. The copper IUD, or Paragard, is the most effective form of emergency contraception for women, regardless of weight.
I want what’s best for my patients, and until further studies are conducted, this is what I’m doing: I’m talking to them about whether Plan B is the best method of emergency contraception for them, and checking whether they’re happy with their current method of birth control. For women who want to use ulipristal acetate, I’ll write advance prescriptions for them to fill before the need arises. Finding the right birth control method can go a very long way in reducing the need for emergency contraception.
More research is needed on the connection between body mass and efficacy. Until we find out more, it is important that all women, regardless of their body size, have access to contraception options that will work for them, including emergency contraception.
Today, the U.S. Supreme Court announced that it will hear a challenge from Hobby Lobby, an Oklahoma-based craft supply chain, and Conestoga Wood Specialties Corporation, a Pennsylvania furniture-making company, to a key component of the Affordable Care Act that enables women to have insurance coverage for preventive care, including contraceptive coverage, without additional cost.
Board Chair Dr. Nancy Stanwood responds:
“As physicians, we object to any attempt to place women’s need for affordable birth control at the mercy of the moral or religious inclinations of their employers. Preventive care, including birth control, is basic health care for women—and the decision to use birth control is a conversation between a woman and her medical provider, not a woman and her boss.”