EC to Go’ takes off at Maryland sites
"The lights go out, sparks fly, one thing leads to another, and then . . . the condom breaks," reads the newspaper advertisement. "What now?"
Baltimore-based Planned Parenthood of Mary land and the Baltimore City Health Department have joined forces in helping women prepare for such scenarios with "EC to Go," which distributes free emergency contraceptive pills (ECPs) through Planned Parenthood’s seven affiliate sites and the city’s three family planning centers.
A grant from an undisclosed area foundation provided funds for purchase of the product. The distribution program began in October 1999 and will continue until the product runs out, says Linda Anders, MPH, director of clinical operations at Planned Parenthood. Both Preven, the first dedicated ECP product, marketed by Gynétics of Belle Mead, NJ, and Plan B, the first approved levonorgestrel ECP, marketed by Women’s Capital Corp. of Bellevue, WA, are being used, according to Deborah Patterson, CRNP, Planned Parenthood associate medical director.
"Basically, what we did was buy a combination of Preven and Plan B and looked at using the expiration dates," explains Patterson. "We are rotating product in relationship to that."
Although the program is still in its infancy, it is definitely making its mark. The agency recorded some 800 prescriptions of ECPs in the last fiscal year; 600 prescriptions have been logged in just the first six months of the current fiscal year, says Patterson.
When the Baltimore City Health Department first approached Planned Parenthood about the ECP distribution program, program officials knew that raising public awareness about the need for emergency contraception was going to be a major challenge in shifting public understanding.
"When we first started to talk about using condoms for safer sex, most people said, No, I’ve got my contraceptive method,’ and didn’t quite make that connection until it just became more understandable to use a dual method of contraception," explains Patterson. "I think it’s going to be the same with EC."
To get the word out, Planned Parenthood developed a newspaper advertisement, placed in area college newspapers and neighborhood publications, and a 60-second radio spot, says Nesli Karakus, Planned Parenthood communications director. Although such advertising had to be purchased, Planned Parenthood was able to get added radio time because it regularly uses airwave promotion. Coupons also were developed that stated the availability of free ECP prescriptions to be kept on hand "just in case." The coupons listed the phone numbers for Planned Parenthood and the health department.
"I think that what is interesting is that while women want emergency contraception desperately when they need it, they are not real proactive about keeping a spare," says Patterson. "We think it is a wonderful idea to have a spare, in case they need it, as part of their first aid kit."
Planned Parenthood worked with the Baltimore City Health Department in putting together a plan for marketing and coupon distribution. The groups dispersed coupons to all three health department family planning centers and Planned Parenthood of Maryland centers.
The coupons, newspaper advertisement, and radio spot highlight the fact that emergency contraception is a higher dose of birth control pills that, if taken within 72 hours of unprotected sex, can prevent pregnancy.
"We still have some apprehension in our culture about using hormonal contraception from all the old wives’ tales that still continue to hang on, even though they were related to much higher-dose methods of contraception," notes Patterson. "We have that knowledge gap that we have to breach, and that is why promotion and education are such important components."
Process streamlined
Emergency contraception has been available at Planned Parenthood of Maryland sites since 1995, according to Patterson.
"Our staff is pretty comfortable with the provisions of EC, so it really wasn’t a big stretch to begin this program," she offers. "The stretch was to be able to respond more readily."
Planned Parenthood of Maryland affiliates automatically offer ECPs for take-home use following a negative pregnancy testing, says Patterson. If a woman calls in and reports an act of unprotected intercourse or failed contraceptive method, a focused medical history is taken over the telephone, and she is assessed for EC candidacy. If she is a candidate, she is asked whether she can access a health center or if a prescription needs to be called in to a pharmacy. She does not have to be a prior patient to come in for EC, says Patterson.
Members of the clinic staff have been oriented to perform the telephone evaluation to determine whether a woman is a potential EC candidate, explains Patterson. "All members of the clinic staff can evaluate a patient to see whether or not she’s a good candidate for EC so the clinician isn’t the one who is bogged down. [The clinician] always has the final nod."
• Roberta Antoniotti, Planned Parenthood of Maryland, 610 N. Howard St., Baltimore, MD 21201. Telephone: (410) 576-1400. Fax: (410) 385-2762.
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