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Plan B — The FDA and Emergency Contraception
http://www.100md.com 《新英格兰医药杂志》
     To the Editor: Dr. Steinbrook (June 3 issue)1 joins the American College of Obstetricians and Gynecologists in urging "all obstetrician-gynecologists to provide advance prescriptions for emergency contraception to all women of reproductive age at every office visit." It should be noted, however, that all physicians who care for women of reproductive age have the ability to contribute to this effort. Multiple well-designed studies have shown that advance provision of emergency contraception increases timely, appropriate use without adversely affecting routine contraception and sexual risk-taking behavior.2,3,4 Any physician who recommends that a patient use condoms should ensure with a prescription that the patient will have rapid access to Plan B should the condom break. In addition, physicians (such as internists, family practitioners, dermatologists, psychiatrists, and neurologists) who prescribe teratogenic medications to women of reproductive age have a particular responsibility to ensure that their patients are prepared for contraceptive emergencies, by routinely discussing and providing prescriptions for Plan B.

    Eleanor B. Schwarz, M.D.

    University of California, San Francisco

    San Francisco, CA 94121

    schwarz@medicine.ucsf.edu

    References

    Steinbrook R. Waiting for Plan B -- the FDA and nonprescription use of emergency contraception. N Engl J Med 2004;350:2327-2329.

    Glasier A, Baird D. The effects of self-administering emergency contraception. N Engl J Med 1998;339:1-4.

    Jackson RA, Bimla Schwarz E, Freedman L, Darney P. Advance supply of emergency contraception: effect on use and usual contraception -- a randomized trial. Obstet Gynecol 2003;102:8-16.

    Raine T, Harper C, Leon K, Darney P. Emergency contraception: advance provision in a young, high-risk clinic population. Obstet Gynecol 2000;96:1-7.