Two facts have emerged to create a new solution to an age-old problem.

Half of all pregnancies in the United States are unintended, and pharmacists are the most accessible health-care providers, available in the community 24 hours a day, seven days a week.

Putting these two facts together has led nine states to grant patients direct access to emergency contraception (EC) from pharmacists. The states are Alaska, California, Hawaii, Maine, Massachusetts, New Hampshire, New Mexico, Vermont and Washington.

As a result, a woman in these states who has had unprotected sex or whose method of contraception has failed can go directly to a pharmacist and obtain emergency contraception.

Vitally important to emergency contraception’s efficacy is timing: The sooner the product is taken after unprotected sex, the higher the success rate. If taken within 72 hours, Plan B, the only dedicated EC product currently available, has an 89 percent rate of reduction of expected pregnancy.

Alternatively, the Yuzpe regimen, a combination of oral contraceptive products, is also used for emergency contraception. Available in the U.S. since 1998 and used worldwide since the 1970s, the Yuzpe regimen has a 75 percent rate of reduction of expected pregnancy.

Rate of expected pregnancy after unprotected intercourse varies depending upon a woman’s age and fertility status. Basically, for every 100 women who have unprotected intercourse, eight are estimated to become pregnant. If all 100 women take Plan B within 72 hours of unprotected intercourse, only one is expected to become pregnant. Efficacy also has been shown up to 120 hours after unprotected intercourse, but studies suggest the earlier the medication is taken the better the results.

Given the importance of timing in taking this medication, access becomes a vitally important concern.

Kathleen Hill-Besinque, associate professor of clinical pharmacy in the USC School of Pharmacy, has been a strong proponent of emergency contraception since the 1990s. She covers the topic with her Pharm.D. students in the School of Pharmacy, has written a clinical review on the topic that is available to pharmacists for continuing education credit and has testified at state senate and assembly hearings in Sacramento.

Her work and dedication to emergency contraception, among other women’s health issues, earned her the 2005 Pharmacist of the Year Award from Pharmacy Access Partnership.

Besinque sees EC as a good model of the expanding role of the pharmacist in meeting today’s health-care needs.

“It’s a public health service much like immunizations, screenings or asthma care. Patients already go to and greatly depend upon their pharmacists for these health services. Women needing emergency contraception can also depend on their pharmacists,” Besinque said.

Besinque sees EC as a medication that every woman should have in her medicine cabinet “just in case” she needs it. Having been involved in women’s health issues since early in her career, Besinque recognizes emergency contraception as a good alternative to a situation that happens all too frequently: contraceptive failure or unprotected intercourse.

She sees this therapy as a public health victory, with the potential to positively affect the three million unwanted pregnancies that occur annually in the U.S. Half of these unwanted pregnancies currently are terminated by elective abortion.

“Some people say EC is the best-kept secret in women’s health. It really is. It prevents an unwanted pregnancy before the pregnancy occurs. The drug is very safe and has few side effects. And women can get it directly from their pharmacists, either on an emergency basis or in advance,” Besinque said. “EC should not be confused with RU-486 (Mifeprex), commonly called the abortion pill, which treats an existing unwanted pregnancy. EC prevents a pregnancy from occurring.”

At USC, Plan B is available in both the UPC and Plaza pharmacies that serve USC students, faculty and staff, as well as the surrounding communities. Kari Trotter Wall, supervising pharmacist at the UPC pharmacy, reports that Plan B is maintained in stock at both locations.

“Each week, we provide Plan B to approximately 10 women at our UPC location and another one at the Plaza Pharmacy on the Health Sciences Campus,” Wall said. “We counsel patients prior to providing the medication, to be sure that it is appropriate for them. We also stress that Plan B is an emergency contraception and should not be relied upon for regular birth control.”

The week of March 20 has been designated “Back Up Your Birth Control” week.