Center for Women’s Health Adds Emergency Contraception Resources

The new resources complement a growing list of tools being added to the AAFP’s Center for Women’s Health to ensure members always have the latest information about reproductive health and other clinical topics they need to care for patients and manage practices.

“Family physicians are often a patient's first point of contact for any medical questions or concerns, including questions about reproductive health,” said Danielle Carter, M.D., FAAFP, a member of the Academy’s Commission on Health of the Public and Science who helped AAFP staff create the new resources. “Given the confusion surrounding the function and availability of emergency contraception, the time-sensitive nature of its use and the time constraints associated with a busy day in the office, having a quick reference like this will be beneficial to patients and physicians alike.” 

The summary includes a table describing the methods of emergency contraception currently available in the United States and clarifies that emergency contraception should not be confused with abortifacients. It also provides clinical guidance on follow-up care.

The FAQ addresses more than a dozen common patient questions about emergency contraception, covering how it works, when and how soon to use it, and what side effects it may cause. The FAQ includes tables with answers about specific methods of emergency contraception.

Both resources draw from an award-winning AFP review article on evidence-based contraception, with supplemental information from other agencies, such as the World Health Organization and the American College of Obstetricians and Gynecologists.

Carter said family physicians can easily integrate elements of the FAQ into existing patient handouts or in-office educational materials.

“Physicians can use these as a quick reference during patient care, or even to confidently develop protocols for advice and/or prescriptions to be given by triage or office nursing staff,” she said.

Carter added that emergency contraception should be discussed as part of a comprehensive reproductive care plan, especially for those who do not desire pregnancy and do not use another form of contraception.

“While most patients do request emergency contraception episodically, patients should be counseled at preventive care visits about how to obtain it and the timing of its use,” Carter said. “It is equally important that patients feel empowered to have these discussions with their physicians.”

Protecting Clinicians’ Rights, Patient Access

The AAFP created the new summary and FAQ as the Biden administration issued new guidance to protect clinicians' rights of conscience and patients' access to emergency and contraception care, which aligns with Academy advocacy.

A final rule titled Safeguarding the Rights of Conscience as Protected by Federal Statutes, which takes effect on March 11, partly rescinds a 2019 policy that would have removed federal funding from health care facilities that required clinicians to perform services or make referrals for services that went against the clinicians’ moral or religious beliefs. The rule does not alter existing conscience protections; instead, it charges HHS’ Office for Civil Rights with fielding complaints, specifies which conscience laws the OCR will enforce and how, and encourages physician practices and other covered entities to voluntarily post notice of conscience rights.

The rule strengthens protections for clinicians who decline to participate in care that violates their personal ethics. The AAFP Congress of Delegates called on the Academy to advocate for such protections in a 2021 resolution. Last year the AAFP told HHS in a letter that the rule as proposed struck an appropriate balance between upholding clinicians’ right to not participate in non-emergency care they feel violates their personal morals and ensuring appropriate access to care for all patients, especially historically marginalized populations.

“The AAFP makes a clear distinction between declining to participate in a procedure based on moral grounds versus denying access to care to an individual patient,” the letter said. “Declining to participate in a procedure based on moral grounds is a protected right; declining to care for specific groups of people or individuals without adequate notice or an appropriate referral is an unacceptable shirking of health care professionals’ responsibility to care for patients and is contrary to the key underpinnings of the Code of Medical Ethics.” 

An updated FAQ about the rule highlights several other points that may affect family physicians, including:

• “Reasonable medical management techniques” for contraceptives cannot include step therapy, age-related restrictions, excessive administrative requirements or required cost-sharing for ancillary services.
• Contraceptive drugs and drug-led devices will be considered therapeutic equivalents to other products if they are listed as such in the FDA Orange Book.
• Plans and issuers must have “easily accessible, transparent and sufficiently expedient” exception processes that allow patients to access — without cost-sharing — the specific contraceptive drug or drug-led device that their physician determines to be medically necessary.

More Physician Resources On the Way

The AAFP’s Center for Women’s Health is a hub that will continue to grow with clinical guidance, journal articles, news stories, advocacy updates and other resources from the AAFP and external organizations. Bookmark the page for the latest resources as the Academy expands its offerings on women’s health topics throughout the year.

Members can learn more about family medicine pregnancy care in light of the U.S. Supreme Court’s decision in Dobbs v. Jackson Women's Health Organization case in an online CME course. A new on-demand CME activity on reproductive health is scheduled to launch in March on the Academy’s On Demand CME page.