Emergency Contraception in the ER

Hospital emergency rooms, often the first point of medical contact for rape victims, should provide comprehensive services to these women. Astonishingly, many hospitals fail to offer rape victims emergency contraception to prevent pregnancy from sexual assault.

Each year, an estimated 25,000 American women become pregnant following an act of sexual violence. The prompt use of emergency contraception could prevent as many as 22,000 of those pregnancies (1). Yet only 20 percent of rape victims receiving treatment at hospital emergency rooms actually received EC over a seven-year period in the 1990s, according to a national study (2). Surveys in several states have identified wide variations in hospital policies on providing EC to rape victims.

Currently, five states - Washington, California, New Mexico, New York and New Jersey - mandate that all hospital emergency departments offer EC to rape victims. Several other states have similar legislation pending. To see which states have pending EC in the ER legislation, view our state-by-state chart. In Illinois, hospitals are required to inform rape victims about emergency contraception but are not required to provide it on site.

What are we doing to improve access to EC in the ER?
The Education Fund has been working with other reproductive health organizations and with anti-sexual assault groups to increase the number of hospitals offering EC to rape victims. In New York, we worked with the New York State Coalition Against Sexual Assault (NYSCASA) to survey all hospitals in the state on their EC policies. Our findings – that as many as 1,000 rape victims a year were being sent away from ERs without having received EC (3) – helped make the case for the state legislation that was enacted in 2003 requiring that all hospitals offer EC to rape victims.

Focusing nationally, we collaborated with the National Sexual Violence Resource Center and the Clara Bell Duvall Project of the ACLU of Pennsylvania on the publication of an EC in the ER policy toolkit, Preventing Pregnancy from Sexual Assault: Four Action Strategies to Improve Hospital Policies on Provision of Emergency Contraception.

To see a sample of how reproductive health and anti-sexual assault groups have surveyed their hospitals and displayed the results, click here. These are the results of a survey by the Education Fund and the New York State Coalition Against Sexual Assault of all hospital ERs in New York State. The results are displayed using an interactive map that allows visitors to scroll over their home counties to find out which hospitals offer and provide EC to rape victims.

Please note: These results are as of April 2003 and do not reflect current state law which mandates on-site provision of EC.

Coalition of advocates condemns Department of Justice sexual assault guidelines
In January 2005, The Education Fund, the ACLU of Pennsylvania and the national ACLU Reproductive Freedom Project gathered signatures on a letter criticizing the U.S. Department of Justice (DOJ) for failing to include any mention of emergency contraception in a new 130-page "National Protocol for Sexual Assault Medical Forensic Examinations." The letter, signed by 206 national, state and local organizations, urged the DOJ to amend this first-ever Protocol to include information about preventing pregnancy. To view the letter click here.

1. Stewart, F. and Trussell, J. “Prevention of Pregnancy Resulting from Rape,” American Journal of Preventive Medicine. 2000. 19:228-229.

2. Amey, A. and Bishai, D. “Measuring the Quality of Medical Care for Women Who Experience Sexual Assault with Data from the National Hospital Ambulatory Medical Care Survey,” Annals of Emergency Medicine. June 2002. 39:6.

3. Family Planning Advocates of NYS and New York State Coalition Against Sexual Assault. Results of Statewide Survey of Provision of Emergency Contraception to Rape Survivors at Hospital Emergency Departments in NYS. 2003.