With the introduction of emergency contraception, the likelihood of an unintended pregnancy can be reduced by up to 70% to 80%; however, limited access to EC, poor knowledge of its mechanism of action, therapeutic uses and adverse effects and lack of public awareness of its existence have weakened its potential benefits. Numerous studies have been conducted to determine if advanced provision of EC or OTC EC is more effective than prescription-only EC in minimizing the risks of unintended pregnancy.

Methodology: An evidence-based systematic review of the literature was done using Medline, FirstSearch, and CSA databases from 1998 to the present. The MeSH terms utilized in the search were emergency contraception/EC; Plan B; OTC/over the counter; deregulation/regulation; prescription; levonorgestrel. Articles were chosen based on the criteria that they were peer-reviewed, were randomized controlled trials, and that the information in the articles answered the research question.

Results: Twenty-six articles met the criteria and were selected for review. The literature demonstrates that with accurate, adequate education there is little abuse potential with advanced provision of EC or OTC EC. The literature has also shown no evidence of increased frequency of unprotected sex or increased incidence of sexually transmitted diseases with unrestricted access.

Conclusion: Increased access to EC through the establishment of OTC status or advanced provision results in a lower occurrence of unintended pregnancies than prescription-only EC.