The results suggest that the predicted rise in unsafe sex has been overstated and supports the case for lifting the ban on over- the-counter sales in the United States and other countries.

Since January 2001, emergency hormonal contraception (EHC), or the morning-after pill, has been available without prescription across Britain to women aged 16 or over at a cost of GBP 20 to GBP 25.

Overall Use Remained the Same

Opponents claimed that this would lead to "abuse" and encourage unsafe sex, particularly among teenagers, while supporters argued that easier access would help to reduce unwanted pregnancies.

Using national survey data, researchers examined use of EHC among British women aged 16 to 49 to assess the impact of making it available over the counter.

The level of use of different contraceptives remained very similar before and after EHC was made available over the counter. No significant change occurred in the proportion of women using EHC (8.4 percent in 2000, 7.9 percent in 2001 and 7.2 percent in 2002) or having unprotected sex.

A change did, however, occur in where women obtained EHC. A smaller proportion obtained it from GPs and NHS clinics and a greater proportion bought it over the counter, but overall use remained the same.

Important Policy Implications for Health Services

No significant change occurred in the proportion of women using more regular methods of contraception, such as the oral contraceptive pill, or in the proportion of women using EHC more than once during a year.

Authors of the report at the Imperial College Faculty of Medicine London said making emergency hormonal contraception available over the counter does not seem to have led to an increase in its use, to an increase in unprotected sex, or to a decrease in the use of more reliable methods of contraception.

They say this has important policy implications for health services.