User:Ginnymo/The morning after pill on university campuses

Overview
The morning-after pill is a form of emergency contraception that falls under the broader scope of “birth control”. The morning-after contraceptive pill is taken in response to unprotected sexual intercourse, intercourse where previous forms of birth control have failed (broken condoms, missing dose of daily birth control pill), and non-consensual intercourse (rape). The primary active ingredient in the morning after pill is levonorgestrel. Moreover, emergency contraception has since been introduced to health and wellness vending machines which were intended to alleviate fears of social stigma and accessibility of emergency contraception across college campuses, hospitals, and various businesses alike.

Origin
The Shippensburg University in Pennsylvania was the first school to offer the morning-after pill in vending machines. During the Obama administration in 2012, the university’s student association advocated for the installment of the machine. A poll taken by Shippensburg showed that 85% of the students approved of the idea. The morning-after pill is sold in these vending machines for $25, alongside items such as cough drops, condoms, and pregnancy tests. These additional items bring an aspect of privacy to purchases from the machine. The first vending machine was placed in the University’s student center, however, some students worried the placement was too public. At the time of installation, the morning-after pill was only available to those over 17 years of age. The university, however, stated that none of their students were under the age of 17, so the law would not be a concern. From Shippensburg, the concept spread to other universities, with students advocating for the same emergency contraceptive accessibility. After two years of students advocating, the University of California, Davis installed a vending machine in 2017. In September of 2017, Stanford implemented a morning-after-pill vending machine, offering a generic version of the pill for $25. In March 2022, Boston University unveiled its contraceptive vending machine which offers the morning-after pill for $7.25. Currently, 39 schools have the morning-after pill vending machine and 20 schools are looking into the idea.

In Pharmacies, the morning-after pill can still be difficult to obtain. Patrons buying pills from drugstores have noted pharmacists imposing their own biased ideals on those buying emergency contraceptives. Pharmacies, moreover, can run out of these time-sensitive products for long periods, as they await new shipments.

Accessibility
Emergency contraceptive pills are products that are in high demand across the country; across the country, approximately a quarter (23%) of women who engaged in sexual intercourse had used emergency contraception at least once in their life. Studies show that Body mass index also plays a part in the effectiveness of the morning-after contraceptive, body mass index of 25–29.9) or “obese” which is a BMI of 30 or greater . The high demand highlights the importance of all instances of acceptability in regard to emergency contraceptives. However, there are limits in respect to the physical accessibility of contraceptives. According the Health Canada, the effectiveness of Levonorgestrel contraceptives diminishes if the individual taking the pill weighs more than 165 pounds and is not viable in individuals who weigh over 176 pounds . Additionally, according to Planned Parenthood, individuals who take certain medications and supplements may cause the morning-after contraceptives to not work as effectively. Antibiotics like Rifampin, antifungals like Griseofulvin, select HIV medications, select antiseizure medications, and the Herb St John's Wort all may decrease effectiveness. The brand of levonorgestrel contraceptive does not affect how viable its effects are, but rather the individual themselves as well as the external factors that may contribute to diminished effectiveness. In order to maximize the effectiveness of the morning-after pill, it is important to take the contraceptive within 24 hours of intercourse as the effectiveness of the pill diminishes over time. Therefore, to maximize efficacy, the pill should be ingested within 24 hours of intercourse; though the efficacy is significantly diminished, one can still ingest the pill 3-5 days after intercourse.

According to the Education Data Initiative, 43.2 million individuals have federal student loan debt. 73% of university students, moreover, say that they have struggled financially, which causes them stress. The average price of the morning-after pill is $50, a price that is out of range for most college students. To combat this, morning-after pills in universities are sold in vending machines, with prices ranging from $7.25 to $30.00. This brings another level of accessibility to students attending Universities who would normally be unable to afford the pill from commercial drugstores. In college, around 94% of students are sexually active causing the morning-after pill to be in high demand. A study from the National Library of Medicine shows that 32.4% of undergraduate women have used an oral contraceptive, while 23.7% of undergraduate women have used a long-acting method of birth control. 56.1% of women, therefore, are using a method of contraception besides condom s. This means 43.9% of women are not using a form of personal birth control. This number contributes to the demand for the morning-after pill vending machine on campuses.

Access on College Campuses
The 2010 Patient Protection and Affordable Care Act issued guidelines requiring group health insurance plans to cover FDA-approved emergency contraceptives for women, directly through the plan, or indirectly distributed through the government. The act's final regulations in 2013 included insurance offered by both public and private universities. Wheaton College, a private Christian college in Illinois, sued the government for being forced to permit the utilization of their healthcare plans for emergency contraceptive coverage, arguing it violated the First and Fifth Amendments. The Supreme Court gave Wheaton some relief following its decision in Burwell v. Hobby Lobby Stores, Inc., but the Seventh Circuit Court of Appeals still denied Wheaton's request for exemption from the Affordable Care Act. According to a study by the National Institutes of Health situated in North Carolina, Emergency Contraception, as of 2024, was only available at ⅓ of the state's colleges and universities, with an availability deficit localized at religious and/or smaller institutions.

The overturning of Roe V. Wade encouraged a wave of student activists to promote the availability of Emergency Contraceptives across campuses. At the University of California, Davis students worked tirelessly to input a “Health and Wellness” vending machine on campus after a Plan B shortage at their local pharmacy. Corey Vu, Interim Executive Director for Student Health and Counseling Services said, “We sat down and talked about it, and Parteek indicated that he has many friends who had expressed concerns to him about being able to access these wellness and health products.” Students at George Washington University led a movement to include emergency contraception in vending machines in discrete locations across campus. Before their placement in 2023, the students ran a program named “Foggy Bottom Plan B,” in which students could anonymously receive emergency contraception delivered to their dorm from other students.

A study from the American Health Association in 2022 found that 74.1% of Student Health Services provide Emergency Contraception to students. Society for Emergency Contraception reports 50 campuses across the United States that offer low-cost emergency contraception through vending machines. The organization launched the “Emergency Contraception for Every Campus” project in 2019 to expand access to emergency contraception for college students. The project focuses on adding vending machines to campuses most at risk for lack of contraception, including historically black colleges, catholic-affiliated schools, campuses in states with restricted access, and universities with low graduation rates. Similarly, the Power to Decide campaign, a nonprofit aiming to prevent unplanned pregnancies, introduced a new program aimed at providing sexual and reproductive services, including emergency contraceptives to historically Black colleges, at little to no cost. In both Illinois and New York, legislation is being crafted to require vending machine access to Emergency Contraception at all state colleges.