It has been four years since the federal government lifted the age limit for the morning after pill, but college students across the country say gaining access to it remains fraught with confusion and difficulty.
Now some colleges think they have found a solution: Morning after vending machines.
Stanford University unveiled one this month, following in the footsteps of several other colleges, including the University of California, Santa Barbara and the University of California, Davis, which made headlines after it installed a “wellness” machine this year that sells the generic version of Plan B, as well as pregnancy tests, feminine hygiene products, Advil, Claritin and other items.
Parteek Singh, a recent graduate who urged U.C. Davis to install the morning after vending machine, said he had heard from people at more than 30 schools who are interested in learning how to do the same thing on their campuses.
“This will be big,” Mr. Singh said. “It’s just the beginning.”
Since the morning after vending machine was installed at U.C. Davis in April, he said, 50 boxes of the emergency contraception pill have been sold.
The morning after vending pill is a higher dose of the synthetic hormone found in birth control pills, primarily works by delaying the release of an egg from the ovary. It is sometimes confused with mifepristone, which induces miscarriage and is commonly called the “abortion pill.” Unlike mifepristone, if an egg has already implanted in the uterus, Plan B cannot end the pregnancy.
It is most effective if taken within 24 hours of unprotected sex.
Plan B and its generics are supposed to be over-the-counter medications, but experts say drugstores don’t always keep them out in the open because they are expensive. And many university health centers have abbreviated or nonexistent hours on weekends, when Plan B is often needed the most.
In response, students have pushed for ways to buy the drug more easily.
Stanford kicked off its current quarter with the installation of a vending machine that sells My Way (a generic version of Plan B) for $25, as well as condoms.
Rachel Samuels, a recent graduate, worked for nearly three years to bring the machine to Stanford’s campus, inspired by her brother’s success installing a similar machine at Pomona College in Southern California.
Stanford’s health center pharmacy dispenses Plan B, but it isn’t open on weekends, according to its website. So Ms. Samuels and a group of other students sent out a survey in early 2015 asking if students favored expanding access to emergency contraception.
Some of the students said that they found it stressful and embarrassing to visit a drugstore or the health center and that the health center’s hours of operation were problematic, Ms. Samuels said.
A friend of Ms. Samuels said she had to check a CVS, a Walgreens and a Target before finally finding emergency contraception.
In 2016, Ms. Samuels used her platform as an officer in the student government to make the vending machine a priority. The student government and the university reached an agreement: Each would pay half the cost of the machine. This year, it was finally unveiled.
Contraception can still be hard to find
In 2012, Shippensburg University in Pennsylvania became one of the first colleges in the country to offer a morning after vending machine.
At the time, only women 17 or older could buy it without a prescription, but the following year, the Food and Drug Administration ended that restriction.
Even so, there is still “a lot of confusion about this product,” said Kelly C. Cleland, a Princeton University researcher and the executive director of the American Society for Emergency Contraception, which has been surveying pharmacies about the morning-after pill since May.
Their preliminary data shows that of the 133 pharmacies visited in 22 states, 41 percent did not have Plan B or a generic version on the shelf.
“There wasn’t even a space for it,” Ms. Cleland said.
One-third of the individuals canvassing the pharmacies were told that identification would be required to purchase the medication, and 22 percent were told that there is an age restriction. Neither is true.
In another study, published in the journal Pediatrics in June, researchers called more than 900 pharmacies and found that while 83 percent of them indicated that the morning-after pill was available, about 8 percent said it was impossible to obtain under any circumstances.
Sally Rafie, one of the study’s co-authors, runs a clinic inside an independent pharmacy in San Diego.
She said she supported the vending machines. “Anything we can do to make it easier to use emergency contraception is a good thing,” she said.
Although there are “missed opportunities” for counseling when a patient is no longer in a health care setting, she said, sometimes people aren’t looking to speak with anyone.
A desire for anonymity is part of what drew Haydn Bryan, 19, a Boise State University student, to ask his school administrators for a vending machine that carries emergency contraception.
“It’s more private because you don’t have to speak to an actual person,” he said. “It’s also cheaper than going to a Walgreens or Walmart because the university doesn’t mark up the prices.”
At a drugstore, the average price of Plan B is about $50 and the generic version runs about $40 on average. Some schools offer the drugs for less.
Mr. Bryan says the proposal has been well-received by school administrators.
Sienna George, Boise State’s student body president, said it was easy for students to feel apprehensive about seeking emergency contraception because they often feel judged, or worry about running into someone they know.
When it comes to the morning-after pill, she said, “nobody knows what you’re going through — they don’t know your reasons for needing to access services like that.”