The irony is rich: Massachusetts, a state known for exceptional health care and medical research — the place where Worcester scientists invented the birth-control pill — often appears remarkably backward when it comes to contraceptives.

Take emergency contraception (EC), otherwise known as the "morning-after pill." This contraceptive method prevents pregnancy when taken within 72 hours of having unprotected sex. It works by preventing fertilization. Unlike another famous pill, RU-486, EC does not cause abortion. Yet despite EC’s potential benefits, it’s hard to come by in Massachusetts. As Melissa Kogut, who heads the state chapter of the National Abortion and Reproductive Rights Action League (NARAL), explains, "Women aren’t using it, doctors aren’t prescribing it, and pharmacies aren’t stocking it."

Last week, Kogut and her colleagues at Mass NARAL released a study on access to EC throughout the state, which uncovered some startling trends. In 2001, the group surveyed all 73 hospitals and 53 community-health centers across Massachusetts. Each institution received two phone calls. The first came from an advocate posing as an average woman seeking EC; the second from an advocate posing as a rape-crisis councilor seeking EC for a client.

Fifty-one percent of hospitals and 45 percent of the state’s health centers refused to provide EC to women. Some health-care providers hadn’t even heard of the contraceptive method; one hospital worker, for instance, offered this response when asked about EC: "I don’t even know what that is. We can’t help you." Even for rape victims, who typically receive special treatment, the findings were pretty grim. One out of every five hospitals refused to give EC to assault survivors. Kogut finds such results striking because "we view EC as part of emergency care. Of all places, it should be made available at hospitals."

Apparently, EC has yet to achieve the level of awareness it deserves. The federal Food and Drug Administration (FDA) approved EC for packaging in 1998, but it’s actually not a new product. Doctors have prescribed birth-control pills "off label" for emergency contraception for years. So Kogut can’t figure out why people are so reluctant to use or prescribe EC. It’s "a good question," she says.

But one thing is for certain: improved access to EC could prevent as many as 1.7 million unintended pregnancies and 800,000 abortions, according to the American Medical Women’s Association. (Those numbers are based on the fact that about half of all unplanned pregnancies end in abortion.) In Washington, where pharmacists dispense EC over the counter, the nearly 12,000 prescriptions filled in the past 16 months mean that approximately 700 unintended pregnancies and 350 abortions were avoided. EC also meets FDA criteria for over-the-counter medication: it’s safe, effective, easy to use, and will not endanger the health of those with medical problems. All in all, Kogut says, "Here’s a drug with enormous potential, yet no one knows about it."

At least, not until today.

For more information about EC, check out the Mass NARAL Web site at www.massnaral.org, or contact the Emergency Contraception Hotline at (888) NOT-2-LATE.