Assessing sexual assault survivors' access to emergency contraception: Results from a mixed methods study in South Carolina

BACKGROUND: Provision of emergency contraceptive pills (ECPs) is widely recognized as the standard of care to prevent pregnancy after a sexual assault. However, previous research has shown that hospitals do not routinely counsel sexual assault patients about or provide sexual assault survivors with ECPs or accurate referrals.

METHODS: We undertook a mixed methods study to assess policies and practices regarding the provision of ECPs for sexual assault survivors in South Carolina. The study includes four components: An analysis of the South Carolina Victims' Rights Amendment, in-depth interviews with rape crisis agency and state agency representatives, a survey of hospital emergency department staff, and a survey of hospital emergency department administrators.

FINDINGS: Our findings indicate that hospital policies and practices regarding ECP-related services for sexual assault patients are generally consistent with the standard of care. According to hospital staff and administrators, requiring a police report and/or undergoing a rape kit examination before providing ECPs do not seem to be significant access barriers. However, hospitals that do not conduct rape kit examinations transfer patients to other facilities, and these initial hospitals do not routinely provide patients with ECPs before transfer.

CONCLUSION: Our findings suggest that further research to document whether transfer practices and reporting requirements impede access to ECPs is warranted. Furthermore, our results support the recommendation that any woman reporting sexual assault should be immediately offered dedicated, progestin-only ECPs. Last, our results suggest that key stakeholders in the sexual assault community could be engaged to improve sexual assault and ECP-related services in South Carolina.