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CONTEXT: Few nationally representative studies have examined the prevalence and predictors of emergency contraception use or of receipt of counseling about the method. The impact of the U.S. Food and Drug Administration’s 2006 approval of behind-the-counter sales of the method to women aged 18 and older remains to be seen; therefore, understanding patterns of use and counseling before the 2006 policy change is necessary to assess its impact.

METHODS: Data collected from 7,643 women aged 15–44 participating in the 2002 National Survey of Family Growth were analyzed using multivariable logistic regression to assess predictors of receipt of counseling and use of emergency contraception.

RESULTS: Overall, 3% of women reported that a clinician had discussed emergency contraception with them in the past year, and 4% of those who had ever had sex with a man reported having used the method. Only 4% of those who had seen a gynecologist in the past year reported having received counseling. Women’s likelihood of having received counseling was reduced if they were 30 or older (odds ratio, 0.2), and was elevated if they were Hispanic (4.1), black (2.6) or ever-married (2.4). Receipt of counseling in the last 12 months was the strongest predictor of ever-use (11.7).

CONCLUSIONS: Clinicians can play a pivotal role in ensuring that women have accurate information about how to access and use emergency contraception. However, efforts are needed to explore other ways to deliver this counseling.