The Effect of the Liberalization of the Sale of Emergency Contraception on the Reproductive Behavior of Italian Women

Anna Giraldo , Università di Padova
Gianpiero Dalla Zuanna, University of Padova
Marzia Loghi, Istituto Nazionale di Statistica (ISTAT)

In Italy, in recent years, the use of emergency contraception is increased also due to the liberalization of the sales. The progestin hormone levonorgestrel, trade name Norlevo, the so called "morning-after pill" was introduced in 2006. If taken within 48 hours after sexual intercourse, Norlevo can inhibit conception. The "5-days morning-after pill", based on ulipristal acetate, trade name EllaOne was introduced in 2012. If taken within 120 hours of sexual intercourse, EllaOne can inhibit conception. Since May 2015 EllaOne can be purchased without any medical prescription, while Norlevo has become free one year after. Since the sale liberalization, the spread of emergency contraception has seen a significant increase, going from 30 to 40 thousand single-dose packs per month from 2014 to 2016. In this paper we describe the trend of the sales between 2012 and 2016 and we estimate the effect that emergency contraceptives may have had in reducing conceptions. Then, using regression statistical models, we measure the effect of sales liberalization on the abortion ratio. Net of the decline of women of childbearing age, more than a quarter of the decline in conceptions between 2016 and 2014 is due to the greater spread of emergency contraception. Moreover, the "shock" induced by the sale liberalization has contributed to the reduction of the IVG abortion ratio during 2015.

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 Presented in Session P1. Poster Session Fertility, Family and the Life Course