According to a study published in the Christmas issue of the BMJ, sales of emergency contraception in the United States are estimated to increase by approximately 10% in the week following New Year’s Day, signaling a heightened risk of unprotected sex during this time compared to other holidays.
Other holidays, such as Valentine’s Day and Independence Day, were also associated with increased sales, but to a lesser extent.
The researchers point out that the annual increase in sales may seem peculiar, but it indicates „an unmet contraceptive need that requires further attention.“ This is particularly relevant given the tightening of abortion restrictions in many U.S. states.
Celebrations on New Year’s Eve are associated with increased sexual activity, which is less likely to be protected due to increased alcohol consumption. New Year’s Eve is also linked to a higher rate of sexual assaults and limited access to other forms of contraception due to restricted hours of clinics, doctor’s offices, and stores.
To assess the sale of emergency contraception after the New Year’s holiday, the researchers analyzed retail scan data for levonorgestrel, a medication available without a prescription or age restriction, since 2013.
Commonly referred to as the „morning-after pill,“ levonorgestrel is effective when taken within 96 and possibly up to 120 hours following unprotected intercourse. However, its effectiveness is highest when taken earlier, underscoring the importance of timely access.
The study focused on sales in the week following New Year’s Eve and New Year’s Day from 2016 to 2022 in U.S. retail outlets, including grocery stores, drugstores, wholesalers, club stores, dollar stores, and military stores.
To account for potential changes in the at-risk population for pregnancy, weekly sales were divided by the size of the female population aged 15-44 years.
Overall, the sale of levonorgestrel in the week after New Year’s Eve increased by 0.63 units per 1,000 women aged 15-44 years. Based on population estimates in 2022, this equated to nearly 41,000 additional pills sold that year.
The researchers also explored other holidays that may be associated with increased unprotected sexual activity, including Valentine’s Day, Independence Day, and St. Patrick’s Day.
Valentine’s Day was linked to a smaller increase in sales, approximately 0.31 units per 1,000 women, compared to the New Year’s increase. Independence Day saw an increase of 0.20, and St. Patrick’s Day was associated with a rise of 0.14.
Holidays such as Mother’s Day, Father’s Day, and Easter were not correlated with increased sales.
However, the researchers acknowledge certain limitations. For example, sales of emergency contraception do not directly equate to usage, and the data does not encompass emergency contraception acquired through medical clinics, independent pharmacies, and online sales. Differences in how holidays are celebrated and access to reproductive health care may also limit the generalizability of the findings to other situations.
Nevertheless, they suggest that their findings indicate specific celebrations may present important targets for public health intervention, and that „targeted responses to mitigate behavioral risks, prevention strategies to curb sexual violence, and improvements in access to contraception around holidays can limit the risks associated with unprotected intercourse.“
„Emergency contraception is more important than ever for people in the United States, particularly those living in regions with abortion bans or strict restrictions,“ they write.
„Future work will examine how other dynamics at play in the U.S. context, including state abortion restrictions, influence emergency contraception purchasing behavior and imply potential public health interventions to provide contraception to those who need it most.“
Wagner, B. & Cleland, K. (2023). Einzelhandelsnachfrage nach Notfallverhütungsmitteln in den Vereinigten Staaten nach Neujahr: Zeitreihenstudie. BMJ. doi.org/10.1136/bmj-2023-077437.