Five Things to Know About the Morning-After Pill on Its 20th Anniversary

Medication portion of PREVEN Emergency Contraceptive Kit. Photo: Smithsonian Institution

In 1993, the New York Times Magazine posited that the morning-after pill might be “the best-kept contraceptive secret in America.” Even many doctors had no idea there was a fallback contraceptive that could be used shortly after unprotected sex or cases of rape.

In many ways, the morning-after pill had been right in front of U.S. doctors for decades. In terms of chemical composition, it was not much different from standard birth control, using the same main ingredients — synthetic hormones — in higher doses. Moreover, many of their colleagues in Europe and Asia had already been prescribing morning-after pills for years.


In 1998, years of research and advocacy led to the first FDA-approved morning-after pill.


Here, however, the secret was still largely intact. A 1994 study by the Kaiser Family Foundation revealed that two-thirds of American women had never heard of the morning-after pill or other forms of emergency contraception (EC). Less than 1 percent had ever used them.

There was an information shortfall in large part because there was no contraceptive that was approved by the U.S. Food and Drug Administration (FDA) specifically for emergency use. Some providers worked around that absence by using the chemically similar estrogen and progestin medications that were approved for regular birth control. By upping the dosage, they created a suitable morning-after pill on their own. But drug makers couldn’t label or market those birth-control pills for emergency, post-coital use, since they weren’t FDA-approved for that purpose. It also spelled problems for federally funded clinics. Federal dollars couldn’t pay for an off-label medication hack, a makeshift morning-after pill that wasn’t officially approved. Continue reading

For the Safety of Students: Five Questions for Mary Koss

Mary P. Koss, Ph.D.

With close to 300 peer-reviewed publications and a number of academic awards to her name, it’s hard to believe that University of Arizona Regents’ Professor Mary P. Koss once had to fight her way into the doctoral program in psychology at the University of Minnesota. Her test scores put her head and shoulders above other applicants, but it took a tense meeting with the department head — in which she let a bit of profanity slip out — to finally get accepted into their graduate school. Clinical psychology was a very male-dominated field in the early 1980s, when she was starting her career, and that was all too clear when a colleague shared his idea for a study that would explore male undergraduates’ attitudes toward rape — by having models pose in varying sizes of padded bras and be rated for their desirability and culpability if raped.


The term date rape was first used in the news media 35 years ago this month.


From that conversation, though, came the seed of an idea that would soon set Dr. Koss apart from her peers. At that time, Dr. Koss was at Kent State in Ohio, still years before she joined the University of Arizona. She made a name for herself studying campus sexual assault by developing a survey that revolutionized efforts to gauge respondents’ experiences of sexual aggression and victimization, revealing a higher prevalence than previously thought. Her initial study was publicized 35 years ago this month, in Ms. Magazine’s September 1982 issue, in an article that also marked the first time a national news publication used the term date rape. Both Dr. Koss’ research and the introduction of that term to the national conversation were game-changers in many ways.

At the time the article was published, most rape-prevention programs on college campuses were relatively new and narrowly focused on the danger posed by strangers — the assailants waiting in alleyways, rather than the familiar faces in classrooms or dorms. Dr. Koss’ research, as well as the stories writer Karen Barrett reported from Stanford University and the University of Connecticut for the Ms. article, revealed that many cases of rape, especially those committed by the victims’ peers and acquaintances, were often ignored, denied, or misunderstood as something other than rape. The concept of date rape helped many people recognize rape — their own or others’ — that had been perpetrated by people known to the victims.

Greater awareness and understanding of the problem of campus sexual assault soon followed, but the 35 years since then have seen both progress and setbacks. In fact, as the anniversary of that historic Ms. article approached, news began coming from the Department of Education that Secretary of Education Betsy DeVos vowed to revisit Obama-era policies that addressed campus sexual assault. A series of information-gathering meetings included a group that, according to the Southern Poverty Law Center, seeks “to roll back services for victims of domestic abuse and penalties for their tormentors.” Continue reading