“There’s a real failure rate when it comes to using emergency contraceptives, and the scary news is that most students are not aware of it,” Dr. Fortunato Procopio, Director of Medical Services at the University of Rhode Island, said.

Since the start of emergency contraceptives such as Plan B One-Step and ella, women have been able to employ more options in preventing pregnancy.  Both contraceptives can be taken orally within three to five days following unprotected intercourse.  A prescription from a doctor is needed for ella, but the accessibility of Plan B One-Step, an over the counter medication, makes relying on a form of emergency contraceptive even easier for most women.

However, Procopio believes that people have unreasonable expectations of the efficacy of emergency contraceptives.

“People hear what their friends say; they see things on TV,” he said. “There really is not a lot of information out there.”

He also pointed out that introducing over the counter emergency contraceptives has not affected the national pregnancy rate. The lack of change suggests failure rates in the use of Plan B One-Step and ella, of which most women are unaware. Procopio said that he has seen contraceptive failures here on campus.

One reason for emergency contraceptive failure may be linked to a woman’s body mass index (BMI), a measurement of the relative percentages of fat and muscle mass in the human body. Procopio explained that studies have shown a decrease in efficacy of Plan B One-Step and ella in women with a BMI of 25 or higher.

“If your BMI is 25-29.9 you are considered overweight,” he said. “A BMI of 30 or higher is in the obese category.”

According to Procopio, the results of several studies show that in a woman with a BMI in the overweight range, the chance of failure of Plan B One-Step is two times greater than that of a woman with a healthy BMI. An obese woman potentially faces a failure rate four times greater.

Although ella is somewhat more reliable, its results show lack of efficacy in obese woman. An obese woman’s likelihood of getting pregnant while using ella, although lower than Plan B,  is still twice that of a woman with a healthy BMI.

“The problem with these results is that they came from studies that were not originally designed to prove or disprove weight-related issues,” Procopio said. “The data does not fully prove them, but people in the field suggest we warn women of potential weight-related failures.”

At URI Health Services, women have access to Plan B One-Step over the counter and can get a prescription for ella.

“We currently do not stock ella, but we can write a prescription for it,” Procopio said. “We are constantly having discussions about which emergency contraceptives to stock and reassessing our current situation. We want to provide students with what they need.”

However, an overweight or obese woman does not have many options when it comes to reliable emergency contraceptives. If an emergency contraceptive pill is not the best option, an obese woman could research the option of a copper intrauterine device (IUD) inserted to prevent pregnancy. URI health services is unable to provide this service to students.

“It seems unfair, doesn’t it?” Procopio asked. “We just don’t have a full staff experienced in doing it.”

While Procopio believes that the weight disparity in birth control access is discouraging, in his opinion a more pressing issue is college students’ perception of emergency contraceptives.

“The biggest issue is that women and men do not understand that using emergency contraceptives is not the best plan,” he said. “There are better alternatives, such as being better prepared in the first place.”