ORIGINAL ARTICLE Availability of Emergency Contraception in Rural and Urban Pharmacies in Kansas Fernand D. Samson, MD; 1 Rebecca Loren, MD; 1 Nicki Downing, MD; 1 Sarah Schroeppel, MD; 1 Patricia J. Kelly, PhD, MPH, RN, FNP; 2 & Megha Ramaswamy, PhD, MPH 3 1 School of Medicine, University of Kansas, Kansas City, Kansas 2 School of Nursing, University of Missouri, Kansas City, Missouri 3 Department of Preventive Medicine and Public Health, University of Kansas School of Medicine, Kansas City, Kansas Acknowledgments: We would like to thank Edward Ellerbeck, MD, MPH, and Leslie Sullivan, MS, for their excellent mentorship as we developed this project for our fourth year medical school “Health of the Public” rotation. For more information, contact: Megha Ramaswamy, PhD, MPH, University of Kansas School of Medicine, 3901 Rainbow Blvd, MS 1008, Kansas City, KS 66160; e-mail: mramaswamy@kumc.edu. doi: 10.1111/j.1748-0361.2012.00429.x Abstract Purpose: Determine availability of emergency contraception (EC) at rural and urban pharmacies in Kansas. Methods: A sample of 201 Kansas pharmacies was selected using a random integer generator. We measured ability to dispense EC within 24 hours and whether it was in stock at the time of the survey call. We examined EC avail- ability based on geographic differences and pharmacy type. Findings: Of the sample, 186 pharmacists agreed to be interviewed. Of these, 19% (n = 36) were unable to provide EC within 24 hours. There were essen- tially no differences in availability of EC between rural (75% could dispense in 24 hours) and urban pharmacies (85% could dispense in 24 hours) (P = .105). Corporate pharmacies were more likely to be able to provide EC within 24 hours compared to independent pharmacies (OR = 3.79, CI 1.71-8.43). Thirty-one percent (n = 57) of pharmacists did not carry EC at the time of the survey call. With this sample, urban pharmacies were more than twice as likely to report carrying EC compared to rural pharmacies (OR = 2.47, CI 1.31- 4.68), and corporate pharmacies were also more likely to report carrying EC compared to independent pharmacies (OR = 7.77, CI 3.72-16.21). Conclusions: In a sample of Kansas pharmacies, there were no differences be- tween rural and urban pharmacies in 24-hour EC availability; however, there were differences in those who stocked EC at the time of the survey call. Corpo- rate pharmacies were more likely to dispense EC within 24 hours and have it in stock compared to independent pharmacies, suggesting differences in avail- ability of EC. Key words access to care, contraception, pharmacy, policy, rural. Half of all pregnancies in the United States are unin- tended. 1 In 2006, 64% of the births resulting from un- intended pregnancies were publically funded, costing the federal and state governments more than $11 billion. 2 In that same year, unintended births in Kansas cost the state government $37 million, as well as $56 million of federal money. 2 Estimates suggest that half of all unintended pregnan- cies could be prevented with wider access to emergency contraception (EC). 3 A number of factors influence avail- ability of and access to EC. Given the time-sensitive na- ture of EC use after unprotected sex, residents of rural areas in the United States risk not having the benefits of EC due to geographic differences and more sparsely lo- cated EC-carrying pharmacies compared to urban areas. The goal of this study was to determine the availability of EC in rural and urban pharmacies in Kansas, 1 of the 10 most rural states in the country. The Journal of Rural Health 00 (2012) 1–6 c  2012 National Rural Health Association 1