No such thing as an easy (or EC) fix.

To the Editor: In “No such thing as an easy (or EC) fix,” Trussell et al. [1] offer a number of explanations for the recent findings that some studies in which women were offered enhanced (“easy”) access to EC failed to produce a reduction in pregnancy rates. These results are indeed both perplexing and disappointing. However, they in no way indicate that EC “doesn't work” or support the authors' suggestion that resources would be better spent on promoting long-acting reversible contraceptives (LARCs). In fact, LARCs have been the focus of decades of investments in contraceptive development, introduction, service delivery and commodities support. That such investments are successful is evidenced by the United Nations' 2007 global data for contraceptive use: of those women who report using modern contraceptive methods, 33.7% fully rely on LARCs — injectables and IUDs. This rate is slightly lower than the percentage of women relying on sterilization (40%) and substantially higher than the percentage of those relying on pills, condoms and other methods altogether (26%) [2]. EC barely shows up on national surveys. EC promotion is relatively recent and funded by only a handful of progressive foundations, while LARCs have received decades of substantial, sustained support from bilateral and multilateral donors. Instead of spending resources to prove or disprove whether any contraceptive method can reduce unintended pregnancy by itself, we would do better to focus on ensuring that all women have a choice of a full range of contraceptive methods, accompanied by accurate and balanced information about side effects, effects on future fertility and effectiveness.