24/7 EC Access Would Support Many Sexual Assault Survivors
By Alexandra Siebenhaar
Before the COVID-19 pandemic, the University of Maryland: Baltimore County (UMBC) University Health Services offered anonymous and low-cost contraception as well as emergency contraception to patients. However, this service was only available for a reduced number of hours (Monday through Friday, 8:30 a.m. — 5:00 pm). In order to fully support the sexual and reproductive health of all students, UMBC needs to offer wider access of over-the-counter (OTC) emergency contraception. UMBC must also provide at-home pregnancy tests on campus, rather than requiring students taking a urine pregnancy test in the clinic.
UMBC’s University Health Services accepts most insurances, while also offering out of pocket options for emergency contraception through a dispensary, which is often cheaper than purchasing at pharmacies. The clinic also operates with a dispensary because some patients may not want their family, partner, or other relation to know what healthcare services they seek. Through dispensaries, the clinic is able to provide a free consultation visit, which is not billed to insurance. The clinic can supply students with Plan B©, the most well-known brand of OTC emergency contraception, at the cost of twenty-five dollars, while providing them with ella© at the cost of forty dollars (though this requires a prescription). Students can only take Plan B© for up to three days and ella© for up to five days after unprotected sex, so students need to be able to access it at any time to prevent an unwanted pregnancy. Although not regularly, the clinic does offer Paragard©, an intrauterine device (IUD), in which the insertion acts as a form of emergency contraception while offering long-term contraception up to 10 years, but students would have to schedule an appointment in advance.
In 2016, NARAL Pro-Choice Maryland Fund began an accessibility study of OTC emergency contraception in pharmacies and stores. This led to the 2017 report, “What’s Your “Plan C” When You Can’t Get Plan B? . The results helped to inform access issues on and around college campuses, and supported the claims by Maryland college students that meaningful and timely access to prescription and OTC emergency contraception was a real problem. As a result, NARAL Pro-Choice Maryland led efforts to introduce the first state legislation in the nation in 2017 mandating that all public college campuses that house students to offer 24/7 access to OTC emergency contraception. The bill did not proscribe how the campuses were to do this, allowing each college or university to determine what would be the most feasible means possible. One of the ways that this has been achieved on other campuses across the country is to install vending machines outside of student health centers or in other areas with high student traffic such as the student union, library, or convenience store, and stock them with other personal health products. However, Maryland is one of the last two states in the union that prohibits over-the-counter medication to be sold in vending machines, unless an exemption is granted by the state’s secretary of the department of health (requests have been made, but denied). In the 2018, HB1111/SB0969 — Public Health- Access to Emergency Contraception — Student Health Centers and Vending Machines was introduced in the Maryland General Assembly, but also did not pass. Though these bills failed, some Maryland colleges have begun making changes thanks to student activists.
The University of Maryland at College Park became the first campus in the state to provide OTC emergency contraception to students 24/7 at their convenience stores, responding to the calls of student activists in 2017.[i] Joanna Morganelli, NARAL Pro-Choice Maryland’s Outreach and Communication Associate, is the founder of the ReproHotline of Towson, a hotline that organizes volunteers to deliver free OTC emergency contraception to students on Towson University’s campus when they are unable to receive it elsewhere. Morganelli drew inspiration from another student activist, Michyah Thomas, of Hampton University.
Currently, the only space open 24/7 on UMBC’s campus is the Albin O. Kuhn Library and Gallery; however, past advocates pushing for this building to distribute OTC emergency contraception have failed. Emergency contraception should be accessible and affordable to all UMBC students when birth control methods fail, a condom breaks, if one has sex without a condom, or if one is a survivor of sexual assault.
When advocating for 24/7 access of OTC emergency contraception on college campuses, student activists cannot exclude sexual assault survivors. Safe and consensual sexual activity is crucial to the reproductive health of all students on campus. UMBC’s We Believe You supports sexual assault survivors on and off campus.
To ensure the sexual health of survivors, UMBC must think about how they are going to advance their health services for students in the future. Kaitlyn Kylus, Vice President of We Believe You, explained that when discussing sexual assault on campus, it is important to also discuss the related exams. Kylus said:
“I would say if it’s in regard to sexual assault that we have to make clear that UMBC doesn’t offer SAFE exams, but someone could want emergency contraception after an assault without wanting to get an exam.”
SAFE exams (sexual assault forensic exams) give medical attention to survivors, like treatment for injuries, sexually transmitted infections (STI) prevention, as well as access to emergency contraception.[ii] SAFE exams increase prosecution of perpetrators and prevents them from committing future sexual assault or other forms of sexual violence; however, some survivors may skip, stop, or not receive the exam due to the possibility of re-traumatization.[iii]
UMBC’s We Believe You was founded in August 2017 by Dakota Monsen-Murray and Nadia BenAissa. UMBC’s Women Center staff supports the student organization; Assistant Director, Amelia Meman, leads the organization’s anonymous discussion groups for survivors and Jess Myers, Women’s Center Director, is their advisor.
Monsen-Murray had personally undergone the Title IX process to hold her perpetrator accountable, but was failed by UMBC even when evidence proved a sexual assault. Due to a lack of quality resources supporting sexual assault survivors on campus at the time, Monsen-Murray and BenAissa started We Believe You to create a space where survivors were believed and to feel less alone when they experience victim-blaming.
In the fall of 2018, after two women filed a class-action lawsuit against UMBC and Baltimore County officials saying they had covered up “justifiable complaints of sexual assault,”[iv] UMBC students, student activists, and staff demanded accountability and a changed campus culture. When talking about her past involvement with UMBC and the work she did to design better resources for survivors, BenAissa says:
“As a feminist scholar, I’ve always approached issues intersectionally and Retriever Courage was no different. On behalf of We Believe You, I co-chaired the Student Advisory Committee (SAC) and helped write the committee findings and recommendations named in the SAC report. As a member of the Retriever Courage Implementation Team, I was able to advocate for students’ needs and help shape UMBC policies and practices regarding Title IX, support services for survivors, and UMBC’s prevention efforts. We were able to make impressive strides during my time at UMBC, but as Hrabowski always says, success is never final, and the fight continues on. There’s still work to be done and I know We Believe You will be around to keep up the good fight.”
UMBC created the Office of Equity and Inclusion (OEI) in 2019 and We Believe You now works with the Inclusion Counsel that oversees OEI. UMBC is taking steps to support survivors, but implementing 24/7 OTC emergency contraception access would support those with reproductive health needs and those who could potentially become pregnant after a sexual assault.
Another area of concern is the attention not dedicated the diversity of students subjected to sexual violence on or off campus. BenAissa, discusses how neglecting LGBTQ+ survivors and survivors of color in reporting data is a form of institutional betrayal, explaining:
“The remedy to institutional betrayal is institutional courage. Institutions need to prove that they care about the most at-risk populations by collecting data on them and tracking trends and using that data to inform their policies and practices. Otherwise their efforts are halfhearted at best and a form of erasure at worst. Care needs to be shown to these students and providing them the most resources possible is one of the ways to do this. Offering 24/7 support services and emergency contraception is one way to offer resources and engage in institutional courage.”
Research shows that “73% of LGBTQ college students experience sexual harassment or abuse and more than 6% of LGBTQ college students change their school or major as a result.”[v] In addition, “Native American women are 2.5 to 3.5 times more likely to experience sexual assault compared to the statistics of all other races.”[vi] Universities, like UMBC, need to account for the students who report sexual violence on campus by representing them in campus climate surveys.
UMBC students who experience sexual violence on or off-campus should be able to obtain free emergency contraception at any time at UMBC. Not having this ability is another form of institutional betrayal. Sexual assault survivors should not have to deal with the great burden of accessing reproductive healthcare, especially when emergency contraception must be taken within a certain amount of days. OTC emergency contraception can cost thirty to seventy-five dollars[vii] when purchased off-campus and the added travel raises the price and creates more barriers to timely access. Not only do almost half of Maryland pharmacies and stores place OTC emergency contraception products behind the counter, forcing customers to ask pharmacy or store staff for assistance, but some pharmacies won’t restock emergency contraception when they run out.[viii] UMBC needs to offer OTC emergency contraception to all students because the total cost and lack of consistent availability at pharmacies may prevent timely access to the contraceptive and leading some sexual assault survivors to face an unwanted pregnancy.
Owens explained the need for 24/7 OTC emergency contraception on UMBC’s campus for survivors of sexual assault, saying:
“24/7 emergency contraception access goes so far beyond the fundamentals of health and wellness. Having unlimited and constant 24/7 EC access means freedom and peace of mind. Members of the survivor community should not have to go on a wild goose chase for any services that they need and desire, and this especially includes health and counseling resources. No one should have to chase after and fight for services they deserve. Although not every individual may find themselves needing it [EC], the ability to always have access to it is crucial, absolutely crucial to both mind and body health restorative and to the healing journey.”
Students may also experience discrimination or receive unnecessary questioning when buying OTC emergency contraception at stores, even though there are no age restrictions or ID requirements per FDA regulations.[ix] Most survivors do not speak out about their sexual assault because many are not believed. If survivors experience shaming from pharmacists or cashiers, this additional form of violence may also trigger re-traumatization for sexual assault survivors.
Not only do sexual assault survivors feel external shame, most also experience internal shame. Individuals may feel shame before even accessing emergency contraception and this culture shame may affect them purchasing it altogether. Feeling shame in accessing their reproductive healthcare may add to the self-blaming as a sexual assault survivor. If UMBC had OTC emergency contraception available 24/7 in vending machines, many sexual assault survivors would not experience the needless questions that uphold rape culture. NARAL Pro-Choice Maryland anticipates continuing to advocate for the passage of state law requiring OTC emergency contraception 24/7 access on college campuses, once the prohibition of the selling over-the-counter medications in vending machines is lifted. However, this should not stop UMBC from identifying other ways to increase access to care for any student seeking to prevent an unintended pregnancy, no matter how and where the unexpected sexual contact occurred.
I would like to give a special thanks to the student-activists at We Believe You and my colleagues for letting me interview them about their very important work they do in supporting sexual assault survivors and why access to reproductive healthcare matters when dismantling sexual violence on college campuses.
RAINN Hotline: 1–800–656–4673
Trans Lifeline: 877–565–8860
National Suicide Prevention Lifeline: 1–800–273–8255
[i] “Emergency Contraception,” NARAL Pro-Choice Maryland, (2020).
[ii] “What Is a Sexual Assault Forensic Exam,” RAINN, (2020).
[iv] “UMBC president: ‘We need to do much more’ regarding sexual assault on campus, The Baltimore Sun, (Oct. 12, 2018). 2020.
[v] “Prevalence Rates of LGBQ Survivors,” End Rape on Campus, (2020).
[vi] “Survivor of Color Prevalence Rates,” End Rape on Campus, (2020).
[vii] “Campus Organizing and Emergency Contraception,” NARAL Pro-Choice Maryland, (2020).