As a nursing student and consumer of emergency contraceptives, I think their cost has a more significant impact on their use than the article ("The Underutilization of Emergency Contraception," April) explained. Even young adults or the working poor who have health insurance may find that emergency contraception is too expensive.

The article mentions briefly that those who are economically disadvantaged can obtain emergency contraceptives like Plan B from family planning centers at no cost. Yet these centers, such as those run by Planned Parenthood, are not located in every city. Moreover, many family planning centers close at 5 PM, which makes it difficult for working mothers to access their services.

To effectively increase the use of emergency contraceptives, nurses should be guided on how to advocate policy changes that reduce their cost and improve patients' access to health care services.

Wale Adeniji

San Francisco

Author Kit S. Devine responds: The focus of my article was on increasing knowledge about emergency contraception and enabling nurses to educate patients on this important factor in the reduction of unintended pregnancies. However, the goal of nurses working to improve access to health care and reduce costs is laudable.

The reader makes a valid point in that the cost of obtaining emergency contraceptives may not be fully covered by insurance. In addition, family planning agencies are not open at all times, although many have variable hours of operation to allow for better access to their services. It's important to note that the cost of emergency contraception is a fraction of that associated with pregnancy or its termination.