SEATTLE — On the basement floor of the University of Washington's main undergraduate library, one vending machine stands out. Instead of bags of chips and candy, the shelves are stocked with emergency contraception, pregnancy tests, condoms and over-the-counter pain medications.
The vending machine landed in UW's Odegaard Library in November and aims to expand access to affordable reproductive health care for students. Next year, similar setups will start appearing at public universities and community colleges throughout the state.
Washington recently became the first state to pledge public funding for vending machines that carry emergency contraception — including Plan B, which prevents pregnancy within 72 hours after unprotected sex — at its public universities, technical and community colleges, hoping to address the growing need for reproductive health care on college campuses.
Beginning in 2024, public colleges will be able to apply for a $10,000 grant that would support installation and upkeep of a vending machine, which generally carries Plan B, pregnancy tests, condoms, Tylenol and ibuprofen. The state has set aside about $200,000 total for schools to establish additional vending machines.
"It's really significant to have governmental state support for this," said Taylor Riley, a third-year doctoral candidate studying epidemiology at UW who helped push for the state budget request. She worked with a cross-campus cohort, including UW students studying public health, pharmacy and public policy, and others with the university's disability, gender equity and Black students commissions.
"But there's still a lot of existing unmet needs at our public university campuses across the state, and we really need to expand access as much as we can for comprehensive reproductive health care for students," Riley added.
Nationwide, demand for emergency contraception on college campuses has risen in recent years, but especially since the U.S. Supreme Court's Dobbs v. Jackson Women's Health Organization decision led many states to restrict abortion access, said Kelly Cleland, executive director of the American Society for Emergency Contraception. Now, at least 37 college campuses in 17 states have vending machines similar to the one at UW — including Washington State University and Eastern Washington University — though none are funded by state general dollars.
"Since Dobbs, we've had about a fourfold increase in interest from people reaching out to us to say, 'Hey we need to do something on our campus to improve [emergency contraception] access,'" Cleland said. "I'm so excited about what's happening in Washington, and I think these student leaders have been so instrumental in making this happen."
Cleland's organization works with schools throughout the country to bring emergency contraception to campuses. She and her team are also working to focus efforts in smaller and more rural colleges.
"After unprotected sex, the last option really is abortion, and in places where that's not a possibility, [emergency contraception] is absolutely essential," Cleland said.
Many college students are on their parents' insurance plans, a potential barrier to accessing regular contraceptive care, Cleland said.
When their parents receive records from the insurance company, it "may list everything (the student is) getting care for, which isn't always safe for young people," she said. "Sometimes they need to keep that separate from their parents."
Opponents of the recent expansion of the vending machines, however, argue that adding emergency contraception options to college campuses takes attention away from protecting against sexually transmitted disease — a "risk the pills won't address," said Kristi Hamrick, a spokesperson for Students for Life of America, a Virginia-based organization that advocates against abortion particularly on school campuses across the country.
"One of the problems with pretending that these machines solve all the issues of sexual contact is that the ease of getting to pills can cause vulnerable women to feel safe, when in fact they may be at great risk," Hamrick said.
In Washington, women between 20 to 24 years old — an age range common on college campuses — reported the highest abortion rates between 2009 and 2020, according to the state Department of Health. While recent state data around unintended pregnancies is limited, the Centers for Disease Control and Prevention reported in 2011 rates were highest among women between 18 and 24 years old.
"I think the vending machines really empower young people to take matters into their own hands and not have to basically get permission from an adult to get emergency contraception," Cleland said.
At UW, the vending machine landed on campus as part of a pilot program after the school's student government, the Associated Students of UW, passed legislation last year that demanded an accessible emergency contraception vending machine. One main concern, according to the legislation, stemmed from a lack of access to the student health center — which staffs an OB-GYN and provides emergency contraception, but is closed after 5 p.m. and on weekends.
Within the first three months of the vending machine's arrival, it went through more than 600 boxes of emergency contraception, Riley said.
"That was word-of-mouth," she said. "We didn't do any huge outreach or big pushes to let folks know. Obviously, there's a huge need."
The school's Pharmacists for Reproductive Education and Sexual Health, a student organization, has restocked and maintained the machine since then, with help from Huskies for Reproductive Freedom, UW's chapter of Pro-Choice Washington.
The items are generally much cheaper than they would be in pharmacies, which is another big benefit, Cleland said. At a local drugstore, Plan B often ranges between $40 and $50, whereas UW students can buy similar emergency contraception at the campus vending machine for closer to $12 to $13. In other parts of the country, where schools often pay for the vending machines and supplies, emergency contraception can cost $8 or less, Cleland said.
"There's also often stock-outs of Plan B [at pharmacies], and sometimes there's stigma from the pharmacists," Riley said. "The whole idea was, 'Let's make this discreet, accessible and affordable.'"
She and other students are hoping to add additional emergency contraception vending machines around the school in the future, but are also focusing on access to medication abortion on campus.
"The goal is comprehensive reproductive health services for all students," she said. "That's what we need."
Huskies for Reproductive Justice is looking for inspiration from similar laws passed in California, Massachusetts and New York that ensure student health centers on public college campuses will provide medication abortion, said Anya Fogel, a senior studying biology who helps lead the student organization.
In Washington, colleges or universities refer students to off-campus clinics for any type of abortion. If a student needs an abortion, they might have to miss class or work to travel to an off-campus clinic — which might not take as long in Seattle, but could be especially difficult in more rural parts of the state, Fogel said.
UW administrators are aware of recent student advocacy around on-campus medication abortion care and are exploring the idea, but say they're still working around obstacles.
"The Hall Health team supports improved access to all types of reproductive health care, including medication abortion," the school said in a statement this week. "Hall Health is working through the steps necessary to begin offering medication abortion."
This includes training medical staffers, collaborating with other UW Medicine abortion care providers, ordering medication abortion pills, assuring after-hours coverage, and funding other necessary equipment — all of which remain "significant" obstacles, the university said.
Still, Fogel and others are disappointed with UW's pace.
"It's just frustrating that medication abortion is seen as such a stretch, when implementing it is a basic necessity," she said.
