Emergency contraception in a historic southern city: Mystery caller study in Birmingham, Alabama.

Background: Alabama's Human Life Protection Act (the Act) signed in 2019 became law in 2022, making provision of abortion a felony offense.

Objective: In 2020, we assessed the accessibility of emergency contraception (EC) pills in Birmingham, Alabama prior to the Act's enactment given the probable increased need for EC access due to abortion criminalization.

Study Design: Pharmacy staff were asked about availability, price, location, and identification requirements to obtain EC.

Results: Of 69 pharmacies, 59% had levonorgestrel EC and none had ulipristal acetate EC available.

Conclusion: There are persistent barriers to EC accessibility that should be addressed as abortion is increasingly restricted.