objective: this study aimed to determine if non-prescription emergency contraception (ec) availability impacted self-reported unintended pregnancy rates and to assess women′s knowledge and awareness of ec prior to and after non-prescription availability. methods: a survey regarding contraception use and knowledge was verbally administered to a cross-sectional, convenience sample of 272 pregnant women receiving prenatal care at a large urban community women′s clinic between august 2003 and october 2008. statistical analyses determined the differences between two groups (before [ba] and after, [aa] non-prescription ec availability in the u.s. drug market) in terms of self-reported unintended pregnancy rates, knowledge and awareness of ec. results: the aa group reported higher incidence of unintended pregnancy when compared to the ba group (90.7% vs. 72.7%, p = 0.0172). the majority of both groups reported that they were not using any contraception at the time of conception (ba-84.4%; aa-83.3%). there was no significant difference in the participants′ awareness of ec between the two groups (ba-46.8% vs. aa-43.0%) nor was there a significant difference between the two groups in the self-reported willingness to use ec in the future (ba-53.1% vs. aa-63.4%). however, among participants who were unaware of ec, 61% reported they would consider using it in the future after receiving brief ec counseling from a pharmacist or student pharmacist. neither age nor pregnancy intention was associated with self-reported ec awareness but there was an association with income (p = 0.0410) and education (p = 0.0021). conclusion: the change from prescription-only to non-prescription status of ec in the u.s. drug market did not impact the unintended pregnancy rate in this patient population. lack of knowledge and awareness is still a major barrier to widespread ec use.