Beginning with eight women’s experiences in accessing emergency contraception from a pharmacist, this research brings into view the undocumented “sexual health work” of obtaining the drug in northern Ontario. Between 2005 and 2008, emergency contraception was deregulated to behind-the-counter, forcing women to submit to mandatory counselling and screening about sex, menstruation and contraception at the pharmacy. Situating unwanted pregnancy as harmful in this context, an institutional ethnographic analysis explores the activities of health service delivery and identifies the different ideological practices that shaped women’s access like the steady creep of neoliberalism, professional specialization and clinical power. Ideological discourses construct an ideal contraceptive user, who is patient, compliant and appears “responsible”, contributing to the stigmatization of women. Findings suggest that an inaccurate government definition of emergency contraception contributes to ignorance and misperceptions about function; this, along with an empty federal policy vacuum for women’s health contributes to its problematic status in women’s contraceptive options.