A U.S. district court judge is expected to issue a ruling in the next few days on whether the Food and Drug Administration should make emergency contraception available over the counter for all women and girls of child-bearing potential.
U.S. Health and Human Services Secretary Kathleen Sebelius upset women's health advocates in December 2011 when she overruled an FDA recommendation that the Plan B One-step, or the morning-after pill, be sold over the counter without age restrictions. Currently, the pill is only available behind the counter to women 17 years and older, or with a prescription for those who are younger.
Following Sebelius' controversial decision, the FDA rejected a citizens' petition filed by the Center for Reproductive Rights to lift the age restrictions on all levonorgestrel-based emergency contraception and sell it on regular pharmacy shelves. The group then challenged Sebelius and the FDA in a U.S. district court, arguing that both decisions were based on politics rather than the sound recommendations of the scientific and medical communities.
"Politics has completely interfered with the process," said Janet Crepps, senior counsel for CRR. "The medical people within FDA said there was enough evidence to allow emergency contraception to be made available completely over the counter without restrictions, but [Sebelius] came back and said there was insufficient evidence to support making it available to younger minors. If you look at the reasoning, it doesn't hold up."
Sebelius and the FDA, who are being jointly represented by attorneys from the U.S. Justice Department, argued in court that Sebelius' decision to overrule the FDA recommendation was based on a lack of scientific evidence demonstrating that girls younger than 17 can effectively and safely use the morning-after pill on their own.
The FDA did not immediately respond to calls for comment. A representative for HHS referred HuffPost to a 2011 press release that coincided with Sebelius' decision.
U.S. District Court Judge Edward Korman is expected to decide within the next week whether to uphold the restrictions on emergency contraception, to lower the age restriction but keep the drug behind the counter at pharmacies, or to ask the FDA to remove the age limit completely and sell the pill over the counter.
Doctors and women's health advocates largely disagree with Sebelius' decision and believe that putting any barriers between teenagers and contraception does more harm than good. Emergency contraception must be taken within 72 hours of sexual intercourse in order to be effective, and requiring girls under the age of 17 to obtain a prescription for it could prevent them from being able to take it in time. Moreover, young adolescents and low-income women may not have the government-issued ID required to obtain the pill from a pharmacist behind the counter.
"We have the highest teen pregnancy and unplanned pregnancy rate in the developed world," said Tracey Wilkinson, a pediatrician and fellow with Physicians for Reproductive Health. "The way we currently access contraception is not effective enough to change that. Most teens use condoms as their main form of birth control, which isn't very effective if they don't use them consistently or the condom breaks. They need access in a timely manner to an alternative form of birth control."
Wilkinson said the morning-after pill is the hormonal equivalent to about four regular birth control pills and that parents should not be concerned at all about the medication's safety. "I would tell parents that a bottle of Tylenol is much more dangerous than emergency contraception," she said. "If you take an overdose of Tylenol, you can cause irreversible liver damage, but those risks are not present with emergency contraception."
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