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The Right Plan for Plan B

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PLAN B
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In a country where nearly half of all pregnancies are unplanned, effective birth control isn't just a convenience -- it's an urgent health need that too many women are still unable to meet. We've seen some promising signs of progress recently, including a government decision to require new health plans to cover contraceptives without copayments. Yet every step forward seems to trigger a reflexive backward leap. This week, after years of acknowledging that emergency contraceptives are safe and effective for nonprescription use, the government missed a tremendous opportunity to make emergency contraception more available to women who need it.

I'm talking about the decision regarding Plan B One-Step, the "morning-after" pill. After a careful review of the scientific record, the independent nonpartisan Food and Drug Administration (FDA) determined that the product should be freely available on store shelves -- just as other over the counter medicines are -- so that any woman of reproductive age can get it quickly in the event of an unplanned or unwanted sexual encounter. After all, it's called emergency contraception for a reason -- it is meant for emergencies and works best when used as soon as possible after unprotected sex.

After reviewing extensive clinical evidence, FDA Commissioner Margaret Hamburg agreed with the agency's scientific advisors that Plan B One-Step "is safe and effective and should be approved for nonprescription use for all females of child-bearing potential." By overruling Hamburg's decision, the Department of Health and Human Services has ensured that Plan B One-Step will stay out-of-reach for too many women -- hidden behind pharmacy counters rather than appearing on store shelves. The product is already available on request to people 17 or older, but requires finding a pharmacy, with a pharmacist, that's open. Women also face the real chance of having a pharmacist deny their request for emergency contraception, because some states allow pharmacists to refuse to provide emergency contraception from behind the counter.

Unfortunately, the opponents of birth control of all types have painted a picture of 11- and 12-year-old girls rushing to the local drugstore to snap up emergency contraception. How crazy is that? As a mother of three kids, I'm pretty aware that very few kids that age are sexually active, and even fewer are looking to shell out $50 for a treatment they don't need.

Planned Parenthood strongly supports parents in their efforts to protect their teens' sexual health, and we work with teens to encourage responsible decisions and help them delay sex until they are ready for it. In fact, Planned Parenthood provides more sex education to young people and their parents than any organization in America. Studies consistently show that the more we provide honest information and health care services to young people, the more likely they are to make responsible decisions and delay sexual activity.

The reality is that some teens become sexually active before they're old enough to buy Plan B without a prescription and 750,000 teens become pregnant every year. That means we should do all we can to keep teens from being parents before they are ready. Requiring a prescription provides an additional barrier to accessing Plan B, which means an additional barrier to preventing teen pregnancy. And as researchers have pointed out, physician supervision through issuing a prescription does not improve a woman's ability to follow the directions for medication usage. Put another way, young adolescents should not be singled out due to concerns about an inability to follow the directions.

Unfortunately, this hysteria is a smokescreen that has obscured the real issue: women need better access to this safe, effective and vitally important medication. As its name implies, emergency contraception is intended for use in urgent situations -- like when another form of birth control fails. The sooner you take it after unprotected sex, the more likely it will be to prevent an unintended pregnancy and all of the serious health and life consequences that accompany it. When that emergency arises, often the local pharmacy will be closed for the night, the weekend, or a holiday. By stocking Plan B One-Step on the shelves in drugstores, supermarkets and convenience stores, we could improve women's chances of finding it when they need it most. That's one reason a back-up form of contraception shouldn't be kept behind pharmacy counters.

But it's not the only reason. Even for a 30-year-old woman, slipping a packet from the store shelf into your shopping basket is a lot easier than announcing your predicament at a crowded pharmacy counter. In some towns, the lack of privacy can be a real disincentive for women in need. The current restriction would make sense if women needed pharmacists' oversight to use emergency contraceptives safely. But Europeans have bought them off store shelves for years, and research has shown no need for more medical oversight.

Despite all the political efforts to restrict it, access to emergency contraception has expanded steadily in recent years. But we can't afford to accept the status quo when women's health is at stake. The right plan for Plan B is to ensure women can access it when they need it.


Cecile Richards is president of Planned Parenthood Federation of America and the Planned Parenthood Action Fund.