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Cecile Richards

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The Right Plan for Plan B

Posted: 12/09/11 12:43 PM ET

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.

 

Follow Cecile Richards on Twitter: www.twitter.com/cecilerichards

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...
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...
 
 
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Karissa36
Saving lost boys and fighting pirates.
11:18 AM on 12/13/2011
In reference to some concerns about pharmacies expressed in the article, women should know that Plan B is widely available for purchase without a prescription, (if at least age 17), on the internet. Overnight delivery is guaranteed. There are also many internet sites which will help you locate a pharmacy where Plan B is available. Finally, 19 different commonly prescribed birth control pills, if taken according to a special dosing schedule, will act exactly the same as Plan B. Their names and dosing schedules are also available on the internet. One site is run by Princeton University.
07:37 PM on 12/11/2011
This decision was not about "womens' health." It was about children's access to birth control. This is a decision that should be based on politics as well as science. There are many parents who do not want their children taking birth control without their knowledge.
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HUFFPOST COMMUNITY MODERATOR
jessicadevyn
Danger Zone
09:39 PM on 12/11/2011
Minors already have the right to birth control without their parents knowledge. Doctor-patient confidentiality is a privilege that already extends to them. That's why they can be put on birth control without permission.
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goatini
We are two-legged wombs, that’s all
12:21 PM on 12/12/2011
This decision was NOT about "children's access to birth control".

It was about interfering in and attempting to impose controls on the bodies of females. Just more of the same-old same-old.

Notice the lack of all this phony weeping, wailing and gnashing of teeth with regard to the ability of teenage boys to obtain condoms. Notice that no such overweening concern exists about MALE "children" obtaining "birth control without (parental) knowledge". I'm even willing to wager that most parents, upon finding a condom amongst their teenage son's effects, congratulate the young man on his mature sense of responsibility - IF anything is even said to him at all. It would take him stealing Dad's Viagra to gin up anything remotely near the level of hysteria that always surrounds access for women (both adult women and biologically functional female teens and pre-teens) to reproductive healthcare options.

It's all about the hypocrisy.
09:45 PM on 12/12/2011
As I note in reference to one of your other comments, your comments display a rigid, ideological mindset that has nothing to do with what I am saying. You sound like a caricature of a feminist as pictured by Limbaugh.

I am talking about parents rights and responsibilities for their children. And while I don't disagree that some parents view sexual activity by their sons different than by their daughters, it is much less prevalent than you suggest, and virtually disappears when we are talking about younger children (and remember, the issue here is children younger than 17).

The great majority of parents care about whether their male children are having sex. They don't want their younger boys taken advantage of, and they don't want their older ones to find themselves fathers at a young age, or to get in trouble with the law, or to be taking advantage of younger girls. And they recognize that for boys as well as girls, sex can make early relationships more intense, leading to more emotional pain when they end, and can lead to an atmosphere where other risky behaviors take place.

Your comments do not focus on any real concerns, just largely ideological chimeras.
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cadawa
02:46 PM on 12/11/2011
A real women's organization wouldn't vote for or give money to a candidate that didn't support women's health.
12:15 PM on 12/11/2011
Why don't we just made the pill, the regular plain old birth control pill easier to get?

I realize there are complications that can occur just like with any foreign substance you ingest but nobody gets told no when they go to the doctor and the doctor has to make an educated guess on what will work for the women and girls it is being prescribed to. So why can't we make it as simple as this:

Low hormones: Take generic pill A
Heavy cycles: Generic Pill B
Smokers: Pill C
and so on and so forth. As someone who has been off and on BC since I was 14 years old I can tell you that all docs do is guess and if for some reason one pill doesn't work they just move on to the next one. I really would have no problem whatsoever with my daughter walking into a pharmacy and buying the pill anymore than I would have a problem with her buying cold medicine, Midol or Tampons...all products with the potential to kill if take wrong.
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HUFFPOST SUPER USER
avicenna
02:14 PM on 12/11/2011
I am a strong proponent of choice for all women and access to termination of pregnancy. However, I am also a researcher who has studied the consequence of oral contraceptives and exogenous hormones on women's health - and it isn't all benign. I think women need to make informed choices and need to understand the different formulations (they are confusing even for doctors) and how they affect the body. Everyone doesn't metabolize nor make hormones at the same level - and why would you expect that everyone responds to synthetic hormones the same way? These drugs also weren't tested in children/adolescents who haven't yet established their normal hypothalamic hormone cycles - so they could be permanently disrupted when they are put on the pill before their cycles become regulated and could be at risk of not developing their peak bone mass putting them at risk for osteoporosis later on. It isn't as simple and benign as it is made out to be - especially by the pharmaceutical companies who are strong lobbiest for making these drugs available like candy.
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3RawBob
My Bible: the Jefferson Bible
11:07 AM on 12/11/2011
The only health safety warnings on Plan B One Step:
(1) Do not take Plan B One Step if you are pregnant because it will not work.
(2) Do not take if you know you are allergic to Plan B One Step.

I wonder which warning the young teens will not understand.
07:38 PM on 12/11/2011
It is about parents retaining control, as it should be.
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3RawBob
My Bible: the Jefferson Bible
11:54 AM on 12/12/2011
I am sure you are against sex education in school also. Or are you for home schooling? Some of us like living in an educated society that recognizes that kids may have unprotected sex, and do not want them to become pregnant.
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goatini
We are two-legged wombs, that’s all
06:08 PM on 12/12/2011
Translation: It's all about the female's "honor". Control over her body, in particular her virginity, must be maintained, as any besmirchment will reflect poorly upon the status and power of her patriarchal owner.

http://www.thespec.com/news/canada/article/634953--honour-killings-about-men-controlling-women-s-bodies-expert-tells-shafia-trial

Of course no such constrictions are applied to teenaged males.
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Chris Wundrow
09:32 AM on 12/11/2011
DHHS's decision was pure politics and nothing less--a naked cave-in to the Religious Right, plain and simple.
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09:45 PM on 12/11/2011
And when has Sebelius ever 'caved in' to the Religious Right? She has never done that before.
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Gunderan
Who let the Libertarians out without supervision?
03:53 AM on 12/11/2011
Not all men are obsessed with controlling Womens reproduction. Personally I would double Planned Parenthood's funding make this available over the counter and cheaper.
I am male and do not believe that making this easier to get will lead to any increase in sexual activity in teens and might even help reduce teen pregnancy.
To all those people who mention longterm side effects isn't it better to have one pill maybe once in someones life than taking contraceptive pills for decades with known bad side effects.
Lastly and most important it should be a persons choice based on whats best for them in their circumstances
07:40 PM on 12/11/2011
"Not all men are obsessed with controllin­g Womens reproducti­on"

The decision requires a prescription for those under 17. Its about children, not about women.
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ElleKaye
Beware the Zealots.
10:16 PM on 12/11/2011
Yes. Female children who can become pregnant, sometimes from the age of 10. The operative word is "Emergency".
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goatini
We are two-legged wombs, that’s all
06:15 PM on 12/12/2011
A preteen who has gone through menarche is a functional woman. Unwanted pregnancies occur in functional women under, and over, 18. Unwanted pregnancies do not happen to children - they happen to functional women
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Gottlieb
hated by left since 1973 and right since 1982
01:24 AM on 12/11/2011
Keep up the good work and keep pushing forward for the right of everyone to plan their parenthood.
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11:41 PM on 12/10/2011
Obama’s Secretary of Health and Human Services this week blocked the over the counter sale of the emergency contraceptive “Plan B” from being purchased by girls under 17 years old. Because the pill is most effective when used in the first 24 hours Obama is intervening to help ensure that girls 16 and under are more likely to get pregnant. I don’t know why the Republicans are trying to defeat Obama. It seems with this decision along with other similar decisions that we already have a Republican president.
11:08 PM on 12/10/2011
I would think the age to be able to purchase plan-B should at least be the same as the age of consent in a particular state. If they are legally old enough to engage in consensual sex, they should be legally old enough to purchase plan-B.
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DakkonA
www.DisentangledReality.com
11:59 PM on 12/10/2011
The age of consent only governs sex by above the line with those below the line. Relations between people below the age of consent are not illegal.
07:40 PM on 12/11/2011
That statement is not legally true, at least, not in most jurisdictions.
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03:13 AM on 12/11/2011
So people that can't legally protect themselves should be blocked from making any educated decisions...? I'm not seeing how you connect the two points of argument.
05:54 AM on 12/13/2011
Maybe I worded it wrong. My point was I don't see how they can set the age to buy it to an age higher than the age of consent. If someone can leaglly consent to sex, then they should be able to legally purchase plan-b. I understand the concerns about two minors having sex or in the case of a rape. Realistically they have to set a minimum age of some kind, I just believe it shoudn't be higher than the age of consent.
06:07 PM on 12/10/2011
I think most of the commenters here show that they are people who are concerned about the welfare of children, especially young girls. Those that have children are probably good parents, but...

What about those parents/adults who've dropped the ball... or even refuse to pick it up? Why are girls being left to shoulder the burden of their parents' neglect/ignorance?

My mom was an anomaly considering her conservative, rural WV background. She had no problems talking to my sister and me about sex. She told us every line/pretense/persuasion tactic males would use to get what they wanted (Dad just nodded), and because she was open and honest, we believed her.

Nowadays, many parents don't want sex ed in school. They want to handle this topic at home. Then they don't. Sometimes they avoid this 'embarrassing' subject for religious or cultural reasons (or both). Sometimes parents are busy or think their little angels couldn't possibly be thinking about sex because they get good grades, etc. Whatever the reason, so many parents have dropped the ball that girls as young as ten are getting pregnant in 21st century America... and we as a society are paying for it.

IMHO, FEMALES should be able to choose whether to alter their lives forever with a child. If she's IRRESPONSIBLE enough to have unprotected sex, let her be RESPONSIBLE enough to try to correct her mistake. Don't make it hard for her to do so.
07:42 PM on 12/11/2011
That is your opinion. Other parents want to know if their young daughters are trying to get birth control. Obama was right on this one. This is a political decision, as it should be.
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goatini
We are two-legged wombs, that’s all
06:17 PM on 12/12/2011
Somehow, I think that those same parents couldn't care less - and, in fact, may be pleased - if their young sons are trying to get birth control.

It's all about controlling females.
04:54 PM on 12/10/2011
No one mentions what the cost is for Plan B - how much is it?
Does one have to have a consult with a Pharmacist when buying?

If its expensive - no Pharmacist will put it where it can be shoplifted.

The lawyers need to get a grip and go into a Pharmacy and check out locations of such items as Plan B, condoms etc. That's if they can manage it between drinks and engaging with a young staffer !
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03:16 AM on 12/11/2011
You think this is an argument over shoplifting....? Wow.
11:40 AM on 12/11/2011
No, I think the Lawyers making these absurd decisions need to visit a Phamacy and check the layout - it's nothing like they this it is. But then their minions do their shopping so how would they know ! However, shoplifting is a huge problem - check out Nicorette which is now LOCKED away !!!
11:12 PM on 12/12/2011
The author of the article mentioned "slipping a packet from the store shelf into your shopping basket". At $50 a pill, anyone who knows 8 and 10 year olds need the pill also knows it will never hit the shopping basket.
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HUFFPOST SUPER USER
lrobb
Gold Standard = four paws and a tail
01:53 PM on 12/10/2011
The new rules for Plan B allow anyone over the age of 17--a high school senior--to purchase it over the counter. Let's concentrate on law and science and eliminate the ideological chaff.

Even the new rules for Plan B push the envelope 12 months too far. By legal definition, anyone in the US under the age of 18 is a minor. They can't legally smoke, drink, sign contracts or even own property without a Guardian. Anyone who thinks having unprotected sex is preferable to smoking or drinking probably disagrees with the new Plan B rules.

All the rules say is that the emergency contraceptive can't be purchased without a doctor's prescription. In many states a teen can go to a doctor on their own initiative without parental permission. What the rules do is inject a certain amount of dispassionate adult advice into the mix.

Before a doctor will sign for the prescription, he/she will do an exam and talk to the young girl about her options. Since when is this a bad thing? How many 12 to 16 year olds do you know who are competent to make life-changing decisions without adult input?

The adolescent brain works entirely differently from the adult brain. You can't say teenagers should be exempt from prosecution as adults simply because they are teenagers and in the next breath say teenage girls are competent to make adult judgements about their sex life based on exactly the same research.
04:44 PM on 12/10/2011
And yet 17 year olds are treated as adults in our criminal justice system every day. This line was blurred a long time ago. I would think a 17 year old girl could make a decision about her desire---or lack of desire---to carry a fetus to term. It's her body, after all.
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lrobb
Gold Standard = four paws and a tail
05:06 PM on 12/10/2011
I take the opposite view. 17 year olds--or even 18 year olds--have no business being treated as adults in any system of justice--criminal, civil or social. If we are going by scientific evidence the teenage brain does not function like the adult brain.

Think of the teenage brain as a car with a superb engine and no brakes.
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Kurt Reply
11:42 AM on 12/11/2011
There is a biologic scientific flaw in your last statement: It's her body, after all. The fetus is IN her body, but it is not part of her body. A mother's own immune system recognizes the fetus as a foreign invader and without the placenta to shield the baby from mom's white blood cells, all fetuses would be attacked and consumed and our species wouldn't have survived the first generation. Taking the fetal cells from an abortion and injecting it under the mother's skin will cause a huge immune reaction. You may wish to think in your imagination that the fetus is a part of your body, but your own body disagrees with you.
05:04 PM on 12/10/2011
One thing that you're forgetting is the very person you're trying to protect: young teens.

A 13-year-old girl who has had sex ('consensual' or not) isn't thinking like an adult. They don't sit down, grab the phone and call their doctor to make appointments. They often panic. If the girl doesn't have adults she can talk to (for whatever reason), or money or access to a free clinic, she may bury her head in the sand and refuse to think about the consequences until it's too late. And if a girl is having sex at 13, she's missed out on A LOT OF HELP already.

I think this OTC pill should be available to kids 15 and older, though. Some health concerns can outweigh the eighteen-is-an-adult law, IMHO.
06:34 PM on 12/10/2011
If a 13 year old is having sex it is statutory rape and a felony in most states.

We have a felony and people are concerned about access to erase the evidence.
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HUFFPOST SUPER USER
tweeksmom
Pppfffftttttttt.....
01:16 PM on 12/10/2011
Maybe we should put condoms behind the counter too. Make everybody have a conference with the pharmacist so they can be educated on their proper use and have to show proof that they are old enough to be having sex, make them bring their partners in and check their age too.....If they aren't old enough to have sex the pharmacist can call the cops. What 14-year-old would be going to a doctor for a prescription for this medicine and would the physician be beholden to notify the authorities that a minor is having sex illegally?

If I had teenage daughters I'd keep a box of Plan B (along with a box of condoms) in the bathroom closet right next to the tampons....
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jessicadevyn
Danger Zone
03:57 PM on 12/10/2011
I really feel that people are against Plan B for girls because this society is much more paternalistic and controlling about girls bodies than boys bodies. I saw another poster say that if there was a contraception that stopped boys from impregnating a girl within 72 hours of intercourse that it would be included in every happy meal and I feel like they are kind of right. Boys can get condoms from public restroom vending machines but I've never seen anyone get their knickers in a twist over that.
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nikanj
free the fnords
04:27 PM on 12/10/2011
Condoms are not synthetic hormones with yet-to-be-determined
long-term side effects. Does anyone besides me remember DES ?
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fgrammit
07:21 PM on 12/10/2011
me too but then we have MEN making the rules so what else would you expect.
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Soulsurfer
Solar Electrician,Longtime Surfin'Fool
10:28 AM on 12/10/2011
It's an election year.
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PurpleLove08
03:59 PM on 12/10/2011
And?!
04:45 PM on 12/10/2011
No need to go out of one's way to tick off a large proportion of the voters.