It's long overdue, but U.S. policy on women's health keeps moving in the right direction. On April 22, the Food and Drug Administration (FDA) announced that it will allow 17-year-olds to purchase the emergency contraceptive method Plan B (also known as the "morning-after pill") without a prescription.
The FDA's announcement was as welcome as it was expected. It followed a U.S. District Court decision in March 2009 finding that the FDA had bowed to political pressure from the Bush administration in its 2006 decision to limit access to emergency contraception without prescription to women aged 18 and older. The court ordered the FDA to expand over-the-counter access to 17-year-olds within 30 days. It further ordered the reconsideration of all age restrictions, which never had any scientific basis and were ideologically driven.
The new policy is a small step in the right direction. While emergency contraception can help prevent unintended pregnancy when taken up to 120 hours after unprotected sex, it is most effective the sooner it is taken. Eliminating the requirement of a prescription for 17-year-olds--and possibly for women of all ages--will reduce delays in obtaining the method, thereby helping to lower young women's risk of an unintended pregnancy.
Having easy access to a reliable back-up method of birth control is crucial given that the typical American woman spends only a few years of her life trying to become or being pregnant, but about three decades trying to avoid pregnancy. Recent Guttmacher research documents the many barriers women confront in using contraception consistently and correctly over a lifetime. Finding the "right" contraceptive method is not a one-time decision--rather, women make a series of choices in response to their changing life circumstances and contraceptive needs.
Our study found that life changes, such as beginning or ending a relationship, losing or changing jobs, moving to a new home or experiencing a personal crisis, can contribute to lapses in contraceptive use--increasing the risk of unprotected sex. Emergency contraception can play a key role in helping women ensure that a contraceptive lapse or failure does not lead to unintended pregnancy.
But just changing the policy is not enough. Continued efforts to raise public awareness about emergency contraception are essential and should include debunking myths about the method. For example, many women and men still do not know that emergency contraception exists or are confused about how the method works. Also, emergency contraception contains the same hormone that is found in ordinary birth control pills.
Importantly, and claims by birth control opponents notwithstanding, emergency contraception will not in any way disrupt an established pregnancy. And it is not to be confused with mifepristone, sometimes called RU-486, a drug used to terminate a pregnancy that is only available and administered at clinics or doctor's offices.
Much still remains to be done to help women and their partners improve their contraceptive use overall. The more we can identify and remove barriers to consistent use--while ensuring that people know about and have access to a back-up method like emergency contraception--the better-prepared women will be to avoid unintended pregnancies and plan for the children they want, when they want them.
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