On Monday, March 23, a U.S. District Court found that the Food and Drug Administration (FDA) 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 FDA to reconsider the application to eliminate all age restrictions to over-the-counter access to emergency contraception, which is sometimes called Plan B or the "morning-after pill."
The ruling comes just two days before the eighth anniversary of the Back Up Your Birth Control Day of Action, a day devoted to increasing awareness of and access to emergency contraception. 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 women younger than 18 will reduce delays in obtaining the method--thereby helping to reduce young women's risk of an unintended pregnancy.
The typical American woman faces a daunting challenge: Given that she wants two children, she spends only a few years trying to become or being pregnant, but about three decades trying to avoid pregnancy. Recent Guttmacher research documents the difficulty 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.
The study found that life changes, such as the beginning or end of a relationship, a job loss or change, moving to a new home or a personal crisis, can contribute to lapses in contraceptive use, increasing the risk of unprotected sex. That's why emergency contraception, a back-up birth control method, can play a key role in helping women ensure that a contraceptive lapse or failure does not lead to unintended pregnancy. Health care providers are especially well positioned to counsel women about the potential impact of life events on their contraceptive use. They can also help women prepare for those transitions, as well as for potential method failures (like condoms breaking during sex) by providing emergency contraception to keep at hand in case it is needed and by educating them about its benefits and availability.
Continued efforts to raise public awareness about emergency contraception are essential and should include debunking myths about the method. Many women and men still do not know that emergency contraception exists or are confused about how the method works. Emergency contraception contains the same hormones that are found in ordinary birth control pills. It 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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