12/15/2011 01:07 pm ET Updated Feb 14, 2012

In Contraception Battle, Teen Girls Are Ones Who Lose

Once again, teenage girls are pawns in a political battle that is only partly about them.

I'm talking about the unfortunate decision of the Obama administration to continue to require emergency contraception be sold only behind the pharmacy counter and, for girls 16 and younger, only with a doctor's prescription.

Conservatives - who oppose anything that, in their minds, encourages girls and unmarried women to have sex -- are pleased. For more than 8 years, they've been lobbying against the morning-after pill, so named because it's taken after unprotected sex. They argue, with little supporting evidence, that it would lead to a high incidence of blood clots and heart attacks, increase sexual promiscuity and incidence of STDs, and be used by predators to entice girls to have sex with them.

They grew concerned when they learned early last week that the Food and Drug Administration, after painstakingly careful study, was going to recommend the pill, known as Plan B Step One, be sold without restrictions in grocery stores, drugstores, and other retail outlets.

Birth control supporters, on the other hand, were elated. Finally, a safe and effective pill, which has been tested more than most other medications found in Americans' bathrooms, would be easier for females of any age to buy. Their elation turned to outrage, however, when Kathleen Sebelius, Health and Human Services Secretary, denied the FDA recommendation. Sebelius, a pro-choice Democrat, argued that the FDA did not prove conclusively that girls as young as 11 or 12 could understand instructions on the pill's label.

Her stated rationale was, in my view, a bright red herring. Less than 1 percent of girls that young have sex. In fact, the FDA sample that measured how well young girls understood the labeling instructions started with 12-year-olds because -- surprise! -- sexually active 11-year-olds are very hard to find.

So what was the HHS decision really about? What everything seems about in Washington these days: Garnering political support for President Obama in next year's presidential race.

Plan B works most often by preventing an egg from being fertilized. Some Catholics and other conservatives seize, however, on the unlikely possibility that an early fertilized egg forms and then is stopped by the pill from embedding itself in the womb. They call this latter possibility, abortion.

I don't buy for a minute Obama's assertion that this was Sebelius's decision alone. As one veteran Washington specialist on youth health issues said to me, "Nothing in the reproductive health field is decided without some involvement at the highest levels in this administration."

The result of the decision is that everyone -- including 20-somethings, who have the highest unplanned pregnancy rate of any age group -- will continue to have to go to a pharmacy counter to buy Plan B One Step: younger women with a prescription, older women with an ID showing they're 17 or older.

That is unfortunate. There are very good reasons why emergency contraception should be placed where it's easy to get to -- between the bubble gum and batteries as the president put it, trivializing the issue. One is that the pill is effective only up to 72 hours after intercourse. The sooner a person takes it, the more likely it is to work.

Another reason is that pharmacists are not always easily accessible. Girls who live where drug counters are closed at nights or on weekends are at a distinct disadvantage.

Conservatives argue that making the pill easier to buy would encourage teen girls to have sex. There is little scientific evidence to support that. They also say -- correctly -- that parents should be involved in the decision to take the pill. But some young women don't enjoy a good relationship with their parents. And some are too embarrassed to approach a pharmacist. What are these girls supposed to do? Cross their fingers and pray?

Asking a pharmacist for emergency contraception at any age is hard," says the health specialist. "I know women who practically wear a disguise when they buy tampons, and don't get me started on buying pregnancy tests.

Being able to go to the store and buy emergency contraception in the aisle like you'd buy Tylenol (which, I should point out, can actually harm you if taken incorrectly, unlike Plan B One Step) would have been an important public health victory and a step toward solving the huge unplanned pregnancy challenge in this country.

Without that change, we may very well see what no one desires: continued high numbers of unwanted pregnancies -- and more abortions.