A Need for a Plan B

Sep 072005
Authors: Meg Burd

Recently, the emergency contraceptive Plan B has been in the news, as the Food and Drug Administration denied the drug over-the-counter status. While already approved for use around the world, this stonewalling by the FDA and indeed other recent issues surrounding emergency contraception information and access, seem more like political moves that serve to restrict women's health information and women's rights.

Using higher levels of hormones such as those used in birth control pills, the Plan B pill is described on the FDA website as working "like other birth control pills to prevent pregnancy. Plan B acts primarily by stopping the release of an egg from the ovary (ovulation). It may prevent the union of sperm and egg (fertilization). If fertilization does occur, Plan B may prevent a fertilized egg from attaching to the womb (implantation)."

Like birth control pills, studies have found that Plan B will not affect a pregnancy if implantation has occurred. "If a fertilized egg is implanted prior to taking Plan B, Plan B will not work," the FDA continues.

Besides providing women a chance to alleviate pregnancy fears associated with unprotected or unwanted sexual activity, Emergency Contraceptives are also viewed by many agencies as an important tool in lowering abortion rates, something that could possibly save many women potential emotional, physical or financial hardships. As the International Consortium for Emergency Contraception (ICEC) stated in a press release, "The World Health Organization… has estimated that every year, unintended pregnancies lead to at least 20 million unsafe abortions, resulting in the death of some 80,000 women." Even staff members of the FDA are reported by the Washington Post to believe access to Plan B would significantly lower the number of both abortions and unintended pregnancy.

While Plan B has been available by prescription since 1999 in the U.S., Barr Laboratories Inc. (distributor of the drug) applied for Over-the-counter status in 2003. While the FDA expert panel voted 23 to 4 in favor of allowing Plan B to be sold over the counter, the FDA still rejected the application last year. Susan F. Wood, assistant FDA commissioner for women's health and director of Office of Women's Health, resigned her position just last week due to what she saw as a "political rather than scientific" decision, as National Public Radio reports. The New England Journal of Medicine echoed these concerns, accusing the FDA of stalling the approval due to "political meddling."

Citing potential difficulties if women under the age of 16 were allowed unfettered access to the drug, the FDA issued a "Not Approvable Letter" against Plan B. While the distributing company suggested approval for over-the-counter availability for women 17 and over, and prescription availability for younger women, the FDA still refused, saying such a plan would be difficult to enforce. This issue of adolescents having access to emergency contraception hasn't proven a major problem elsewhere, however: the ICEC reports that adolescents in France have emergency contraceptives available free of charge and teen pregnancy rates there are four times lower than in America. Canada has already approved Plan B to be sold without a prescription, and so have many other nations around the world.

Proponents of making Plan B available over-the-counter point out that women facing such an emergency situation (potentially after being raped) are in need of such a contraceptive within the 72 hour time limit, and getting appointments and prescriptions within that time limit may be difficult, say if the day after was a Sunday.

Besides such difficulties in getting a prescription, the fact that many hospitals and health practitioners might not even provide information about emergency contraception to women in situations of crisis adds to the difficulty of obtaining such a needed drug via prescription. In May of this year, Governor Bill Owens vetoed a bill that would have required Colorado hospitals to provide information on options to rape victims, including information on emergency contraception. Currently, hospitals that are run by religious institutions have the option of not informing rape victims about such contraceptives. Women who have been attacked and who go to such hospitals might not be presented with the opportunity for a prescription by their doctors.

Women's health care providers should offer information on such an option to women facing rape, and such access should not be an added difficulty for women already going through a traumatic experience. Add to that the fact that many pharmacies (such as the national chain Wal-Mart) refuse to carry the pill, and indeed some individual pharmacists will refuse to fill prescriptions (such as occurred at a Walgreens in Milwaukee earlier this year, the Milwaukee Journal Sentinel reports) and the need for women to have unfettered access to such a necessary contraceptive measure becomes all the more apparent.

 Posted by at 5:00 pm

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