Older news: FDA approves Plan B for 17-year-olds

27 04 2009

As detailed in many news papers and other media outlets last week, including the Boston Globe, the FDA will be approving over-the-counter Plan B for people ages 17 and older.

Plan B, also known as emergency contraception (EC), is medication that uses a high dose of hormones to prevent a fertilized egg from attaching to the uterine lining, which prevents pregnancy; if a woman takes it within three days of having unprotected sex (or sex with faulty birth control), she has an approximately 89% chance of preventing possible pregnancy.  Plan B does not induce abortion; it will not affect a pregnancy that has already occurred.

Why is it so important that emergency contraception be available over-the-counter (or, more accurately, behind the counter)?  And why is it so essential that it be available to women who are under the legal age to have sex (but still above the age of consent)?

First of all, we need to have EC available over-the-counter.  After all, what’s the alternative?  Let’s say a man and a woman have sex on a Friday afternoon, and the condom breaks; can the woman call her doctor and make an appointment?  Probably not.  Many clinics aren’t open on Saturdays either, which means that there’s a high chance the woman will have to wait until Monday to see her doctor, if she’s not, you know, at work or in class.  If she can’t take herself to the appointment, she’ll have to get someone to take her (like a parent).  And EC is most effective the sooner it’s taken.

With EC over-the-counter, this woman could just go to the store (or her sexual partner could go to the store) and pick up some EC so she can start taking it right away.  Tadah.

Next, why is this drop in age so important?  Consider that many teens under the age of 18 are having sex; even if it seems irresponsible at that age, or perhaps not the wisest decision, it’s happening.  Denying it won’t make it stop.  And so it stands to reason that women under the age of 18 might find themselves in a tough situation, where they didn’t realize they could insist on using contraception, couldn’t access it, or used it and had it malfunction (condoms do break, and aren’t even 100% effective when used perfectly).  If you’re a high school aged woman, you might be keeping sex a secret from your parents; how are you supposed to explain to them that you might get pregnant and you need to hit up the doctor?

Conservatives against this measure argue that since 17-year-olds shouldn’t be having sex, they don’t need access to Plan B.  Many also argue that preventing a fertilized egg from attaching to the uterine lining is the same thing as abortion.

Of course, arguing that 17-year-olds shouldn’t be having sex is silly; it doesn’t matter if they should or shouldn’t because many are. Not all are, of course; but those who decide to should have access to the right information and resources, including contraception and emergency contraception.

And it’s also inaccurate to claim that EC is an abortion pill.  If a fertilized egg doesn’t adhere to the uterine lining, there’s no pregnancy, regardless of what prevented the adherence (EC, chance, biology).  The argument against EC on these grounds is nothing more than the basic “all contraception is wrong” argument that many people believe in, but that is not a scientific or legal issue (merely a personal and/or religious one).

What’s the next step here?  While, again, many people aren’t happy with the availability of EC to anyone and even more unhappy with the lower age restriction, the age restriction needs to be abolished completely.  EC isn’t like cigarettes.  It’s not recreational.  It’s there for women’s health purposes, and it’s for emergencies. The side effects are generally the same as the side effects that many women experience from high-dose birth control pills.  EC is not dangerous to take, but who would take it unless they needed to?  I, for one, have had to switch to lower-dose birth control because having morning sickness ain’t fun; there’s no basis for believing that women will take EC for funsies.

Will it make women less responsible about birth control?  Well, birth control is a two-way street; men and women need to be responsible for it.  And just as better sex education (as opposed to abstinence-only sex education) improves contraception use and seems to be a better way to reduce abortion rates (as abstinence-only has failed miiiiserably), it will probably help keep the need for EC lower than opponents fear it might be.

Let’s not let “slippery slope” and morality arguments prevent women from accessing what is needed to be healthy and retain choice.  And remember, EC is available at Tufts Health Services.