Now that a full year has passed since the abortive attempt by the U.S. Food and Drug Administration’s Commissioner, Dr. Margaret Hamburg, to make the “morning-after pill” available to anyone over-the-counter (OTC), what is the status of this plan?
The unfortunate answer is: nothing has changed since her boss, Health and Human Services Secretary Kathleen Sebelius, quashed the FDA’s plan last December.
The FDA wanted to remove any Plan B age restrictions, based on research showing that access to the morning-after pill does not increase a woman’s likelihood to have unprotected sex, and that this drug is safe for use by girls as young as 11. Two studies reported that, when provided with Plan B, girls ages 11 to 17 were able to understand the package directions, and demonstrated that they could use emergency contraception safely and appropriately without the help of a physician. In fact, Plan B is safer than many other current OTC medicines, such as aspirin and other painkillers. While an overdose of any of these medications can have dangerous consequences, it is actually impossible to overdose on the morning-after pill. And any theoretical risk is far outweighed by the risk of an unplanned pregnancy in girls and young women.
The alleged rationale for the unprecedented step by HHS was that young teenage girls were not qualified to decide if and when to take the emergency contraceptive pill, which can protect against pregnancy for up to 4 days after unprotected sex.
Many of us in public health felt that this was merely an excuse for Sebelius’ boss — President Obama — to avoid another controversy involving reproductive policies in the face of a tough election battle then upcoming. After all, if a 15 year old is old enough to have sex — and many teens do act accordingly, whatever their parents and authorities wish to believe — then she should be deemed old enough to protect herself against such a major life event as teen pregnancy. Further, while not 100 percent risk-free — no drug is — the morning-after pill is close to it, and much safer than an unwanted pregnancy in a teenager.
Now, the election is over. Further, the new healthcare law, the Affordable Care Act (“Obamacare”), has been upheld. Seizing upon this new opportunity, a consortium of eleven professional medical, nursing and reproductive medical academic societies — far from forgetting about the issue — have expressed their own concerns about enhancing access to emergency contraception through an open letter to Secretary Sebelius, published on the website of the American Congress of Obstetricians and Gynecologists: as well as in several other specialty journals.
There are some who continue to oppose this approach, believing (falsely) that more access to birth control and emergency contraception will encourage earlier sexual activity and promiscuity. There is no evidence that this will occur, and plenty that it won’t. These folks fail to take account of the tragic rate of unintended teen pregnancy and births in our country, the highest in the developed world.
Unless some major shift in our philosophy about teen sexual activity occurs — including more comprehensive sex education and information about birth control methods based on facts, not superstition or fears — as well as easier access to pregnancy prevention, the unacceptably high risk of future-destroying or abortion-inducing teen pregnancy will go on unabated. Hopefully, the president and his HHS Secretary will be more flexible on Plan B when the FDA tries to OK it again in the near future.