Making Plan B available to women is long overdue

Friday, August 25, 2006 In a rare and welcome departure from allowing politics to overrule medicine, the Food and Drug Administration has approved the sale of Plan B emergency contraception without a prescription to adult purchasers. Plan B, also known as the morning after pill, was approved for sale as a prescription drug in 1999 and the American Medical Association announced its support for over-the-counter sale of the drug in early 2000. Plan B is not a new or radical drug regimen. Oral contraceptives were approved by the FDA for marketing in the United States in 1960, and it wasn't long before doctors found that they could subscribed a combination of oral contraceptives as an "off-label" use as an emergency contraceptive. But it wasn't until 1997 that the FDA declared that six brands of oral contraceptives, when used in a specific way, could be a safe and effective "morning after" contraceptive. Two years later, Plan B, then owned by the Woman's Capital Corporation but now owned by Barr Pharmaceuticals, was approved as a prescription drug. The United States has lagged far behind most of the Western World in recognizing that women should have access to emergency contraception. Indeed, in 2000, France approved dispensation of emergency contraception by school nurses to high school and junior high girls (which, we'll acknowledge, may not be something with which most Americans would be comfortable). Blurring the line Conservative religious groups were on the attack Thursday even before the official announcement was made by the FDA. They make no differentiation between an abortion and the use of Plan B by a woman a day or two after she had unprotected sex — even if she was raped. They are entitled to believe that and they are free to conduct their own lives accordingly. But they have no right to inflict their religious convictions on all American women. Taken within 72 hours of unprotected sex, the two-pill series can significantly lower the risk of pregnancy. The drug works by preventing ovulation, preventing fertilization by altering tubal transport of sperm and/or egg and altering the endometrium, which may inhibit implantation. The sooner the drug is taken, the more effective it is, which makes its availability without a prescription particularly important. Recently the Washington Post ran a first person account by a middle-aged professional woman, a mother of two children, who was unable to get a Plan B prescription over a weekend. She became pregnant and had an abortion. The Alan Guttmacher Institute released a study in 2002 that estimated as many as 51,000 abortions were averted in 2000 because of the availability of Plan B as a prescription drug. Its availability as an over-the-counter drug should be hailed by anti-abortion forces for its potential to reduce the number of abortions in the United States. The FDA has, after delaying tactics that were inspired not by medical concerns but by narrow religious-political considerations, has made the correct decision. A woman who has unprotected sex or who has reason to believe that the contraception she or her partner was using had failed, will have access to a safe alternative with a minimum of delay. Availing herself of that option will be her choice, not that of bureaucrats or politicians or religious activists whom she doesn't known and may not care to know. That is as it should be in a free country.