Playing Politics with the Morning After Pill

Lorraine

We try to stay away from politics here but yesterday brought news that infuriated me: An over-the-counter and safe method of birth control called Plan B--that is, The Morning After Pill--will continue to be denied to teenage girls under 17. Under 17 you need a prescription--that is, tell a doctor who may tell your mother, and anyway, by the time you get that script, it is likely to be too late for Plan B.

But you know what? A whole lot of teens have unprotected sex the first time because they are not planning on having sex. The Obama administration's head is in the sand on this issue, only slightly less buried than the previous Bush administration's, which allowed Plan B to be sold without a script only to those 18 and over. In 2009 after a federal court judge excoriated the FDA for placing politics and ideology ahead of public health, the Obama administration lowered the age to 17.

ARE THEY NOT READING THE SAME STATISTICS WE ARE?
Yet almost half of all teenage girls have had sex before their 17th birthday. Not everyone wants to tell their parents or the family doctor she is planning on having sex, not every teenage boy carries a condom in his wallet because...maybe tonight, so let us assume that a lot of teenagers under 17 will have intercourse without some kind of birth control. In fact, because many teens have no access to easily obtainable birth control, the United States has the highest rate of unintended pregnancies of young people in the developed world. That disturbing trend translates into one of the highest rates of teenage abortion and adoption anywhere. This is appalling. Not only is this inane restriction pushing the abortion rate, it is also serves to increase the number of teenagers who will give their babies up for adoption, and both will spend their lives with the sad and lingering consequences of that harrowing decision.

Yet Plan B is safe. After a careful and lengthy study the Food and Drug Administration found that Plan B was not only safe and effective, but also that adolescent girls can understand how to use it and what it does (prevent pregnancy), and what it doesn't do (prevent sexually transmitted disease). Plan B contains 1.5 milligrams of the female hormone progesterone, a slightly higher amount than is found in low-dose birth control pills, and considerably less than what is prescribed for other conditions.* It should be taken as soon as possible after unprotected sex because with time it loses effectiveness. Advocates for years have pushed to make it readily available to anyone who needs it. The American Medical Association, the American Congress of Gynecologists and Obstetricians, The American Academy of Pediatrics, and the expert advisory committee of the FDA all approved the sale of the drug to women and girls--yes, adolescent girls--of any age. If you are old enough to need it, you should be able to get it.

Women who have unprotected sex have approximately a 20 percent (one in five) chance of becoming pregnant. Taken within three days, Plan B cuts that risk to 2.5 percent (one in 40). "Very few medications are this simple, convenient and safe," Dr. Kathleen Hill-Besinque, of the University of Southern California School of Medicine, told The New York Times.

Had it been available, Plan B would have prevented my own pregnancy because I knew at the time I had sex I was likely to be ovulating (the old-fashioned rhythm method pushed by the Catholic Church taught me that), but the man involved was persuasive and I was in love. Would I have been at the drug store that very evening? You bet I would. But if I had had to wait for a doctor's appointment the following Monday to get a prescription in a city where I did not have a doctor--as was the case--it would have been too late, just as it will be too late for a teenager shy of 17.

POLITICS OVER PUBLIC HEALTH WHEN SEX IS INVOLVED
The FDA was about to approve the over-the-counter sale of Plan B, but for the first time ever, the Health and Human Services Secretary, Kathleen Sebelius, overruled the FDA. Her argument? Girls 11 or 12 would have difficulty understanding what Plan B was or how to use it. Apparently the fact that fewer than one percent of 11-year-old girls are sexually active, according to the Guttmacher Institute, was lost on her.

Margaret Sanger

But what was not lost is the evangelical criticism in an election cycle: While the drug’s principal effect taken as described here is to prevent ovulation, Plan B may also make the lining of the uterus less hospitable to a fertilized egg, making it anathema to anti-abortion activists. However, Plan B has no effect on established pregnancies. It is not an abortion pill nor is it related to RU-486, which is an abortion drug.

ABORTION AND ADOPTION RATES WILL STAY HIGH
Teenage girls today are often under considerable pressure to have sex, according to numerous surveys--way beyond what it was like in earlier decades. Many will give in. Whether the sex is half-halfhearted or not will not alter the odds whether pregnancy results; it's simply the luck of the draw. The morning after, when the high emotions and the pressure of the night before are long gone, is exactly when birth control needs to be available to teenage girls. Continuing to restrict the sale of The Morning After pill will assure that the abortion and adoption rates will continue to soar over other developed nations. In the U.S., we have a population nearly six times greater than that of England and Wales, but more than a hundred times the number of infant adoptions each year. This is not only unnecessary, but catastrophic. Let us be clear: giving up a child destroys whatever life you had before. It changes you forever. You do not have a baby, walk away and forget. Open adoption does not solve all ills.

The regressive thinking of the Obama administration is blatant politics that harks back to a time nearly a century ago when Margaret Sanger was arrested for distributing a pamphlet called Family Limitation. The details have changed, but we as a country have not yet comes to terms with sex. Sixteen- and fifteen-year-olds are having sex. Let them have easy access to birth control. This ruling will only continue to punish teenage girls. --lorraine
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* For other uses of progesterone, see my comment below.
For more on the lifelong effects of giving up a child, on both mother and child, see:  Response to The Adoption Option