Finally!

by Eszter Hargittai on August 24, 2006

No time to comment at length, but I had to post about this since it is a big deal. It shouldn’t have been such a big deal, but it became one and so it’s worth a note: the U.S. Food and Drug Administration has finally approved over-the-counter access to Plan B (“morning after pill”, emergency contraception) for women 18 and over. More here.

Planned Parenthood is quick to point out that it’s still a problem that those under 18 continue to require a prescription:

While we are glad to know the FDA finally ended its foot-dragging on this issue, Planned Parenthood is troubled by the scientifically baseless restriction imposed on teenagers. The U.S. has one of the highest rates of teen pregnancy in the western world — anything that makes it harder for teenagers to avoid unintended pregnancy is bad medicine and bad public policy.

They’re right. But let’s take a moment to be excited about the progress that’s been made anyway. There are a lot of people who worked on this for years and to them a huge THANK YOU. Again, no time to comment at length, but I wanted to post a brief note to mark the occasion.

{ 28 comments }

1

kid bitzer 08.24.06 at 11:02 am

yup. very good news indeed.

I suspect my wife and I are going to buy a few. Some for when the condom breaks (and, yes, things like that have happened to us).

And some for the pre-teen daughter. She is not sexually active, of course, and with any luck won’t be for years (decades). But a) rape happens, even when people are really careful; and b) given how crazy this country is going to get under the McCain regime, there’s a fair chance she won’t have the option of buying it down the road if she ever needs it.

2

ingrid robeyns 08.24.06 at 11:03 am

You are right, Eszter, it is a big deal indeed.
Wouldn’t it be possible to find a way around the age restriction in practice, through some smart political activism? (that doesn’t affect the moral/political problem with the law of course, but sometimes there are in practice ways around these things).

3

SamChevre 08.24.06 at 11:24 am

I have a question and hope that someone has a well-supported answer.

Is there a reasonable ground for requiring a prescription for minors? I ask because the amount of misinformation that circulates among underprivileged teens is quite stunning. (I taught in an alternative high school, and my wife taught in a reform school. Among pieces of “information” shared: using condoms will make your penis crooked; using birth control pills causes you to get fat; and others of comparable inaccuracy.) It seems to me that there is a risk that Plan B will be used as a substitute for other contraceptives; and if so, would that use pose any health risk?

4

kid bitzer 08.24.06 at 11:40 am

#3–
boy, that explains some things.

I’m not saying it’s crooked, exactly, but it has been involved in some misappropriation of funds, a little embezzlement now and then, fixing the odd traffic ticket, that sort of thing.

More seriously: Plan B replaces what used to be the standard morning-after treatment, which was to take a whopping great dose of hormones, forget which ones, the result of which was *intense* nausea on the order of the worst episode of morning-sickness imaginable. (And yes, I was with my wife 20 years ago when we had to do the morning-after thing, and also with her through many episodes of morning-sickness).

I don’t know if Plan B will have the same nausea-inducing effects, but if it does that might be enough to persuade people to keep it for emergencies only.

5

Eszter 08.24.06 at 11:57 am

It’s also expensive ($20-$25) so few would be able to afford it as their regular method of contraception.

On a separate note, something I didn’t include in the original post, there is a “government ID” requirement (driver’s license or passport) for women 18 and over to prove their age.

6

Lollius 08.24.06 at 12:11 pm

Good news, indeed. Unfortunately, just in time to become an issue in the 2006 elections.

7

Paul Gottlieb 08.24.06 at 3:20 pm

As irritating as she so often, this time the enormous THANK YOU should go to Senator Hillary Clinton who, along with Senator Patty Murray, unrelentingly kept the pressure on the FDA and used every lever of power available to them to bring about this result

8

Theron 08.24.06 at 3:29 pm

I heard on the radio whatever official was announcing this. He made a big deal bout the fact these pills would not be available in convenience stores and gas stations and the like. That, it seems, is exactly what opponents to this fear, simply that birth control will be easy to get. It seems strangely vital to them that sex must have consequences, and that those who transgress the norms should be punished, especially women, and especially young women. It’s all quite odd.

9

mpowell 08.24.06 at 4:18 pm

#8- Its not just odd, I think its sick.

10

Theron 08.24.06 at 4:48 pm

For the umpteenth time, some day I will learn to type.

11

Richard Bellamy 08.24.06 at 4:55 pm

One wonders if those who want unfettered access to abortion pills for minors feel the same way about unfettered access to plastic surgery for girls under 18 (for whom there were 3500 “breast augmentations”, 14,000 nose jobs, and 4,500 botox injections last year, assumedly all WITH a doctor’s consent, I assume. One only imagines what the numbers would be if boob jobs were DIY.)

http://www.surgery.org/download/2005stats.pdf

“With a perscription” does not mean “parental consent”.

12

The Ridger 08.24.06 at 5:19 pm

One wonders why one can’t type “I wonder”.

I wonder why you think the two things are even vaguely comparable.

13

Kenny Easwaran 08.24.06 at 6:08 pm

I believe the announcement said that they wouldn’t actually have any means of enforcing the age restriction, so presumably progressive-thinking pharmacists would allow it to underage girls (unless they’re obviously extremely young), the way many bars allow people to buy alcohol without being too careful about their age. However, I wonder if many underage girls who need it would be much more scared than the many underage drinkers who have all the time in the world to work up the courage to try to order without an ID?

14

Andrew 08.24.06 at 7:37 pm

Yeah it’s going to be impossible for 16 and 17 year old kids because they know no one over 18, and thus have no friends or family to help get the pills for them.

Just like cigarettes! I’ve never seen 16 year olds smoking.

15

Alice 08.24.06 at 9:54 pm

What I would like to see…women in the 50+ age bracket going in and buying Plan B to hoard for their daughters, granddaughters, nieces, etc. After all, there is no upper age limit…what can they say? I think it would be a fun way to underline the absurdity of denying Plan B to the very ones who are most likely to need it.

16

Uncle Kvetch 08.24.06 at 9:56 pm

One wonders if those who want unfettered access to abortion pills for minors feel the same way about unfettered access to plastic surgery for girls under 18

One also wonders what kind of political agenda lies behind the use of terms like “abortion pills” to describe a form of contraception.

17

Eszter 08.25.06 at 12:37 am

I believe the announcement said that they wouldn’t actually have any means of enforcing the age restriction

Actually, as I noted in a comment above, access to the pill is going to require a government ID so that is a way they are going to try to enforce the age restriction.

While it’s possible that people may gain access through older acquaintances, don’t forget that it may not be that easy for a 16-year-old to tell her parents about this. Moreover, timing is an important issue with the pill, and the need for having to look for an older friend won’t help the efficiency of the contraceptive. Plus is it so obvious that in certain communities just any 18-year-old friend would want to take it upon themselves to go and claim the need for this?

18

abb1 08.25.06 at 5:43 am

What Alice said. It seems that the age restriction and especially price puts it outside of the reach of maybe 70-80% of those who would’ve benefited most. So, it’s nothing but a travesty, isn’t it.

19

Another Damned Medievalist 08.25.06 at 8:03 am

it’s better than nothing. Really.

20

eudoxis 08.25.06 at 9:08 am

It’s a little confusing to say that teenagers under the age of 18 are more likely to need emergency contraception. Presumably, one means to say that the social outcomes for a pregnancy in an adolescent under 18 is much worse than for older women. But the likelyhood of needing contraception is related to the unintended pregnancy rate of adolescents under 18, which is considerably lower for that age group than that at 18 or over. The majority of pregancies in teens or adolescents occurs in the 18-19 year age group. (The social travesty associated with that is questionable – it’s biologically healthier to have children at that age.)

That said, IMO, there should be vending machines with condoms and emergency contraception on street corners.

21

Eszter 08.25.06 at 1:05 pm

Re condom vending machines, at the Am Soc Assn meetings in Montreal a couple of weeks ago, I felt that the presence of condom vending machines in the bathrooms at the convention center was a quick reminder that one was not in the US.

22

SamChevre 08.25.06 at 2:18 pm

Eszter,

Was that because they were in the women’s bathrooms? Condom dispensers are extremely common in men’s bathrooms in the US in my experience.

23

Christopher Ball 08.25.06 at 11:45 pm

I’m glad Plan-B is available but I’m waiting for someone to respond to the substance of #11 because there are important issues of autonomy at stake. California reintroduced a ban on body-piercing without parental consent (except for ears) in 2006. I’m unclear on why minors should be denied medical autonomy in one case but allowed it in another. Are denials of medical autonomy to minors in body-piercing, plastic surgery, abortion, and emergency contraception all wrong, or are some denials permissible and others prohibited? I’m asking this not in legal terms, but in philosophical terms. Put differently, should a 16-year old be able to consent to a hymen restoration surgery or breast augmentation? If not, why?

(Re the ‘abortion pill’ v. contrapception issue, Plan B does not just prevent ovulation and fertilization but it will also function by preventing implantation, so the fertilized egg will go silently screaming away for anti-abortionists).

24

paperwight 08.26.06 at 12:00 am

(Re the ‘abortion pill’ v. contrapception issue, Plan B does not just prevent ovulation and fertilization but it will also function by preventing implantation, so the fertilized egg will go silently screaming away for anti-abortionists).

My understanding is that there’s no evidence for this either way.

For example: http://www.popcouncil.org/publications/popbriefs/pb11(2)_3.html

25

eudoxis 08.26.06 at 8:51 am

Plan B does not just prevent ovulation and fertilization but it will also function by preventing implantation, so the fertilized egg will go silently screaming away for anti-abortionists

No, absoluteley not. Plan B, or levonorgestrel acts prefertilization and has no effect post-fertilization. That’s why it has to be taken within 72 hours. Many people confuse Plan B with Mifepristone or RU486, which is an anti-progestone with a different mechanism of action.

26

Christopher Ball 08.26.06 at 11:57 am

Re #24 & 25, that’s not what the makers say (my boldfacing):

Plan B® works like a regular birth control pill. It prevents pregnancy mainly by stopping the release of an egg from the ovary, and may also prevent the fertilization of an egg (the uniting of sperm with the egg). Plan B® may also work by preventing it from attaching to the uterus (womb). It is important to know that Plan B® will not affect a fertilized egg already attached to the uterus; it will not affect an existing pregnancy.

The ICCR animal studies that #24 refers to cast doubt on Barr’s claims that Plan B may stop implantation, which is too bad, because if someone ovulated prior to intercourse, standard contraception failed, and fertilization occurred before she took Plan B, then she’ll have to go to RU-486 instead.

But no one addressed the autonomy issues — we’re still in the pro/anti-abortion/contrapception rhetoric zone.

27

dsquared 08.26.06 at 6:36 pm

One wonders if those who want unfettered access to abortion pills for minors feel the same way about unfettered access to plastic surgery for girls under 18

One can wonder all sorts of things. I, for example, wonder whether people who use the “one wonders” construction for their nasty, fascistic little views think that anyone is fooled as to their general character.

28

paperwight 08.27.06 at 4:38 pm

@ #26: I know that’s what the makers say, but notice that they say may when referring to that mechanism, because there’s not really any proof of the effect — it’s speculative. They’re actually doing themselves more harm than good there, because it gives the “personhood begins at fertilization” crowd a hook to howl about.

Comments on this entry are closed.