Yesterday, the US Department of Health and Human Services announced that they are blocking Plan B from being sold on pharmacy shelves to whoever needs it. This goes against FDA recommendations to remove all restrictions to accessing Plan B, including lifting age restrictions and requiring Plan B to be sold on pharmacy shelves instead of behind-the-counter.
Plan B One-Step is a brand of morning after pill, which works the same way as birth control pills to prevent pregnancy. It’s more effective the earlier it’s taken, but can be taken up to 72 hours after sex. Plan B cannot terminate a pregnancy- -it is not an abortion pill. Plan B is currently available over the counter to people 17 years old and older. Anyone under 17 must go to the doctor and get a prescription before they can get Plan B.
Plan B is extremely safe, and as the FDA’s approval has shown, there is no reason for it to be locked away. A report released this month makes this clear, stating that “no deaths or serious complications have been causally links to emergency contraceptive. According to the U.S. Medical Eligibility Criteria for Contraceptive Use, there are no situations in which the risks of using [emergency contraceptive pills] outweigh the benefits.” Compare that to the 450 deaths from liver failure in 2004 due to an overdose of acetaminophen,the drug found in Tylenol. And yet walk into any pharmacy and you’ll find Tylenol available over the counter.
Although it’s clear that Plan B is safe for women and girls of all ages, HHS Secretary Kathleen Sebelius overruled the FDA’s medically-based, scientifically accurate decision. In her very brief memorandum, Secretary Sebelius claims to worry about the 10% of girls who begin ovulating by 11.1 years old. Yet she doesn’t seem to suggest a problem of health, but instead “significant cognitive and behavioral differences between older adolescent girls and the youngest girls of reproductive age.” It seems that she is suggesting that young teens would not understand how to use Plan B, or that they would not act in a mature enough manner for Plan B.
This attitude is extremely condescending. No one fears that teenagers, even young teenagers, will not know how to use or will misuse Tylenol or Benadryl or Aleve, and thus should not have access to them. Even more damning is that condoms ARE available on the shelves. If we can trust people of any age to buy condoms, why can’t we trust them to buy Plan B? I am willing to bet that anyone 12, 13, or 14 years old who is going into a drugstore to buy Plan B is buying it because they need it. Young teens can’t drive and often don’t have large disposable incomes, so many would be purchasing Plan B with the help of their parents, older sibling, or friend. And if you don’t live in a city with easy public transportation, it takes a lot of effort for someone under the legal driving age to get to a drugstore without their parent’s knowledge; this is not something you’d do on a dare.
Young teenagers know about sex. They see it in our media, they hear about it in school (despite abstinence-only efforts) and they learn about it from their parents or friends. Plan B is a time sensitive medicine that is used after something has gone wrong. Whether that something is rape, a broken condom, or drunken, unprotected sex is important, but not so important as to block access to Plan B. If we’re worried about the “cognitive and behavioral differences” of young teens, we need to work on putting comprehensive sex education into schools, not taking away access to a safe medication.
It’s hard to understand how the Secretary thought there was good reason to contradict the FDA, especially when many clinicians, members of Congress, reproductive rights advocates and healthcare professionals saw no evidence to prevent Plan B from being over-the-counter. In fact, the effort to make emergency contraception available to all people of reproductive age started six years ago. In 2005, Susan Wood resigned from the FDA because of delays in approving Plan B over the counter. Today, she’s quoted in the Washington Post, saying:
“There is no rationale that can justify HHS reaching in and overturning the FDA on the decision about this safe and effective contraception. I never thought I’d see this happen again.”