By Brooke Fox and Emily Chung
Over-the-counter access to emergency contraception is a
necessary precondition for women being able to make private choices
about their reproductive health, yet it may not become a
reality.
Access to valuable reproductive technology in the United States
has recently come under scrutiny, with the socially conservative
policy agenda of the Bush administration jeopardizing women’s
reproductive health over the next four years.
The threat to a woman’s right to choose has become a hot
topic of discussion as our country faces the prospect of one or
more new Supreme Court Justices that could overturn Roe v. Wade. In
light of such circumstances, it is difficult to see how emergency
contraception can be made more available.
Access to safe and effective contraception is an ongoing
important public health issue. Public health is concerned with the
prevention of unintended pregnancies through access to safe and
effective contraception.
Commonly known as the morning-after pill, emergency
contraception has been proven safe and effective for use by women
to prevent pregnancy.
In 1999, the Food and Drug Administration approved Plan B
““ Barr Laboratory’s brand name for emergency
contraception ““ for use by prescription only.
In December 2003, the FDA heard arguments for switching Plan B
from prescription to over-the-counter status. Although the FDA
Nonprescription Drugs Advisory Committee and the Advisory Committee
for Reproductive Health recommended Plan B for over-the-counter
status, Dr. Steven Galson, director of the FDA Center for Drug
Evaluation and Research, rejected the recommendation and denied the
request in May 2004.
Dr. Galson cited his concern over the safety of Plan B for girls
under the age of 16 as the reason for his decision. In response,
the drug’s manufacturer has resubmitted a proposal to sell
Plan B without a prescription to women over the age of 16.
This would be the first case of restricted access to an
over-the-counter drug based on age. This policy implies that women
of reproductive age are not capable of making decisions about their
own bodies.
In addition, a policy like this sets a dangerous precedent for
discriminating access to drugs based on age.
Experts believe emergency contraception can prevent half of all
unintended pregnancies each year. Emergency contraception is the
most effective way to prevent pregnancy after contraceptive failure
or if a woman is raped.
This issue is about equal access ““ giving all women,
regardless of age, the right to choose their contraceptive
method.
Providing emergency contraception without a prescription is an
easier option for many women who are busy, want to protect their
privacy, or lack adequate health insurance. Without health
insurance, a woman could not easily have access or afford to visit
a doctor simply to get a prescription for emergency
contraception.
Over-the-counter access gives teens more options for pregnancy
prevention and respects their privacy by reducing barriers that
keep young women from obtaining contraception.
There are currently other ways to access emergency
contraception, even though it is not available over-the-counter. In
all states, prescriptions for Plan B can be obtained from a
physician.
In five states, including California, select pharmacies offer
emergency contraception directly from a certified pharmacist,
without a doctor’s prescription.
But not all pharmacists are certified and some businesses choose
not to provide this service to its customers.
Women should not have to search for a pharmacy where they can
get emergency contraception directly from the pharmacist””mdash;all
women should equally have this convenience.
It is important for the public and pharmacists to understand
that emergency contraception does not abort an existing pregnancy;
rather it prevents pregnancy from occurring.
This moral issue causes pharmacists to make “conscientious
objections” to filling valid prescriptions for emergency
contraception.
Some states are proposing legislation to protect pharmacists
from legal action if they refuse to fill emergency contraception
prescriptions.
While pharmacists are right to be concerned for the health and
welfare of their clients, they must remain objective in their job
and not impose personal beliefs on their customers.
Emergency contraception is preventive, safe, inexpensive and
effective, and does not replace other contraceptive methods.
Over-the-counter access will allow women to make private choices
about their reproductive health.
Restricting over-the-counter access to emergency contraception
is a step backward for women’s health.
Brooke Fox and Emily Chung are graduate students at the UCLA
School of Public Health.