Toothpaste, Cough Drops, Aspirin, Contraception

By Katha Pollitt, The Nation. Posted March 4, 2004.

For a moment, it looked as if the FDA was going to do the right thing. It was going to go with medical science and make emergency contraception available over the counter, so that women who've had unprotected sex would have ready access to a postcoital method that prevents pregnancy 89 percent of the time. This was, after all, the overwhelming recommendation of its own advisory committee (of twenty-seven members, only three voted against OTC status, all professionally undistinguished Bush appointees from the Christian right: David Hager, the notorious promoter of prayer as the cure for PMS and denier of birth control to unmarried women; and Susan Crockett and Joseph Stanford, who won't prescribe it, period).

It makes sense: After all, emergency contraception, also known as the morning-after pill and marketed as Plan B and Preven, is only a quadruple helping of certain birth control pills. Women in the know have been dosing themselves this way for years; the FDA found it safe and effective in l999. EC is available over the counter or directly from a pharmacist in some seventeen countries, including the United Kingdom, France, Switzerland, Scandinavia, Canada and Portugal. The current system in the United States, in which women have to find a doctor or clinic and a pharmacy that stocks EC ideally within twenty-four hours (EC works for seventy-two hours, but less effectively as time goes on), is clearly too cumbersome. In a few states -- California and Washington, for example -- pharmacists can dispense it directly, which is better, but still an unnecessary complication.

You would think that anti-choicers would leap to embrace emergency contraception, which, according to the Alan Guttmacher Institute, already prevents 51,000 abortions a year, making it a significant, if little-noted, factor in the decline in abortion. This is the Bush Administration, though, in which science and women's rights and the actual, factual lessening of the need for abortion are all less important than "values" -- i.e., the narrow ideology of the Christian right. In December, forty-four Congressional Republicans sent a letter to the FDA advisory committee urging its members to reject OTC status: EC "stacked casually on shelves next to toothpaste and cough drops" would allow "our schoolchildren" easy access to a drug that, according to Jesse Helms, is an "abortifacient." After the committee endorsed it, forty-nine Congressional Republicans sent another letter, this time expressing alarm at "the impact this decision will have on the sexual behavior of adolescents." On February 16, FDA head Mark McClellan (brother of Bush press secretary Scott McClellan) postponed the agency's decision; now he's leaving to take charge of Medicare, and EC risks being delayed again by future appointees.

Years ago, pundits scoffed when prochoicers argued that antis would target birth control too if they could. EC primarily works by preventing ovulation and fertilization, but like the birth control pill, it may also prevent the implantation of a fertilized egg in the womb. As Gloria Feldt, head of Planned Parenthood, pointed out when I spoke to her by phone, "antichoice people are trying to redefine pregnancy to begin at fertilization rather than implantation," which is the medical definition of pregnancy, and EC is the wedge. If EC is a "human pesticide," so are the Pill, the patch, injectables. If "schoolchildren" ought not purchase EC without parental supervision or knowledge, nor should they be able to obtain those forms of contraception without parental permission, as current law allows. And if being able to purchase EC like "aspirin or hairspray" promotes promiscuity -- studies suggest, by the way, that it will not -- the same can be alleged of birth control in general. In fact, contraception has always been attacked as promoting loose morals among women (curiously, "schoolchildren" excepted, one hears less about the fact that condoms promote loose morals among men -- why not make them available only by prescription, too?).

Recently a pharmacist and two assistants at an Eckerts drugstore in Denton, Texas, refused to fill an EC prescription for a teenage rape victim (they were fired). In Virginia, state legislator Robert Marshall, who last year was able to prevent James Madison University from filling EC prescriptions, is noisily seeking to extend the ban to all the state's public colleges and universities. EC, he claims, turns young women into "chemical Love Canals for frat house playboys." Instead of the natural love canals God meant them to be? This spurious concern for women's health is the cousin of the argument that abortion should be banned because it is "traumatic" for women -- a line that has persuaded the state legislature of South Dakota to pass a flagrantly unconstitutional ban on all abortions and that Norma McCorvey, Roe of Roe v. Wade, is pushing in her ridiculous attempt to get the decision overturned on the grounds that she has changed her mind -- about an abortion she never had.

Doctors and clinics are beginning to offer prescriptions for women in advance of need, which is great. But women can be proactive too. At a recent demonstration in New York City, women symbolically handed EC pills to others, declaring their willingness to break the law to put the drug in the hands of any woman who needs it (it is illegal to give a prescription medication to someone for whom it has not been prescribed). Any woman with the right kind of birth control pills can package her own EC and share it; years ago, journalist Debbie Nathan would walk into Mexico from her home in El Paso, buy birth control pills for two dollars a cycle and make EC necklaces with foil, glitter and charms. Until women can pick up EC along with, yes, "aspirin or hairspray," that ingenuity and boldness is just what we need.

Katha Pollitt writes for the Nation.

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