The Blessing of Emergency Contraception
Imagine you are raped or your contraception fails for instance, your condom breaks. Frantic, you know that you have only a limited amount of time to obtain emergency contraception (EC). But you need a prescription, and it's the weekend or a holiday, and your doctor's office is closed. Meanwhile, time is passing quickly, and soon it will be too late.
Today, on Dec. 16, Congress will consider whether EC, which can be so valuable to women facing the possibility of pregnancy, should be available over the counter. If every woman of reproductive age had access to it when she needs it, half of abortions and unintended pregnancies in this country could be prevented. But there is a danger that ideological claims by anti-choice hardliners may influence what should be an objective scientific process.
At the joint hearing, the FDA Nonprescription Drugs and Reproductive Health Drugs Advisory Committees will specifically consider whether a type of emergency contraception called Plan B should be made available without a prescription. Research indicates that widespread availability of EC could prevent 1.7 million unintended pregnancies and 800,000 abortions each year in the United States.
Emergency contraception meets all customary FDA requirements for over-the-counter use: it is safe, there is no potential for overdose or addiction, no medical screening is necessary, the need it fills can be self-diagnosed, the dosage is uniform and it has no important drug interactions. Contrary to the claims of some extremists, it is not an abortifacient, that is, it does not induce abortion. EC prevents the egg from implanting and it does not interfere with an existing pregnancy.
Emergency contraception pills are a special combination of birth control pills that reduce the risk of pregnancy when started within 120 hours of unprotected intercourse. However, the sooner EC is administered, the better it works, making early access critically important. In cases of contraceptive failure or in cases of rape or incest, EC is the best way to avoid pregnancy. It greatly reduces the need for abortion, something everyone should support.
The prescription requirement for EC is obviously a barrier to timely access. And during the weekend or evening hours, when demand for EC is highest, most doctors' offices are closed. Even when a woman obtains a prescription, she may have difficulty filling it. For instance, one survey of pharmacists in Pennsylvania revealed that only 35 percent stocked EC pills. Worse, 6 percent said that providing EC was against store policy, and 7 percent claimed dispensing the drug conflicted with their personal beliefs.
Women seeking emergency contraception are often dependent on clinicians or pharmacists who are ignorant about the nature of the drug. In a telephone survey of 300 state pharmacists conducted by Planned Parenthood of Connecticut in the summer of 2003, nearly half incorrectly believed that emergency contraception causes an abortion.
Such prejudice and ignorance can have devastating consequences for women. But these obstacles would be removed if emergency contraception were available over the counter. That is why virtually all major medical and health-care organizations, including the American College of Obstetricians and Gynecologists, support the switch.
Emergency contraception is available without a prescription in more than 25 countries, including Denmark, France, Israel, South Africa, Sweden, and the United Kingdom. Evidence shows that women use it responsibly.
Government oversight of medicine is meant to protect and enhance public health, and improved access to emergency contraception does just that. The FDA should move quickly to expand the availability of emergency contraception nationwide.
Gloria Feldt is president of the Planned Parenthood Action Fund.