Make Plan B a Viable Option

For years, if a woman missed a birth-control pill, tore a condom or engaged in unprotected sexual intercourse, she was powerless to prevent pregnancy. The 1999 introduction of the emergency contraceptive Plan B, known as the “morning-after pill,” allowed some women to avert unintended pregnancy. But barriers to obtaining the emergency contraceptive—available by prescription only—precluded it from becoming a viable back-up plan for most women.

In a move that could allow Plan B to live up to its name, an advisory body of the Food and Drug Administration (FDA) recently recommended that the progestin-only emergency contraceptive be sold at drugstores and pharmacies nationwide without a prescription.

The over-the-counter switch would allow the drug to be sold without a prescription and mean that for the first time, women would be able to procure the drug quickly and easily. With Plan B, time is of the essence, as the emergency contraceptive is most effective within 72 hours. Gaining access to the drug within the prescribed window has been near to impossible for some women. Physicians are hard to reach on such short notice and are typically unavailable during weekends and holidays. Many pharmacies don’t even stock the drug. Women seeking hospital care haven’t fared better: Half of all hospital rooms in Massachusetts refuse to provide the morning-after pill for women who ask for it, according to a survey conducted by the National Abortion and Reproductive Rights Action League Pro-Choice Massachusetts. Placing the emergency contraceptive on shelves across the country would eliminate the risk of missing the 72-hour mark.

With increased access to Plan B, significantly fewer women would endure unintended pregnancies and abortions. Plan B—75 to 89 percent effective when used as directed—has the potential to prevent about two million unintended pregnancies and 500,000 abortions annually, according to the American College of Obstetricians and Gynecologists (ACOG).

Available without prescription in five states—Alaska, Hawaii, New Mexico, Washington, and California—and in 33 of the 101 countries where it is sold, Plan B is considered safe by FDA medical reviewers, the American Medical Association and the ACOG. The morning-after pill is a high dosage of birth control pills that works by inhibiting ovulation, fertilization or implantation. In this way, the emergency contraceptive differs from the abortion pill RU-486. While Plan B blocks a pregnancy from forming, RU-486 aborts a fertilized egg that’s attached to the uterine wall.

The FDA advisory committee found that the potential for misuse or abuse of the morning-after pill is slim. Opponents charge that easy access to the emergency contraceptive would lead to an over-reliance on the pill as a primary form of birth control. But according to a recent Planned Parenthood study, most women who had used Plan B did not mean to substitute it for more reliable contraceptives like the birth control pill. Nor is it likely that the morning-after pill will replace other contraceptives in the future, considering the high incidence of side effects like nausea and abdominal pain associated with Plan B.

While the FDA usually heeds its committees’ recommendations, it is particularly important for the organization to follow the committee’s advice when it makes its final decision in February. In the three decades during which a woman can bear children, the risk of an accident—a condom tearing or a missed pill—is high. Selling the emergency contraceptive over the counter would provide women with a needed safety net and prevent an accident from turning into a disaster.