Plan B, aka the “morning-after” pill, has been in the news a lot lately. Plan B is another name for the medication levonorgestrel, which can be taken up to 72 hours after intercourse to prevent conception from occurring. For a long time, it was available without a prescription only to those 17 and over.
In 2011, the FDA approved Plan B for unrestricted over-the-counter sales. This was blocked by the head of the U.S. Department of Health and Human Services, Kathleen Sebelius. There were several lawsuits, and recently federal judge Edward Korman ruled that Plan B should be available over the counter with no restrictions. The FDA responded by approving a proposal by Teva, the pharmaceutical company that makes Plan B, to make Plan B without a prescription to teens 15 and older (but not generic versions.) Korman opined that this did not address the issue, and ordered that Plan B should be available with no restrictions. Where are we now? Waiting until May 20th, for an appeal by the Justice Department.
My (and Dr. Evans’) opinion is that Plan B should be available over the counter with no restrictions. Here’s why:
- Plan B is incredibly safe. As medications go, it has a great safety profile, and is overall safer than many other medications available over the counter with no age restrictions.
- Plan B can be used effectively by younger adolescents. Plan B One-Step involves taking one pill, which is definitely in the cognitive range of most young women old enough to menstruate. (I should note that, to my knowledge, studies haven’t been done on young women under 13.)
- Plan B only works in the first 72 hours after intercourse, and is most effective in the first 24 hours. For Plan B, the earlier it’s used, the better the chances that it will prevent a pregnancy. Getting a prescription, or parental buy-in, takes precious time. This is especially true for teens who fear their parents will punish or be disappointed in them for being sexually active; they may delay the discussion or simply hope they will be lucky enough to not get pregnant.
- Plan B does not cause an abortion, and in fact can prevent a teen from needing to seek abortion services later. It is not recommended for women with an established pregnancy to take Plan B, but it will not end the pregnancy. There has been some question about whether Plan B can prevent the implantation of a fertilized egg in the uterus. Recent evidence shows this is unlikely.
- Having Plan B available does not increase sexual activity in teens, or make it less likely that they will use birth control. Some people worry that teens would take Plan B availability as a “free pass” to have unprotected sex, but studies show that is not the case.
- Not all teens can rely on their parents for communication and/ or help with health care. If a young woman under 15 was sexually active, I would hope she could communicate with her family about the situation. But for some young women, this could provoke a reaction ranging from emotionally abusive to physically dangerous. Also, not all teens can count on their parents taking them to the doctor in a timely manner if a prescription is needed. As much as I wish it were different, the bottom line is that not all teens have loving and stable parents who can help them in a time of crisis.
What do you think? Do you agree with Sebelius that women younger than 15 should not have over the counter access to Plan B? Or do you agree with Judge Korman that access should be available to everyone?