Thursday, December 8, 2011

Science vs. Politics: Plan B Initiative Rejected

You may be wondering why I've placed this picture on the blog today. If you read the fine print at the bottom it states: "He's hot, he lights you up inside, you can't switch it off and before you know it, the sparks are flying...
The thing is, we see more women with an unplanned pregnancy in January than any other time of the year. We don't want you to be one of them. Getting hold of a morning after pill over Christmas can be difficult so it's useful to have it before you need it. bpas is giving away FREE morning after pills in advance throughout December."

Today's post is all about Plan B and the current controversy over whether there should be age restrictions on it's over-the-counter availability.

Since 2005, Plan B (commonly referred to as the morning after pill) has been in the middle of politics. Now it seems the dispute is between the Food and Drug Administration (FDA) and the government. On Wednesday, the FDA recommended Plan B be made available over-the-counter with no age restrictions. The decision was not made lightly. Margaret Hamburg, the FDA Commissioner, took 10 months in making her decision. The FDA is supposed to base their decisions entirely in science, and she found that Plan B is safe and effective.

Following this decision, however, an Obama administration official, U.S. Department of Health and Human Services Secretary Kathleen Sebelius, used her veto authority and rejected this initiative, instead contending that the age restriction was necessary. Sebelius argued that adolescents may not have the "behavioral maturity" to know how to use Plan B. She said there is not enough evidence to be sure adolescents can understand the instructions on the label. It doesn't seem that hard really. It's a pill. Put it in your mouth, rinse around with water. Swallow.

Plan B is a hormonal contraceptive found to be 89% effective at safely preventing pregnancy if taken within 72 hours of having unprotected sex. Acquiring this drug is easy for individuals 17 and older (ask a pharmacist for the drug); however, individuals who fall in the 16 and younger category must get a prescription from their doctor in order to get Plan B.

While it might be easy, you think, to make such a decision. I would argue there are quite a few things to consider on the side of both opponents and proponents.

First, does Sebelius have a point? Young people are choosing to engage in sexual intercourse younger and does providing Plan B (just as is the argument about condoms and abortion) suggest to these young people that this is okay?

Also, as a society we have seen a massive increase in the number of teenage mothers and fathers. I've mentioned before that I assisted in a research project on this very topic. In many of the interviews, the teens stated they didn't know their options, didn't know how to access their options, or didn't feel they could talk to anyone (especially their guardians) about their options for preventing pregnancy. So, is our abstinence-only message really working? I think not. Is the solution Plan B? Perhaps society should be more open about providing condoms? Education?

I've got two questions for you. The first is whether Plan B should be available over-the-counter at all. And, the other is about the issue in this blog regarding age restrictions.

There are many other arguments (which I'd be happy for you to tell me about in my comments), but in the end, I am asking you, do you think Plan B should be provided over-the-counter without age restrictions?


  1. I'd like to respectfully challenge your idea that in your research, the reason so many of the teens were young parents was because they were given an "abstinence-only" message. I would argue that they, in fact, were given no clear message at all. Maybe a parent/guardian held an expectation of these kids to abstain, or “be smart” and use protection if they decided to engage in intercourse, but I really question how much of this was discussed, talked about, and TAUGHT.

    I think abstinence education is great – key word here being education. A single sentenced “don’t have sex” to a teenager is not education. Nor is a limitless availability of condoms in nurses offices, availability of birth control pills to young girls, or even, over the counter Plan B. Both extremes are ineffective. Neither is educational. Taking the time to truly educate, listen, explain, actively speak with kids/teens about their sexual decisions, their perspective, your expectations of them, explaining reasoning behind expectations, asking if they agree, arming them with the right tools to make the “smart” decisions in moments when they might not be thinking clearly, making all possible consequences known and unambiguous, and helping them take decisive ownership of their ultimate choice – this is what sex ed needs to be. Clearly, for my family, I will teach my children abstinence EDUCATION. But the same ideas should be said for all sex ed. Handing your kid a condom and telling them to “be safe”, on its own, is irresponsible without backing it up with the full education portion. As is the “don’t do it because I say so” action.

    I totally agree with what the women said on the video that a reason Plan B should not be available over the counter, and an argument for women under 16 having to get a prescription, is because they should be talking to SOMEONE about their decision, their actions, the consequences. Although not marketed as an abortifacient, Plan B may inhibit implantation (that’s straight from their warning label), which means that Plan B can prevent a fertilized egg from attaching to a women’s womb by causing the lining to thin. To some people, this fact can be a big deal. To others it may not be. Either way, education is necessary and informed decisions and choices are paramount when it comes to not only the Plan B Initiative, but the entire sex education realm.

    As always, thanks for your thoughtful and through provoking posts, Devon!

  2. Alexandra,
    I think you're exactly right on so many of these things. While I can't agree with your statement regarding what the teens in my research stated (since I interviewed a majority of them and they specifically stated things about the abstinence only education), I do concede that many of them likely hadn't received and didn't know alternatives or hadn't spent a great deal of time thinking about why they didn't engage in safe sex after making the decision that sex was something they wanted to engage in. Consequently, they may have defaulted to the abstinence argument either because it came to mind, because it is the only message they had received, or for a number of other reasons. Notably, all of the teenagers interviewed for the project were parents (a number had multiple children).
    What I absolutely agree with you about is the idea of education. It is not education to either simply hand someone a condom and say "be safe" nor, is it education to say "don't have sex." Neither of these is likely to be effective, at least not for an extended time.

    I am so glad you posted and I hope you'll continue to challenge, question, think about, and post more :)

  3. I am interested to know if the bill was also rejected not only because 16 and younger girls weren't behaviorally mature enough to read the instructions, but more so to read and understand exactly what this pill will do and the side effects that come from it. I have a friend who has used it before and was in bed for 2 days with female issues that are common side effects associated with Plan B.

    I think you were both right about education needing to be the top priority. These girls need to know not only their options and preventions measure to take but education about the side effects that come with taking this pill. It doesn't just magically keep you from getting pregnant with no side effects.