Sex and Political 'Science'

Having an unanticipated pregnancy is a young woman's worst nightmare. Whatever your political leaning might be, there are few who will argue with that. Of course it’s important to be careful, but the reality is that mistakes and accidents happen. Harvard women are lucky to have a health clinic that realizes this and is available to write prescriptions for emergency contraception seven days a week. But the majority of women do not have that luxury.

The “morning-after" pill (its more common name) is essentially a high dose of the hormones in conventional birth control pills. If taken within 72 hours of intercourse, emergency contraception can reduce a woman’s risk of becoming pregnant by between 75 and 99 percent. Like regular birth control pills, it inhibits ovulation, fertilization and implantation—but will not affect an existing pregnancy. The Alan Guttmacher Institute estimates that 51,000 abortions were prevented in 2000 due to better access to and better knowledge of emergency contraception.

The morning-after pill has been around for years, but obstacles to access often hinder its widespread use. In most states, women seeking emergency contraception must first set up an appointment and make a trip to the doctor’s office to obtain the necessary prescription. But most doctors’ offices are not open on the weekends—a time when the most number of women are probably in need—and pharmacies are not always free from moral prejudice. A Kaiser Family Foundation survey found that currently only six percent of women of childbearing age had ever used the drug.

Several months ago, the Food and Drug Administration (FDA) considered a proposal to make emergency contraception over the counter and place this birth control right on pharmacy shelves. Yet despite its potential to reduce teen pregnancy, politics trumped rationality and an organization that was created to keep partisanship out of important medical decisions caved in under political pressure. In a letter to the FDA, 44 members of Congress wrote, "We urge you to reject the petition currently before you to make the morning-after pill as accessible to our nation's teenage daughters as aspirin or hair spray." Apparently, these members of Congress would rather see their daughters pregnant.

Never mind that both the American Medical Association and the American College of Obstetricians and Gynecologists both promoted over-the-counter emergency contraception as medically safe. Forget the fact that an FDA advisory panel voted 24-3 to recommend that emergency contraception be available without a prescription. Ignore the estimate that over-the-counter availability is predicted to result in 1.7 million fewer unwanted pregnancies and 800,000 fewer abortions each year in the United States. While the FDA technically functions as a medical regulator—not a morality stipulator—it decided to delay a decision on the proposal until they could garner more information about emergency contraception’s use among teenagers.

When it comes to pregnancy prevention, high school and college females have always been the victims of these kinds of morality policies. While the FDA approved the birth control pill in 1960, state laws and local policies made it nearly impossible for a single woman to obtain a prescription. And until the late 1960s, it was actually illegal for an unmarried woman under 21 to obtain the pill without consent from her parents. Sex—or more accurately—safe sex was considered inappropriate in the eyes of the government for single gals. Those who violated these social norms would simply have to face the consequences.

Almost 45 years later, we still can’t seem to shake our nation’s sexually conservative agenda. A pending bill in Missouri would allow pharmacists to refuse to fill prescriptions for the morning-after pill on moral grounds and similar legislation was introduced in Indiana, Minnesota, Michigan, North Carolina and Washington this past year. Meanwhile, the Colorado state legislature recently decided that medical care providers should not be required to inform rape victims that emergency contraception is available to them. And in Virginia, the state legislature is considering a bill that would prohibit the health clinics at public universities from even offering emergency contraception.

What makes over-the-counter access to the morning-after pill all the more important now is that it would render many of these restrictive measures moot and keep these morality demagogues out of a woman’s personal family planning decisions. Yet the FDA seems more concerned with how this policy will affect teen sex rates rather than how it could reduce teen pregnancy rates. A recent editorial in the New England Journal of Medicine condemns the FDA for allowing “political considerations” to delay their decision on this issue.

Unfortunately, young women will suffer the most as a result. A recent study published in the Journal of Pediatric and Adolescent Gynecology found that providing sexually active teenage girls with emergency contraception pills did not make them more likely to have unprotected sex—but it did cause them to use emergency contraception more. That translates to less unintended teenage pregnancies—and fewer abortions. With over 3 million unintended pregnancies per year in the United States—half of which end in abortions—we just can’t afford to be this shortsighted.

Lia C. Larson '05 is an economics concentrator in Adams House. Her columns runs on alternate Fridays.