Politics and a Pill

After politics trumped science last May, the Food and Drug Administration (FDA) is once again considering Plan B, otherwise known as “the morning after pill,” for over-the-counter sale. The agency rejected the first such application last year, claiming there was not enough research on the dangers of the drug to young teenagers. Yet the FDA’s own expert panel agreed that the emergency contraception should be made available over-the-counter—and so do we.

The FDA’s advisory panel voted unanimously last spring to approve the drug for over-the-counter sale, which only underscores the unacceptable interference of politics in the FDA’s previous decision. While opponents worry that over-the-counter availability of the drug will result in more risky sexual behavior amongst teenagers, here it seems that science also disagrees. In a six-month study of women who were given a supply of emergency contraception to keep at home, researchers found that they were no more likely to have unprotected sex than those without unrestricted access to the drug. Other studies have shown that access to the drug did not increase teenagers’ likelihood to engage in promiscuous sex. But, regardless, the role of the FDA is to approve drugs for over-the-counter sale based solely on the medical evidence of their safety and effectiveness; to make medical—not moral—decisions. Again refusing to approve a medically safe Plan B for over-the-counter sale would seriously damage the credibility of the FDA to impartially regulate the drug market. Moreover, it would be a serious blow to women’s reproductive rights.

Over-the-counter access to emergency contraception is a crucial resource for all women, especially because it can prevent pregnancy after unprotected sex, but it is not an abortion. Emergency contraception can stop the egg fertilization and implantation necessary for pregnancy, but it has no effect on an implanted egg if a woman is already pregnant. It therefore provides an important option for women who want to avert pregnancy, especially if they do not want to choose abortion. Given that the drug’s effectiveness is directly linked to how soon after sex it is taken, making it available without a prescription is fundamental to maximizing that effectiveness. Otherwise women may end up waiting days over weekends and holidays to get a prescription, which reduces the chances the drug will work. And women forced to wait for a prescription are therefore more at risk for pregnancy. That is, of course, to say nothing of the impact on women with inadequate access to medical care in the first place.

Harvard students are fortunate to have emergency contraception easily available in a non-judgmental environment at University Health Services. But across the country all women are not so lucky. The science says that emergency contraception is safe for over-the-counter sale; the FDA should stick to the facts.