Emergency contraception should be available over-the-counter

FACTOID: The political hijacking of the scientific review is particularly unfortunate.

In early May, in an unprecedented political takeover of an independent scientific review, the Food and Drug Administration caved to the Bush administration and their socially conservative allies, and rejected over-the-counter sales of emergency contraception.

This startling decision proves once again whose opinion President George W. Bush’s values. Over-the-counter sales of emergency contraception are strongly supported by the medical community, and have broad public approval. But the far right is strongly opposed. In this administration, that’s apparently all it takes ñ even when the Joint Advisory Committee to the FDA voted 23-4 in favor of making the emergency contraceptive Plan B® available over the counter.

For years, doctors, public health officials and advocates of women’s health and reproductive rights have known about the value of emergency contraception. Proven to be safe and effective, and frequently referred to as the “best-kept secret in reproductive health,” emergency contraception is one of the most promising avenues for reducing unintended pregnancy and the need for abortion.

Emergency contraception is often confused with RU-486, the “abortion pill” or Mifepristone. While RU-486 is an option for early termination of pregnancy, emergency contraception works to prevent pregnancy. In fact, emergency contraception is just a concentrated dose of the same hormones found in regular birth control pills.

Because emergency contraception is most effective when taken within 24 hours of unprotected sex, it is essential that the drug’s availability not be determined by the limited business hours of a physician.

As early as 2000, both the American Medical Association and the American College of Obstetricians and Gynecologists issued resolutions supporting over-the-counter access to emergency-contraception pills.

Making emergency contraception available over the counter would enhance access to emergency contraception and protect against unnecessary impediments.

Lawmakers and emergency contraception opponents who argue that improved access to emergency contraception leads to riskier behavior or increased STD rates are distorting the well-established facts and attempting to disguise their political ideology as science.

Scientific studies on emergency contraception use indicate that women will use emergency contraception correctly if it is available over the counter, and that frequent use of emergency contraception is uncommon, even among young women. 

For example, a University of Pittsburgh study published in 2004 found that young women given an advance supply of emergency contraceptive pills are more likely to use it when needed, report fewer unintended pregnancies and no more sexually transmitted diseases than those not given an advance supply. Advance provision of emergency contraception did not increase the likelihood of unprotected sex, nor did it result in less condom or hormonal contraceptive use. In fact, at the six-month follow-up, more young women in the advance group reported using condoms than those not receiving emergency contraception in advance.

Sadly, the FDA’s recent actions mirror other attempts by the Bush administration to elevate politics above science ñ as seen in its attempts to discredit the effectiveness of condoms and erroneously assert that abortion causes breast cancer.

With approximately three million unintended pregnancies occurring each year nationwide, it is appalling that anyone ñ much less the FDA ñ could allow a political agenda to so blatantly guide their judgment. It is shameful that the Bush administration would rather kowtow to the far right than work to reduce the number of abortions. As Princeton University reproductive-health expert James Trussell recently stated that if over-the-counter availability of emergency contraception could prevent even 10 percent of unintended pregnancies it would annually result in 150,000 fewer abortions per year.

Let’s put aside politics and ideology. Science and public policy support over-the-counter sale of emergency contraception; it is time for the FDA to do the same.

Tim Stanley is the executive director of NARAL Pro-Choice Minnesota, he welcomes comments at [email protected]