November 18, 2005
Morning After Pill About Contraception, Not Abortion
Teen promiscuity. Everyone in favor of teenagers having sex
with lots of different partners, raise your hand. See? Except
for a few very bad people, there's no constituency for teen promiscuity.
But there is quite a constituency for the morning-after pill,
a contraceptive that goes under the brand name of Plan B. Some
social conservatives see the morning-after pill as a green light
for teenagers to have sex. Most Americans do not. They see the
pill as a measure to avoid pregnancy when conventional contraceptives
-- what we might call "Plan A" -- are not used. The Federal Drug
Administration is deaf to such reasoning. It is giving Plan B
a hard time.
What we have here is another example of the Bush administration's
approach to health policy: Ignore the science, and indulge activists
on the right.
When it came to the morning-after pill, the FDA apparently threw
out the rulebook for approving drugs. The tale of Plan B is bizarre
-- so much so that the Government Accountability Office was asked
to look into what the heck was going on. The report issued by
this nonpartisan panel does not reflect kindly on the administration's
competence in regulating health matters.
The FDA apparently rejected an application to allow over-the-counter
sales of Plan B months before the government had completed a scientific
review of it. Made by Barr Laboratories, Plan B is currently available
only through prescription.
The decision to forbid over-the-counter sales was made in a "very,
very rare" way, a top FDA review official told congressional investigators.
Higher-ups in the agency hijacked it. In other words, they ripped
up the step-by-step procedure for considering drug applications
and gave their own private thumbs-down.
We don't know the role that former FDA Commissioner Mark McClellan
played in this saga, because his e-mails on the subject have been
deleted -- or so he says. How convenient. Appalled by the machinations,
Susan Wood quit in August as FDA assistant commissioner for women's
Behind the seedy politics gurgles a swamp of misinformation about
Plan B. Some people have gotten it into their heads that Plan
B is an abortion pill. It is not. Even the FDA says it's a contraceptive.
What Plan B mostly does is stop the release of an egg from the
ovary or prevent fertilization of the egg. Plan B has no effect
on a fertilized egg once it is implanted in the womb. Implantation
is when a pregnancy starts.
To work properly, Plan B must be taken shortly after sex. Making
women get prescriptions for it first may cause delays that render
the drug useless.
In a rational society, it would be the job of Plan B's foes to
get straight with the biology. Everyone else should not be denied
full access to a good product because some people don't understand
As for the promiscuity part, there's little merit in the argument
that giving teens access to Plan B removes a deterrent to having
sex. That's because the options don't end at Plan B. Women have
a Plan C to fall back on. Plan C is abortion. Most everyone prefers
that women prevent pregnancies over ending them. Logic dictates
that social conservatives would be out in front on that one --
but logic has left the room.
I fully share the conservatives' concern over the sexual activities
of high-school students. Sex at these young ages exposes children
to pregnancy and disease. These teens are not mature enough to
handle the health and emotional issues involved. If social conservatives
could push the genie of teenage sex back into the bottle, I'd
be there pushing with them.
But teen promiscuity is a social problem best handled by the
home, the schools and the media. Plan B is not some new opportunity
drug, but an extension of the birth-control pills, diaphragms
and condoms that teens already obtain.
While it can't stop teen promiscuity, Plan B could stop teen
pregnancy. And what about older American women? Don't they have
the right to pick a pill off their pharmacy's shelves that would
help them prevent a pregnancy?
This isn't about abortion. It's about contraception, for heaven's
sake. It's about making abortions unnecessary. Imagine: The muddled
brains in the Bush administration are hassling women over contraception.
2005 Creators Syndicate