Try this nightmare on for size: It’s Friday night and the condom breaks. What now?
Emergency contraception–the morning-after pill–allows women to prevent pregnancy in the event of such an accident.
But even responsible women who know about the pill (a shockingly low 12 percent in the U.S.) may have trouble finding it in time. Emergency contraception helps prevent pregnancy only if used within 24 to 72 hours after sex.
Hunting down a doctor can be difficult over the weekend or holidays, and getting and filling the prescription takes time too.
Thankfully, the problem could be solved soon. In a few weeks, federal health officials will consider making EC, essentially a concentrated dose of birth control pills, available over the counter without a prescription.
France, the UK and other European countries already allow women to buy EC directly. It’s also available prescription-free for women in five states–Alaska, California, Hawaii, New Mexico and Washington.
But all American women should be able to manage their own reproductive health. The Food and Drug Administration should make EC a non-prescription drug.
Critics say the morning-after pill is not contraception, it’s abortion, but that’s not medically true. EC works by preventing fertilization of the egg or preventing a fertilized egg from lodging in the uterus. It doesn’t terminate pregnancy; it prevents it.
Anti-abortion forces should support making the morning-after pill easily available. Increased EC use could reduce the number of unintended pregnancies and reduce the need for abortions.
Critics also argue that if EC is available over the counter, couples will be careless about using regular contraception.
No way. When the condom breaks, most women are terrified. EC is not a license for sexual experimentation. It doesn’t offer any protection against sexually transmitted diseases. There’s every reason to continue practicing safe sex.
Plus, we’re not talking about popping two Advil the next morning. EC can cause side effects such as severe nausea, vomiting and abdominal pains–and the packets cost about $20 each. It’s not the type of drug you’d want to take often.
As the December hearing approaches, FDA officials say their main concern is whether women understand how to take the drug properly. They’re considering making it a non-prescription drug available at the pharmacy counter. To buy it, women would first consult with the pharmacist.
Contraception advocates oppose this idea, but maybe it’s the right way to go–for now. Too few women know about EC, let alone how to use it, which is surprising for a drug with a 30-year history.
Even some health professionals aren’t well-versed in EC. Just 20 percent of ob/gyns educate their patients about it when discussing contraception choices, according to a public health foundation.
Also, until a few years ago, birth control pills were the only method of EC on the market. Drugs specifically designed to prevent unplanned pregnancies were not available until 1995, when the FDA approved PreVen for distribution.
(The drug company that makes Plan B, the other widely distributed EC, is behind the push for over-the-counter sales and first approached the FDA.)
Increased access to the pills hopefully will boost public awareness, but a more aggressive education plan is required. EC shouldn’t be a secret for those in-the-know. Packets of regular birth control pills should include instructions on how to use the drug as emergency contraception, which can be done. Literature should be available next to the condom display at the drugstore.
There are many ways to avoid an unwanted pregnancy–condoms, rings, diaphragms and patches. EC is an emergency backup that needs to be easily available because no method, and nobody, is perfect.
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