Plan B: Victory in reproductive rights struggle

Women won round one in the battle for Plan B, an emergency method of contraception, on Aug. 24 when the Federal Drug Administration decided to allow nonprescription sales to adults.

This is a step forward for women’s rights and health care. It will allow millions of women easier access to the “morning-after pill,” helping to prevent unintended pregnancies and making many abortions unnecessary.

This took years of struggle to win. Activists mobilized demonstrations; petition, phone and email campaigns; lawsuits—all types of public pressure. Pro-choice organizations and women’s-rights activists, health-care, legal and community advocates fought hard against the right wing inside and out of the Bush administration to gain the right to the non-prescription emergency contraceptive.

But it is far from a complete victory. There’s an enormous gap in the FDA’s decision. Non-prescription Plan B will be denied to millions of women under the age of 18 who are among those who need it the most. Women of color, impoverished and rural youth will be disproportionately affected.

Young women critically need access without obstacles to all methods that prevent unplanned pregnancies, including Plan B, a vital form of birth control. Because the emergency contraceptive is most effective when taken within a 72-hour period, immediate availability is crucial. Young women’s access will be greatly hindered if they have to wait for a doctor’s appointment, or if they lack health insurance or funds to see a doctor, or if doctors refuse to write the prescription.

Health organizations including the American Academy of Pediatrics and the American College of Obstetricians and Gynecologists oppose the age restriction.

The FDA is denying youth emergency access for many bogus reasons, with no scientific or medical basis. Bush appointee and acting FDA Commissioner Andrew C. von Eschenbach decided the age limit although the scientific advisers did not suggest it.

In fact, FDA advisory committees recommended in 2003 —eight months after the manufacturer applied for non- prescription status—that Plan B be made available to all age groups. Prescription sales had already begun in 1999.

Bush-appointed FDA officials denied that recommendation and kept delaying wider access to emergency contraception for three years, putting reactionary forces and ideology ahead of science and the medical needs and basic rights of millions of women.

The National Women’s Health Network says, “Top FDA officials privately acknowledged that the age restriction is a political concession to conservative activists who have been fighting to keep barriers to contraceptive access in place.” (www.nwhn.org, posted Aug. 29)

Susan Wood, former FDA assistant commissioner for women’s health who quit over the agency’s anti-Plan B stance, said, “For nearly three years politics took precedence over good science and good health policy decisions, and women’s health suffered.” (USA Today, Aug. 25)

The reactionary “American Life League” and “Stop Planned Parenthood International,” among others, have attacked and lied about emergency contraception for years to prevent its use. They falsely label it an “abortifacient” (abortion-causing) drug, when in reality it is a contraceptive. It is composed of birth-control pill ingredients and works similarly—preventing, not ending, pregnancies. Even now, the right-wing Family Research Council is scheming to end its use.

There are other complications in the Plan B scenario. The FDA requires that it be placed behind pharmacy counters “because it cannot be dispensed without a prescription or proof of age.” Keeping it off open shelves and requiring identification to purchase it will create hurdles for many women, subjecting some to harassment by hostile pharmacy staff or refusals to fill the prescriptions.

This is already happening. Planned Parenthood warns of five drugstore chains that do not pledge to fill these prescriptions. CVS drugstores allow staff to refuse to fill Plan B prescriptions. (Atlanta Journal-Constitution, Aug. 25)

Some state legislatures are going along with this discriminatory practice and are considering measures to restrict EC availability.

Of great concern is the potential for intimidation of sexual-assault survivors of all ages who should be guaranteed emergency contraception in every hospital emergency room, clinic, doctor’s office and drugstore.

Price is also an issue. Barr Pharmaceuticals, Plan B’s manufacturer, may increase the non-prescription price, which even at its current cost of $25-$40 per dose is a hardship for many impoverished women. Medicaid doesn’t cover over-the-counter medications.

All forms of contraception should be readily available to women of all ages who need it—when it’s needed, at low cost, without discrimination or obstructionist rules, laws or objections, free from right-wing coercion or intrusion inside or outside of government.

That is a basic right.

This gain was won through struggle. But protecting and expanding it against the insidious right wing, which seeks to set back women’s reproductive rights by decades—even undermining birth control and truthful sex education—will take vigilance and mass mobilizing.

Already, New York City picketers protested the FDA’s age restriction. Lawsuits have been filed. Determined reproductive-rights organizations and activists are boldly planning to meet this challenge and continue this struggle until all women have access to all essential health care.