Plan

B is coming soon to a store near you

On April 5, a breakthrough in womens sexual health occurred. Federal Judge
Edward Korman ruled that the Food and Drug Administration should allow
emergency contraception to be sold over-the-counter. This means that products
such as Plan B, the morning-after pill, could be found on store shelves nation-wide
in the coming months.

This would dramatically change the current law, in which women under 17 must
have a prescription to obtain the contraceptive. For women who are older than 17,
the drug is kept behind the pharmacy counter and a photo ID must be presented
upon purchase.

Although the FDA originally had the chance to appeal the decision, they chose not
to.

This monumental decision comes following years of debate over abortion and
contraception. Those who are anti-abortion have argued that a fertilized egg is a
person and if a fertilized eggs ability to attach to the uterus is disrupted, then the
act is abortion. For this reason, they view emergency contraception as a form of
murder. Those on the other side of the debate call on studies performed by the FDA
and other leading scientist groups, which show that contraceptives such as Plan B
either delay the release of eggs from ovaries that occur before eggs are fertilized or
they thicken cervical mucus so sperm cannot successfully swim. This would mean
that the pills do not fit the definition of an abortive act.

The abortion versus contraceptive idea often brings into play the arguments
between pro-life and pro-choice stances, as well.

A group of 70 medical and public health organizations first petitioned for
emergency contraceptives to be made available without a prescription in 2001.
Following suit, the manufacturer of Plan B filed an application for the same in 2003.
It took three years for any headway to be made, with the FDA finally allowing Plan B
to be offered without prescription to women 18 and over in 2006. That age was
lowered to 17 in July 2009 by court ruling.

Nancy Northrup, president and CEO of the Center for Reproductive Rights, was a
part of the petitioning group in 2001. Following the ruling, she told ABC News,
Today science has finally prevailed over politics. Women all over the country will
no longer face arbitrary delays and barriers just to get emergency contraception.

The opposite reaction was likely seen in Health and Human Services Secretary
Kathleen Sebelius. In December 2011, Sebelius chose to overrule the
recommendation by the FDA that emergency contraception should be provided over
the counter. She believed there was not enough information to deem the product
safe, although the FDA had spent 10 months prior to the recommendation
continually researching and reviewing scientific data. This data included that the
product was safe and effective in adolescent females, which understood the product
was not for routine use and that the product would not protect against sexually
transmitted diseases, and that adolescent females could use Plan B properly without
the help of a health care provider (FDA).

Sebelius seems to be for the most part on her own, however, as doctors and
womens health advocates across the country are calling the ruling long overdue.
They believe the next step is to adequately educate the public on the use of such
contraceptive and make it affordable.

According to FDA Commissioner Margaret Hamburg, Plan B is a single-dose pill that
works effectively to decrease the chance of pregnancy following birth control failure
or unprotected sex. Plan B should be taken within three days (72 hours) of such an
incident, and it is suggested that it be taken as quickly as possible within that time
span for best results. The pill contains levonorgestrel, an ingredient used in many
common birth control pills, and works in a similar way.

After a thorough examination by The Center for Drug Evaluation and Research
experts (which include gynecologists, obstetricians, and pediatricians) Plan B has
been found to not work if a woman is already pregnant and it will not affect or
endanger an existing pregnancy. It may have unpleasant side effects, such as
changes in menstrual cycle, nausea, lower abdominal pain, fatigue, headache and
dizziness, but they are not particularly dangerous or harmful.

Many critics on the anti-abortion side of the debate also like to compare Plan B to
the abortion pill RU-486, now called mifepristone. However, the two are very
different. Mifepristone is a medicine that is taken to end an early pregnancy.
Generally, it can be used up to 9 weeks after the first day of a womans last
menstrual cycle.

There are three steps to taking the pill. In the first step, a woman will get the pill
from a health care provider and take it along with antibiotics. The pill blocks
progesterone, which causes the lining of the uterus to break down. The second step
consists of taking a second medicine, misoprostol, which causes the uterus to empty.
The final step is a follow-up examination, where a doctor will determine that the
abortion is complete.

The abortion pill effectively ends 97 percent of pregnancies, and because it is known
to cause serious birth defects in pregnancies that are not terminated, an in-clinic
abortion is required. Mifepristone can be obtained from a clinic, private health care
provider or a Planned Parenthood health center. Nationwide, the typical cost of
mifepristone is $300 to $800.

At the moment, Plan B is available at health centers and pharmacies. It costs
anywhere from $10 to $70. The cost depends largely on a womans insurance, where
she lives, and which location it is obtained from. Family planning clinics usually
charge less than private health care providers and drugstores, and some health
centers are able to charge according to income. Yet many argue that this price is still
too high for some young women and teenagers that may be in a position to need
Plan B.

It appears that only time, along with more discussion and research, will determine
whether this ethical debate will be resolved indefinitely.