The New York Times reported on April 5 that a federal judge in Brooklyn has overturned the government’s restriction on over-the-counter sales of the morning-after pill, which had been available only by prescription for girls 16 and under. Senior Judge Edward R. Korman of the Eastern District of New York ruled on April 4 that Sebelius’s decision on Plan B One Step was “arbitrary, capricious, and unreasonable.”
The question of who should have access to emergency contraception has been a contentious issue since the introduction of RU-486 (Mifepristone) in the late 1980s. In 1988, RU-486 was available only in France; the following year, the Bush Administration banned imports of the drug for personal use. After years of continued debate and advanced clinical trials, the drug was finally approved for use in the United States in 2000.
Plan B One Step, a more recent development, is an emergency contraceptive pill taken by mouth after unprotected sex. It is used to prevent pregnancy. It is not intended for routine contraceptive use and does not prevent against sexually transmitted diseases, including HIV.
The decision by Judge Korman effectively reverses a 2011 ruling by Health and Human Services Secretary Kathleen Sebelius, requiring a prescription for girls 16 and younger who wanted “Plan B” pills. Women 17 and older could purchase Plan B without a prescription; but as a restricted-use medication, it was kept behind the counter.
Sebelius’ policy, which overruled the Food and Drug Administration’s recommendation that Plan B be sold over the counter, had received unequivocal support from President Obama. “I will say this, as the father of two daughters,” said the President. “I think it is important for us to make sure that we apply some common sense to various rules when it comes to over-the-counter medicine. And as I understand it, the reason Kathleen made this decision was she could not be confident that a 10-year-old or an 11-year-old going into a drugstore should be able — alongside bubble gum or batteries — be able to buy a medication that potentially, if not used properly, could end up having an adverse effect. And I think most parents would probably feel the same way.”
Abortion opponents argue against Plan B for a different reason: It is an abortifacient. Plan B One Step works by providing a dose of the synthetic version of progesterone, a female reproductive hormone, which prevents ovulation or, if ovulation has already occurred, makes the uterus “less hospitable to a fertilized egg.”
And parents’ advocates argue that over-the-counter sales to minors deny parents the right to be involved in their children’s lives, to help shape their moral character, and to monitor their health needs. With side effects including nausea, abdominal pain, fatigue, headache, and heavy menstrual bleeding, the drug should not be taken lightly and without the knowledge of a parent or responsible adult. Critics point to rules which require a school to obtain parental permission before administering an aspirin to a teen or pre-teen; yet the harsh chemicals in Plan B One Step will now be available to children as young as 10 or 11.
And since the drug offers no protection against sexually transmitted diseases including HIV, opponents argue that immature youth should not be granted access to the pill, which may provide a false sense of security and encourage promiscuity.
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UPDATE: On Friday, April 5, Deirdre McQuade, spokeswoman for the U.S. Conference of Catholic Bishops Secretariat for Pro Life Activities, issued a statement regarding the judge’s decision to lift age limits on purchase of over-the-counter emergency contraceptives. McQuade wrote:
“A federal district judge in New York has ordered the Food and Drug Administration (FDA) to lift all age limits on over-the-counter access to the so-called “emergency contraceptive” drug Plan B and its generic versions.
“Plan B is a large dose of a powerful hormonal drug (levonorgestrel) that is available only by prescription when used in smaller doses for contraception.The court has acted irresponsibly by making this powerful drug available without a prescription to minor children.
“Plan B does not prevent or treat any disease, but makes young adolescent girls more available to sexual predators.The court’s action undermines parents’ ability to protect their daughters from such exploitation and from the adverse effects of the drug itself.
“Many studies have shown that wider access to “emergency contraception” among young people does not reduce pregnancy or abortion rates, but can contribute to higher rates of sexually transmitted disease.No public health consideration justifies the unregulated distribution of such drugs to children.This ruling should be appealed and overturned.”