Plan B: Politics trumps science — again

The following is a reprint of “Plan B: Politics trumps science,” published here December 10, 2011. With minor changes, it is as relevant today as it was in 2011. Remember, a US district judge last month ruled the FDA must make Plan B, the “morning after pill,” available over the counter to all girls and women, regardless of age. In response, the FDA announced this week it would make Plan B and its generic equivalents available over the counter to women age 15 and older, with proof of age required for purchase. It’s a start but obviously not what the court ordered. The next day the Justice Department announced it would appeal the earlier district court ruling. In other words, despite President Obama’s declarations that he’ll protect women’s reproductive rights, he and his administration are continuing their efforts to block full and easy access to Plan B, a drug that scientists and physicians have already determined is safe for women of all ages.

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Something disturbing happened in Washington this week. No, it wasn’t election related. It wasn’t even Congress related.

Plan BIt was a single individual, Katherine Sebelius, Secretary of Health and Human Services, deciding to overrule the FDA and its determination that Plan B, an emergency “morning after” contraceptive, is safe to be sold without a prescription to any female of child-bearing age. Rather than yield to science and logic, Sebelius decided the drug should continue to be kept behind pharmacy counters instead of being openly available on store shelves, and dispensed only to women 17 and older who have either a prescription or proof of age.

We have children raising children in America, often in poor communities, due to lack of education, lack of access to proper health care, lack of adult advice and supervision, or all of the above. We also have pregnancies occurring when other birth control methods fail, or in cases of rape and incest. These things shouldn’t happen, but they do. Kids shouldn’t be having sex, but they do. Kids should go to their parent(s) or doctor if they think they are pregnant, but for any number of reasons, they don’t. That’s the reality, and denying it changes nothing. If it did, America’s teen pregnancy problem would not exist.

There are parents who don’t want Plan B available to their 13-year-old because they, the parents, “want to know”; they want to know if their daughter gets pregnant. Of course they do. But their knowing wouldn’t change anything; their child would still be pregnant. More than likely, they just want to feel like parents, like they are involved in the process and in control of what their 13-year-old does. That’s a normal parental response, but obviously if the child is seeking Plan B, the parent has been out of the loop for a while. Better to equip the child with the knowledge to protect herself and hope she doesn’t need it than to not prepare her and end up with an unwanted pregnancy.

Given the reality of life in the U.S. today, the number of teen pregnancies we have, and the scientific research confirming the safety of Plan B, there seems only one reason for Sec. Sebelius to have overruled the FDA: personal politics. This is the first time any HHS secretary has overruled an FDA decision on drug safety and use. Worse, and incomprehensibly, Pres. Obama supported her decision.

Francesca Grifo, director of the Union of Concerned Scientists’ Scientific Integrity Program, commented:

Secretary Sebelius, a non-scientist, overruled the conclusions of an independent scientific panel that arrived at its decision after careful analysis and consideration of the data. Plan B is considered safe for over-the-counter use not only by FDA scientists and advisors but also by countless esteemed medical associations, from the American Academy of Pediatrics to the American Medical Association.

The secretary’s decision undermines the ability of FDA to make drug approval decisions based on the best available science. The president’s support for the secretary’s decision is unfortunate, as it is inconsistent with his own March 2009 memorandum on scientific integrity.

That memorandum states, in part: “The public must be able to trust the science and scientific process informing public policy decisions. Political officials should not suppress or alter scientific or technological findings and conclusions.”

It was a bad decision by Sebelius and a bad decision by Obama. It is also another blow in the ongoing war on reproductive rights and choice. Should children be buying Plan B? Ideally, they shouldn’t need to. Ideally they shouldn’t be facing such a decision — and certainly not without parental input. But as long as kids have sex or are sexually abused and don’t or can’t seek help from the adults in their lives, Plan B will be preferable to children having children.

Someone named DCMike commented on the Huffington Post:

“Plan B gives young women a tomorrow that belongs to them. Let them have it.”

I would say the same for all birth control, all contraceptives, and all family planning resources.

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16 comments

  1. Personally I consider an unwanted pregnancy to be a disaster for the potential parent(s), for the potential grandparents, and for society and therefore would like to see Plan B freely available over the counter to any kid in puberty. And by the way, from what I’m reading these days, puberty can start as early as age 10.

    As for the Obama administration’s decision to appeal the judge’s ruling I can only surmise that it’s an attempt to deny to the conservative right what would be inflammatory fodder for the issue. I think that’s a mistake – they couldn’t hate him any more than they do, regardless of what he does. If the thing goes all the way to the Supremes I have a feeling the lower court will be overturned. The Court has 6 Roman Catholics on it.

    1. You spelled out my position perfectly. I think it was as long ago as 2000 that the FDA said Plan B was safe for all ages. And still we see politics and religion getting in the way. It hadn’t even occurred to me that there are 6 Roman Catholic justices on the Supreme Court. What a travesty it would be if their religion came into play (of course we’d never hear it stated that way).

    1. I voted for him but have been greatly disappointed with many of the things he’s done — or not done. And this is certainly one of them. It infuriates me that he pontificates about protecting women’s reproductive rights and then doesn’t do it.

  2. Has nothing to do with liking or not liking the President.
    Here, it’s statutory rape at age 15.
    At that age, parents need to know.
    This option should be available to child and parent by a doctor if needed after an examination and serious talks.
    Young teens and preteens don’t fully think – and often take “street knowledge” as truth. “Older” ones will buy it for a panicked younger sister or friend. Rumor will be the information these kids have about this pill – it doesn’t protect against STDs – and they must understand how it the pill works/ the time frame – and possible side effects – when to seek medical help. (drug trials were not done on this age group)
    Yes there are 5th graders getting pregnant – often by a family member.
    And back to that main point: 15 is statutory rape

    1. Doesn’t matter if it’s statutory rape, rape, or just bad judgment. Any female old enough to get pregnant (sometimes as young as 10) should have access to Plan B — immediately. Delay a day or two waiting to see a doctor and it may already be too late to prevent a pregnancy. Where’s the logic in letting a 14-year-old get pregnant but protecting a 15-year-old?

      1. True. It should be available. ER’s have them. Or a parent can buy. Or someone 18?
        But there are real health concerns with young kids using them….and you know even younger kids will get others to buy them if they are scared. (They might not even be pregnant – just want to make sure…and repeat…and repeat)
        Like you say, kids do tend to “pretend” things will magically go away – and wait too late.
        There was a case here – some 10 years ago an incoming 5th grader was pregnant by relative…there was a big fight over whether her parents should be allowed to terminate the pregnancy…the father did not want proof he raped the kid…is there any chance a “caring/raping” relative will repeated give the child the pill to protect himself from going to jail?
        It’s a very complex issue.
        Like kids think legal or not legal ….
        My real concern is the health issue – this has not been tested in clinical trials at this age – the company said so …hate to find out later this was a bad idea.
        Although the pharm company is going to make a ton of money this way…and that’s what’s important, I guess

        1. Well, for starters, you don’t wait until a baby is born before you test for rape and charge someone with it. That should happen in the first 12-24 hours and whether or not the woman ultimately gets pregnant is irrelevant. Rapists are charged at the time of the rape, not 9 months later. Of course it’s possible that some sick person might decide to repeatedly rape a girl and keep giving her Plan B. But normally the rape will be revealed and the rapist will be charged long before any possible pregnancy becomes apparent. Situations like that are no reason to keep the pill away from the thousands of women who would benefit from it. For the girl, it’s her body, her choice. Ideally her family will be involved too. But that’s for them to decide, not us.

        2. It is a real mess. That case went on forever – the kid ran away, Girls said no abortion, please. The parents wanted abortion…judges – lawyers – until it was to late. Father is in jail.
          It is for women to decide. And the option should be available at ER and docs for even children (Over the counter fine for older girls and women)
          But at 15 kids can’t drive, buy beer – because they lack good judgement. Society chose to protect children
          Over the counter bothers me for this young age group. It will be misused and handed out like candy by their peers.
          Do make it easily available: (parents can always buy it for them – ERs, clinics, docs)
          I really believe this is a big money grab by pharm. (no tests on this age group – no test on this age group for repeated use) Young girls died from a rushed birth control pill that was marketed to teens for clear skin. That one was pulled and reformulated.

        3. Yaz was/is available only by prescription. The back story on how it came to market (conflicts of interest), what it contained (a new synthetic hormone), and how it was prescribed is complex. The LA Times
          explained how Plan B is different:

          One reason it’s safe is that, even though Plan B is similar to birth control pills, it has no estrogen in it — only levonorgestrel, a progestin hormone. That means Plan B does not carry the risks of blood clots that pills containing estrogen do. Also, Plan B is a single dose drug, not something women take every day (or nearly every day).

          I suppose any ruling that expands the size of a product’s market could be called a money grab, but in this case I think it’s important to do so. After all, there are plenty of other birth control and contraceptive products for sale over the counter to all ages. Nobody argues that they are money grabs, that they shouldn’t be available to kids under 15, or that they will be misused or abused.

          As I noted in my post, there are kids out there who, for any number of reasons, can’t or won’t talk to their parents about sex or a possible pregnancy. An unwanted pregnancy and its lifelong effects are a high price to pay for not talking to one’s parents.

        4. Also not always your friend are acetaminophen, diphenhydramine, dextromethorphan, or any of the thousands of other non-prescription drugs available over the counter to all ages. Not trying to second guess you, but I think much of the objection to Plan B is not to the drug itself but because it involves s.e.x., and many adults just don’t want to admit that some young girls can and do have sex and get pregnant.

        5. Oh, too much in a hurry – just to clarify, yes there is a time frame to prove rape with physical evidence. But the baby’s DNA can and has identified rapists. (why a raped woman would prefer to have the child is beyond me, but as you say, it’s their choice)
          WIth the young girl, she tried to tell her mom who didn’t believe her. She told a teacher who called CPS and put her in foster care. Once the baby was born, the DNA confirmed the father. (He had fought to eliminate the evidence). Mother divorced him, got custody of daughter and grand daughter and is raising them as sister.
          In another case of college woman, given date rape drug, knew she was raped but didn’t know by whom. DNA fingered the rapist.
          Another case, the rapist’s DNA was in the criminal system records, so they picked him up and charged him. (victim was battered after rape and didn’t see his face at the time)
          Just to be clear, Plan B should be readily available to those of all age who need it. Having it over the counter for 15 yr olds seems profit driven.
          But children raising children isn’t good either.

        6. Doh! Of course the baby’s DNA would prove paternity. Don’t know what I was thinking. But as much as I’d want my rapist identified and convicted, I sure wouldn’t take an unwanted pregnancy to term just to nail him.

          I do remember reading something about that poor girl whose father raped her. Don’t I recall that even though she could have had an abortion, for some reason (other than proving paternity) she wanted to have the baby? Such a sad story. So many lives turned upside down.

  3. I am conflicted about this. I am constantly nagged by pregnancy issues that make it incumbent upon women to terminate pregnancy that should not have happened in the first place and thus make men think they can have sexual access with no consequences – the girl can just undo what they have done to/with her. My mother ran a home for unwed mothers when I was a teenager; I saw the full spectrum of consequences, good and bad, both for women who decided to keep the baby and those who did not. Plus, I do not completely sign on to science that says there is no down side to something like this – we are finding out the consequences of things we did 30, 40, 50 years ago that seemed harmless then and we now have epidemics that so far have no known cause (colitis, Chron’s, MS, autism, allergies). We must proceed with great caution with these tender lives. If a 13 year old needs plan B, then she needs an adult to guide her though that decision, I think. After all, as someone pointed out, at that age, it’s statutory rape. I don’t call it freedom, just putting this stuff on the shelf, I call it abdication of our responsibility as adults to protect our children. I’d put it at 18, with cigarettes, and post a prominent sign that says if you need help with a pregnancy scare, please contact (social service agency, who will have pills to dispense) – these girls need more than just a pill if they are that young.

    1. I appreciate your concerns, but you have the option of assuming responsibility for your children and teaching them to be responsible. You and your family can make that decision. But not all parents are responsible, and certainly not all kids are. Plan B is an option that should be available to those who want and need it. Those who have fears about its safety should just not use it. Consider what an unwanted pregnancy does to a young girl’s life. Or any woman’s life. I’d say Plan B is far better than a growing number of unwanted teen pregnancies among girls who can’t take care of a baby or don’t want to, and whose plans for their adult lives would be shattered by an unplanned, unwanted child. It’s not fair to deny those women the help they need just because you personally have doubts about it. Like abortion, it’s their decision, not yours.

      Perhaps I should point out that my dad was an ob/gyn and a co-founder of Planned Parenthood of Central Oklahoma. And I worked for the medical association for 15 years. So I’m not unbiased. I feel very strongly about women’s reproductive health rights. Plan B is a safe, legal drug for women of all ages and the court has ruled they should have access to it. Politicians are not qualified to overrule the best medical judgment of physicians.

      Of course we should be cautious with children’s lives. But if we had been too cautious, too leery about every scientific and medical advance, children today would not be getting immunized against a number of diseases that used to run rampant. They would not be benefitting from antibiotics and advanced surgeries that save their lives. Yes, over time we sometimes recognize problems and we change or adapt. But look at all the lives that have benefitted in the meantime. One constantly has to weigh benefits against risks and make decisions based on the best available information. In the case of Plan B, those with the best available knowledge have determined it is safe for females of all ages and should be available to them. Consumers are free to use it or not; it’s their choice.

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