Maryland's Plan B

March 07, 2006

Thanks to the Bush administration's politically motivated foot-dragging, states such as Maryland have been forced to confront the issue of the "morning-after pill" or "Plan B" contraceptive. Plan B shouldn't be regarded as particularly controversial. This is not RU-486; it doesn't terminate an established pregnancy. Supporters believe it will actually reduce the number of abortions in this country. But the Food and Drug Administration's failure to decide whether to allow the drug to be sold over the counter - despite the endorsement of the agency's staff and many years of scientific review - has put the onus on states to take action.

Available by prescription since 1999, Plan B is nothing more than two high-dosage pills of the drug levonorgestrel that can be taken up to 72 hours after sexual intercourse to prevent pregnancy. It's a drug designed for the unexpected. That's a prime reason why it needs to be available without a prescription. A teen who has unplanned, unprotected sex on a Saturday night is unlikely to get an appointment with her family doctor on Sunday to discuss her circumstances.

In Maryland, the General Assembly is considering a bill that would give trained and certified pharmacists the ability to dispense the synthetic hormone without a prescription to people who need it immediately: Certain procedures would have to be followed. The pharmacist would have to screen the user to make sure the drug is appropriate, and provide her with information about how to use it - along with a fact sheet on the risks of sexually transmitted diseases.

At least eight states allow trained pharmacists to dispense the drug. And that number is expected to rise: State legislatures recognize that there's little chance the Bush administration will allow the FDA to act on Plan B before midterm elections.

Some religious conservatives oppose this idea, but much of their criticism is moralistic, not medical. They presume that having a contraceptive more readily available encourages teens to have sex. That's the same sort of reasoning that has discouraged traditional sex education and a more widespread use of condoms - and completely ignores the reality of teen behavior.

Plan B is clearly not the ideal contraceptive. It doesn't protect the user from HIV or other sexually transmitted diseases. But that's not the point. The morning-after pill is for emergency circumstances when a woman who has had intercourse wants to avoid becoming pregnant. The primary effect of the drug is this: fewer unwanted pregnancies. By any reasonable secular standard, that's a desirable outcome.

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