HEALTH CARE policy should be subject to science, not politics. But it’s hard not to see politics behind Health and Human Services Secretary Kathleen Sebelius’s decision last month to restrict girls’ access to the emergency contraceptive known as Plan B.
Sebelius made the unprecedented move of overruling a decision by the Food and Drug Administration, which had reviewed scientific studies, determined that Plan B is safe for girls, and recommended that the drug be made available without a prescription. As it currently stands, girls under 17 cannot obtain it without a doctor’s order.
This could amount to a significant barrier, since Plan B, which reduces the risk of pregnancy if taken within three days of intercourse, is more effective the earlier it is taken. But Sebelius said that if young girls got ahold of the drug, they wouldn’t be able to “understand the label and use the product appropriately.’’ President Obama supported her decision, invoking his squeamishness as a father of two girls.
But the FDA is charged with determining health and safety, and it confirmed that Plan B was safe for use without a prescription. Sebelius’s claim that teenagers might not understand the label is a fig leaf for moral concerns about adolescent sexual behavior, and a possible nexus between contraception and encouraging sexual activity. However understandable these concerns are, hijacking an FDA ruling is the wrong way to address them.
A more reasonable approach would be to label the drug safe for use without a prescription but for states to pass laws requiring it be kept behind the pharmacist’s counter. That alone would convey to teenage girls that it’s a serious step to be taken only in an emergency, and ensure that a pharmacist is available to answer any questions.
But overturning an FDA ruling on the basis of extreme scenarios involving very young adolescents ignores the good that broader availability of a demonstrably safe drug would do. For instance, making Plan B more accessible would likely reduce abortion rates - particularly among young girls. A recent study from the Guttmacher Institute found that teens are more likely than older women to get second-trimester abortions. And Patricia Quinn, executive director of the Massachusetts Alliance on Teen Pregnancy, points out that the minors most likely to use Plan B know they don’t want to have babies, and would likely seek an end to any pregnancy.
Easy access to Plan B would also help victims of sexual assault. The Centers for Disease Control and Prevention found that nearly 1 in 5 American women is the victim of rape in her lifetime, often by an intimate partner. And 42 percent of those cases were before the victim was 18. After a trauma like that, emergency birth control would amount to one form of relief.
Sebelius’s claim that teenagers might not understand the label is a fig leaf for moral concerns.
Sebelius has said that Teva, the drug’s manufacturer, can marshal more facts and resubmit its application. If the company chooses to do so, a decision should come swiftly - without politics, and for the benefit of girls.