Thursday, June 01, 2006

EC for EW (Emergency Contraception for Every Woman Who Needs It When She Needs It)

Note: given the news about the FDA’s current proposal to allow plan B Emergency Contraception (EC) to be sold over the counter—BUT with requirements that women under age 18 must have a prescription and that pharmacists must keep all EC behind the counter thus making it more difficult for women of any age to access, I thought a brief reminder of what EC is and why it should be fully accessible to all who need it is in order.

Want to reduce abortions by half? Want to know who is keeping the means from American women?

The topic is emergency contraception—EC for short. You might have heard it called the morning after pill. It’s birth control—just basic birth control pills in a formulation that can prevent pregnancy from occurring if used within 120 hours after intercourse.

Research predicts that if it were readily accessible, well-advertised, and properly used, EC could prevent about half of all unintended pregnancies and abortions. Imagine!

The World Health Organization says it is completely safe for over-the-counter use, and 39 countries already make it available that way for women of all ages. It is supported by the American Medical Association, American College of Obstetricians and Gynecologists, American Academy of Pediatrics, and a wide array of public health professionals.,

And no, making EC widely available doesn’t make women promiscuous. We actually have the brains to use it appropriately.

Nor do women use EC as a substitute for their regular methods of contraception. In fact, when they have EC in their medicine cabinets in advance of need, it seems to serve the same purpose as the proverbial string tied around your finger.

So if EC really could prevent many unintended pregnancies and abortions, what’s the debate? Why is there any debate? And why should we care?

The fact is, Emergency Contraception is a vital component to comprehensive health care for women—it is literally, a woman’s “plan B”—if the condom breaks, if a woman has been sexually assaulted, if she thinks her regular contraceptive didn’t work for whatever reason--and that should be personal.

But it has become a political fight in which the science and medicine are being trumped by the politics of an ideological battle. For a timeline of the long-running battle over EC, take a look at this: Over-the-Counter Insurgency.

Those opposed to EC are the same people who oppose both abortion and family planning in other venues based on narrow ideological and religious views they want to force upon all of us regardless of what the evidence shows. In Fact, FDA officials have testified that they were forced to place the politics over the known scientific facts and their own best judgment.

An editorial in the New England Journal of Medicine called it “A sad day for science at the FDA”, when FDA management bowed to political pressure…and continued to ignore the recommendations of its own scientific committees.

I think “sad’ is way too timid a word. It is an outrage.

Because, after all, mistakes happen. Condoms break. And not always during regular business hours. And women who have suffered the trauma of rape should not have to endure the second trauma of worrying that they might become pregnant.

One courageous and ethical woman, Dr. Susan Wood, resigned from her FDA position as director of its Women's Health Division in protest over its disregard of science regarding EC. Like Susan Wood, I think women deserve health care based on science, not politics, and they shouldn’t have to fight their government to get it.

So do Senators Hillary Clinton (D-NY) and Patty Murray (D-WA), rightly held up the confirmation of Andrew von Eschenbach to the post of FDA commissioner. Their stance has caused the FDA to make its latest tepid proposal. I say, Senators, hold tight until the FDA decides to actually make the approval with its current restrictions removed and an affirmation that the scientific evidence will prevail.

Since unfettered access to EC could prevent half of all unintended pregnancies and abortions, let's celebrate this incremental step forward for women's health while we continue to work toward what 39 other countries have already done: make EC available without prescription to all women of all ages. There is no medical reason not to.

The Bush administration has played retail politics with women's health for many years. Now they have been bested at their own game. Senators Patti Murray (D-WA) and Hillary Clinton (D-NY) held up confirmation of Dr, Andrew von Eschenbach's nomination to be FDA commissioner until he capitulated and replaced his shameful political-ideological policy with legitimate science.

It took politics to overcome politics and allow medical science to prevail on medical decisions. I hope the Democrats will grow some balls when they see that they really can play to win. And how about the fact that it took two women to demonstrate this fact?

© 2006 Gloria Feldt

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