Back to Plan B
THOUSANDS OF unplanned pregnancies, many of which would result in abortions, could be prevented if the Food and Drug Administration would follow the advice of its own advisory panel and approve over-the-counter sales of Plan B, the morning-after contraceptive. Yet last Friday the FDA bowed once again to political pressures and put off a decision on the birth control method, which is already available by prescription nationally and over the counter in seven states.
More than 18 months after the FDA's experts advised overwhelmingly in favor of making emergency contraception available without a prescription, the agency itself refuses to make a decision. The latest maneuver is ostensibly to allow 60 days of public comment on the manufacturer's plan, presented over a year ago, to offer over-the-counter sales only to women 17 or older. The FDA had balked at an earlier plan without age restrictions.
The new delay breaks a promise by Secretary of Health and Human Services Michael Leavitt for a decision by Sept. 1. He made that pledge after Senators Patty Murray of Washington state and Hillary Clinton of New York said they would otherwise block confirmation of Lester Crawford as FDA head to protest the FDA's stalling.
Plan B, a series of high-dose birth-control pills, prevents 89 percent of pregnancies within 72 hours of intercourse by interfering with ovulation or fertilization. In some cases, it might act by keeping a fertilized egg from implanting in the uterus.
Plan B is criticized by opponents of both birth control and abortion and by those who believe that its ready availability could encourage promiscuity. Plan B advocates include the American College of Obstetricians and Gynecologists and other physicians' organizations, which recognize that the method does not protect against sexually transmitted diseases, as condoms do, but still favor over-the-counter sales.
In Massachusetts, the Legislature has passed a bill that would legalize sales without prescription or age restrictions by pharmacists who have received special training from the state Department of Public Health and have established a relationship with a physician who could supervise its use. The bill would also require hospital emergency rooms to have Plan B on hand for rape victims. Governor Romney vetoed the bill in June, despite having told Planned Parenthood of Massachusetts as a candidate for governor in 2002 that he supported ''efforts to increase access to emergency contraception." The Legislature should override that veto and not be swayed by the FDA's inaction.
But the best way to make Plan B more available to reduce abortions in this country would be for the FDA to approve over-the-counter sales without age restrictions.
