On May 6, 2004, the Food and Drug Administration (FDA) declined to make the morning-after pill, also known as Plan B, available over-the-counter (OTC) without a prescription. Proponents of the morning-after pill fought back, alleging that "politics trumped science." But do their claims stand up to scrutiny?

Claim #1: The morning-after pill does NOT cause an abortion.

Web sites that promote the morning-after pill claim that it "will not cause an abortion." However, they also state that one way that the morning-after pill can prevent pregnancy is by inhibiting implantation in the uterus. They fail to say what is inhibited from implanting. It is an embryo, a human in the earliest stage of life. Embryos contain 23 chromosomes from the mother and 23 chromosomes from the father - the full genetic information of a distinct human being.¹ This "inhibition" caused by the morning-after pill terminates a human life.²

Claim #2: The morning-after pill has been adequately tested and is safe for all users.

The FDA declined to approve the morning-after pill to be available over-the-counter (OTC) because it has not been adequately tested to ensure that this high level of hormones can be used safely by adolescents, who constitute a target market for the drug. As the owner of Plan B admits, there are no data on what occurs in an overdose.³ This could occur if a young woman decides to take an extra dose when she experiences the common side effect of vomiting or, in her belief, to increase its effectiveness. It is currently unknown whether a maximum, safe, daily, monthly, or yearly dose exists.

Promoters have not conducted the necessary studies, yet claim that it's been proven safe.

Claim #3: The morning-after pill will be used for emergencies only.

Proponents describe "emergency" as any "unprotected intercourse or a known or suspected contraceptive failure (i.e., a broken condom)." The morning-after pill is seen as another form of birth control. In fact, the study that Barr Labs submitted to the FDA found that a full one-third of women did not know - after being counseled and reading the label - that it was not to be used as a regular form of birth control.⁴ That number increased among younger women and those with lower literacy, and does not account for those who do not read English.

This proved true in Jamaica when the morning-after pill was made available through pharmacists; pharmacists reported that a disturbing number of schoolgirls were buying the drug, and that a drop in condom sales also occurred.⁵ Doctors in Spain admit that many times, for young people in particular, the morning-after pill is the principal or only contraceptive method used. They recorded some women taking the drug as often as seven times a month.⁶

OTC access means there will be no record of the frequency that a woman takes the morning-after pill. She could go to multiple pharmacies to make multiple purchases of this high-dose birth control. Pharmacists in countries that have tried this easy-accessibility approach, such as Jamaica, Thailand and the United Kingdom, have found this to be the case.^{7,8, 9}

Most disturbingly, pharmacists report that schoolgirls buy it multiple times.¹⁰ This makes sense, considering they would be drawn by the opportunity to keep their activity secret.

Claim #4: The morning-after pill will decrease the number of abortions.

Those depending on the morning-after pill as a contraceptive must take into account that it prevents pregnancy only 75 to 89 percent of the time.¹¹ If more women rely on the morning-after pill, particularly as a form of birth control, the number of failures will increase as well. The final result appears to be more pregnant women who resort to abortion.

Sound far-fetched? Take for example the countries that have made the morning-after pill accessible to the public without a prescription. In Scottish schools, teenage pregnancy among 13- to 15-year-olds rose 10 percent in one year.¹² In 2006, the country reported the highest number of abortions since abortion was legalized in 1967.¹³ In the United Kingdom, abortion rates increased by 6,000 in one year with the largest leap among girls younger than 16 years old.¹⁴

Countries where the morning-after pill is easily accessible have experienced an increase in sexually transmitted diseases (STDs).¹⁵ In the United Kingdom, specific STDs such as gonorrhea increased by 50 percent in only three years after the morning-after pill was distributed without prescription.¹⁶

In a four-year period, the number of cases of Chlamydia went up 76 percent. Gonorrhea went up 55 percent. Syphilis went up 54 percent. Genital warts went up 20 percent.¹⁷

Claim #5: Pharmacists are qualified to distribute the morning-after pill.

Pharmacists cannot conduct medical exams to detect medical conditions. Heart and liver problems, for example, exclude women from taking oral contraceptives, which are just low doses of the morning-after pill. The public setting of a store limits pharmacists' counseling on private matters of abuse or personal medical issues, conversations that are especially crucial in the process of dispensing oral contraceptives to minors. If a doctor is dispensing federally funded birth control and suspects a case of statutory rape, he is required by law to report the situation.¹⁸

OTC availability of the morning-after pill means that women who have not been counseled or screened for medical conditions, and who may not have access to a physician in case complications arise, have unlimited access to Plan B.¹⁹

In the United Kingdom, after the morning-after pill was made accessible through pharmacists, nurses with the Royal College of Nursing complained that pharmacists were failing to warn women of possible complications and failing to carry out routine medical assessments.²⁰ In addition, many pharmacists expressed concern over its easy accessibility, claiming that young girls were requesting the pill multiple times and were easily able to hide their consumption of this drug from their physicians.²¹

Claim #6: Easy access to the morning-after pill will benefit women.

Although supporters of the morning-after pill claim to have women's best interests at heart, easy access to Plan B can actually be used to exploit women and could endanger their health.²² If the morning-after pill is available OTC, anyone could buy it and slip it to a woman without her knowledge. A woman who may want to be pregnant could become the victim of a man who does not want her to have a child.²³

OTC access of the morning-after pill could potentially harm young girls in particular. Interaction with a physician is crucial to discovering STDs that could lead to infertility or cancer, and intervening to rescue girls who are being sexually abused.

As the age of a sexually active girl decreases, the chance that her first sex was unwanted or involuntary increases.²⁴ Teenage girls make up the largest percent of the population that has experienced rising abortion and STD rates in conjunction with nonprescription access to Plan B.^{25, 26}

Easy access to Plan B would enable statutory rapists, adult men who are having sex with minors, to have unhindered access to the pill to cover up their crime.

Claim #7: Women need immediate access to the morning-after pill.

Making the morning-after pill available OTC means it will be available to the entire public, including adolescents and women with contrary medical conditions. Yet advocates are arguing that these women should be put at risk to accommodate women who demand not only quick access to the drug, but with no questions asked by medical professionals.

Claim #7: The FDA and those who oppose easy access to the morning-after pill are putting politics and an "anti-choice" agenda ahead of science.

The FDA declined to make the morning-after pill OTC due to a lack of adequate testing of the pill, and common-sense concern about the consequences.

The morning-after pill is a high dose of the birth control pill. Let's re-emphasize that fact: The morning-after pill Plan B is the birth control pill, except that it is stronger, equal to 25 regular birth-control pills.²⁷

The FDA has never approved a medicine as OTC when a lower dose of the same drug requires a prescription.

Another medication, RU-486, also known as the abortion pill, terminates an unborn child's life in the first trimester. It is associated with six women's deaths in the United States and is different from the morning-after pill. However, abortion advocates have conducted tests using RU-486 as a morning-after pill. If the morning-after pill were approved to be available OTC, it could open the door for consideration of OTC access to RU-486.

Easy access to the morning-after pill has become a political substitute for the abortion debate. As abortion advocates have lost elections, legislation and public opinion, they have diverted attention to the morning-after pill. Yet as the evidence shows, easy access does not live up to their promises.

Women should not have to pay the price of STDs, abortion and abuse so that abortion advocates can score a political victory.

ABOUT THE AUTHORS

Wendy Wright is President of Concerned Women for America (CWA). Jody Porowski, a student at the University of North Carolina-Chapel Hill, is an intern with CWA.

This article originally appeared at http://www.cwfa.org/articles/11112/CWA/life/index.htm on July 13, 2006 and is reprinted with the permission of Concerned Women for America.  The Concerned Women for America Website is located at http://www.cwfa.org  

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