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Saturday, 6 April 2013

Plan B and Why It Should Always Be Available Over the Counter

By: Liberate Zealot
Content Warning: Mentions of rape and child abuse.

So I've been working part-time for a prominent reproductive and sexual health and rights group for a little over a month (which is one reason I've been posting a bit less).  And, as I'm sure many of our readers know, on Friday there was a massive explosion in the US on these issues.

I refer, of course, to the federal ruling that Plan B become available over the counter to people without age limitations.
Which I think is awesome news!  Yay for increased reproductive rights!  Yay for better protections against unintended and unwanted pregnancies!  Yay for increased youth rights!  Yay for science and logic and medicine!

Of course this being the US this awesome news quickly became big and controversial.  And thus I spent much of Friday researching the issue (specifically the anti side) to prep one of our board members (and a doctor practicing at one of the premier hospitals in the country) for the several interviews she gave with local news stations.  And Saturday I received a media briefing where 60 major state and national media outlets wrote about the ruling (and had to read the majority of them).

So now I want to sit down and write about my thoughts on this ruling, specifically to counter all the myths about Plan B and the negative response to this ruling. (Because after this being my life for two days I have so many thoughts).

Plan B is really an abortion pill!

No, just no.  Take some science, please.  Plan B is really just a double dose of standard hormonal contraceptives and works in the same way.  It's primary method of stopping pregnancy is by keeping ovaries from releasing eggs, otherwise it keeps an already released egg from being fertilized.  It does not work if someone is already pregnant, and it does nothing to fertilized eggs.

Plan B is Dangerous!  It's a Mega Dose of something that needs a prescription!
Yes, Plan B is a double dose of hormonal birth control.  Yes standard hormonal birth control (which is taken once a day, 20+ days a month, for many months if not years) requires a prescription. This does not make Plan B dangerous or somethings that should have a prescription.  The reason is the amount of time that you're taking the pills for. For Plan B you take one or two pills over the course of 12 hours.  The regular Pill is taken at the same time every day for months if not years.  This results in a lot of differences between the potential side effects of these medications.  A bad reaction to Plan B includes nausea, headaches, diarrhea, abdominal pain, and an early or particularly painful period (these reactions aren't necessarily rare, but also not standard reactions).  A bad reaction to the standard pill includes stokes and seizures (these are rare but can happen).  See the difference and why Plan B doesn't have any medical/safety need for a prescription but the regular Pill does?

Plan B is Dangerous for Younger Teens!
Nope.  Once your body is capable of reproduction the hormone production of your body and the levels necessary to prevent an unwanted pregnancy are pretty much the same.  They might change person to person, but the changes between 13 and 16 or 19 year olds are practically non-existant.  Which is why the FDA has ruled it safe for people of any reproductive age. (Also they've done the necessary studies).

Plan B will make younger teens more promiscuous/they won't be able to use it correctly!

Wrong again!  First off, it's standard FDA/prescription practice to assume that if older teens can handle taking a medication responsibly than younger teens can too. The reason is that the cognitive differences between 13 and 19 don't really effect ones ability to read and follow directions (and when it comes to Plan B the fact that you take it over the course of one day means it's easier to take than most medications).  However, in the case of Plan B the FDA had reservations on the psychological impact over the counter availability would have on younger teens.  So a study was done on teens' (ages 13-19) attitudes to sex, safe sex, and Plan B.  The only significant difference between teens under and over 16 was their knowledge about Plan B and how to take it, with the younger/less educated teens underestimated the time span during which Plan B would be effective.  In fact, younger teens were (a bit) more likely to state that easier access to Plan B wouldn't make them less responsible about using other primary forms of contraception (though they didn't have the same faith in their peers).
And lets be clear, no one uses Plan B as their primary source of birth control.  It's far more expensive then condoms, the Pill, and other methods.

I'm legally responsible for my child until they're 18 and so I should have final say over their health!
Actually, 21 states have laws granting minors rights over their own medical decisions.  The actual age varies (generally between 14 and 16) but plenty of states and doctors think teens with standard cognitive capabilities can make informed decisions about their health and if there's disagreement then the teens decision trumps the parents!  Furthermore, the US grants special rights and confidentiality to medical visits and treatments when they relate to reproductive/sexual health of minors as well.  The exact implementation of this changes state by state (with some states seeming to cross the line set by the federal government).  But doctors are required to protect the privacy and decisions of their minor patients as they result to sexual health (unless there are fears about safety/abuse) with the only notable exception being in the case of abortion (and the states are split on this as well).
This is because there are a lot of reasons children might not want their parents to know about their sexual concerns/choices and often these reasons are great enough that concerns about confidentiality result in teens not getting the treatment and information that want and need.   These fears include abandonment and potential abuse or neglect if their parents discover and oppose their sexual concerns/needs. And then there's the horrible fact that a parent/family member/guardian might be why the teen needs Plan B or care for their sexual health (we definitely don't want rapists controlling the reproductive choices of their victims).

Plan B is safe for anyone of reproductive age.  It's safe to be over the counter for anyone who might need to take it.  It's necessary that people who feel a need for Plan B can access it without impediments (no matter their age).  Doctors visits are major impediments for plenty of people (because of price, because of time).  Parental objections (or the fear of them) are major impediments for plenty of teens.

When it comes down to it we want people to be able to make the reproductive choices that are right for them.  We want to avoid unintended and unwanted pregnancies.  Plan B is a massively useful tool for these things.  Adults and teens have a right to access it.


  1. Small suggestion. Maybe you could institute a policy whereby every post is tagged with the country to which the poster is primarily referring.

    1. What country are you in and how are women and Plan B treated there? Do you have Plan B in your country or something else?


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