Rights. Respect. Responsibility.® Emergency Contraception Campaign—Make EC Available Without a Doctor's Prescription for ALL Women
Questions and Answers
The Rights. Respect. Responsibility.® campaigns are national campaigns, created by and for young people, demanding our right to sexual health information and services. We are working to secure 1) over-the-counter access to emergency contraception, 2) comprehensive sex education in America's schools, 3) realistic global HIV prevention programs, and 4) increased U.S. funding for international family planning. The Campaigns brings together youth working in the field of sexual health, creating a coordinated movement to fight at local, state, and federal levels. Through these Campaigns, Advocates for Youth supports youth activists from all over the country, encouraging organizations to sponsor and participate in grassroots activities to bring the issue to the forefront of the nation's agenda.
What is emergency contraception?
Emergency contraception is a method of preventing pregnancy after unprotected sexual intercourse or when a young woman's regular method of contraception may have failed. EC is sometimes known as the 'morning after pill' or, sometimes, as "post-coital contraception." Plan B® is the brand name under which EC is distribted in pharmacies. EC can be taken up to 120 hours (five days) after unprotected sex. EC is about 75 to 94 percent effective at preventing pregnancy, depending on how promptly a young woman uses it, the kind of EC she takes, and when during her menstral cycle she had sex. It is most effective when begun in the first 12 to 24 hours after unprotected sex.
Is EC Safe?
Use of birth control pills as emergency contraception has been practiced since the 1960s. In fact, the American Medical Association, the American College of Obstetricians and Gynecologists, and the Society for Adolescent Medicine support easier access to EC, asserting that EC is entirely safe for teenage and adult women. Numerous studies of regular use of oral contraceptives (even the older, higher dose preparations) found no increased risk of birth defects. EC is safe enough that it is already available without a doctor's prescription in more than 30 countries around the world.
EC's Mechanisms of Action |
"The established mechanisms of action of both combination and progestin-only ECPs include delaying or inhibiting ovulation, disrupting follicular development, and/or interfering with the maturation of the corpus luteum. Clinical data have not verified other theorized mechanisms of action that may be involved, such as preventing implantation, altering sperm or egg transport, inhibiting the fertilization process, or changing cervical mucous."
—Position Paper of the Society for Adolescent Medicine published in the July 2004 issue of the
Journal of Adolescent Health |
Does EC Cause Abortion?
EC does not cause abortion, and emergency contraceptive pills do not affect an established pregnancy. The American College of Obstetricians and Gynecologists and the American Medical Women's Association both define pregnancy as beginning with implantation and agree that emergency contraceptive pills have no effect once implantation has occurred. Then, too, the Society for Adolescent Medicine asserts that there is no evidence that EC has an effect on a fertilized egg, even before implantation. In fact, EC prevents abortion. Experts estimate that timely use of EC could prevent up to 70 percent of abortions. In fact, as many as 51,000 abortions were prevented by EC use in 2000.
Why is access to emergency contraception critical for young women?
First, about 70 percent of all young people have had sex by age 18. Most do not intend to become pregnant or to be a parent at such an early age. Yet, contraception can fail and young women—like older women—can make a mistake, such as having sex without protection. Then too, teenage women are at higher risk of sexual assault or forced sex than are older women. Finally, pregnancy and childbirth pose series health risks to young teens. Young women who are at risk of pregnancy—whether due to rape, contraceptive failure, or lack of protection—need unrestricted access to EC. No young woman should have to face an unintended pregnancy when a remedy exists to prevent pregnancy. Yet in August 2006, the FDA ruled that women under age 18 would continue to need a prescription to obtain EC.
What would over-the-counter access to EC mean?
Research shows that many women need EC on holidays, at night, or on weekends. The FDA recently approved non-prescription access to women ages 18 and over. However, a young woman under age 18 must obtain a prescription for EC from a health care provider; then she must take the prescription to a pharmacy to be filled. If she has had to wait to make an appointment and see a doctor, she may have lost considerable time—up to several days—before she can begin EC. Over-the-counter access, regardless of age, would mean that all women could get EC as soon as possible after unprotected sex. They wouldn't have to see a health care provider for a prescription. Over-the-counter access is the best way to make EC quickly and easily accessible to everyone, especially youth.
Why is over-the-counter access to EC especially important for younger teens?
All teens face significant barriers to obtaining EC. Traditional settings, such as family planning and health clinics, often have limited hours of operation, are in locations inaccessible to teens, and/or require unnecessary and expensive extras, such as the pelvic exam. Teens also frequently lack transportation, feel concern that their confidentiality will be violated, fear that parental consent might be required, and feel anxiety about pelvic and other examination procedures. Younger teens face all of these barriers and also face greatly increased health risks from pregnancy—risks such as toxemia and pre-term birth.
is EC available over-the-counter right now?
In the United States, the FDA has authority to determine which medications must be dispensed with a prescription and which may be sold without a prescription or over-the-counter. In August 2006, the FDA determined that EC would be made available without a prescription only for women ages 18 and older. It is now available without a prescription for women ages 18 and older, however, young women under age 18 still need a prescription.
What the Scientists Said |
Addressing the contention that easy availability of Plan B® might result in decreased condom use and an increase in sexually transmitted infections, Dr. Jonca Bull, head of the FDA's office that oversees decisions to make drugs available without prescription, wrote, that "again, the logic is flawed and speculative."
—Washington Post, 6/18/2004
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Dr. John Jenkins, director of the FDA's Office of New Drugs, wrote in internal memos that Plan B® did not pose any particular risks for younger women and that the agency was subjecting Barr's application to more rigorous examination than applications for other drugs ... Jenkins also said that the FDA never before had considered young women's use of oral contraceptives problematic.
—Wall Street Journal, 6/18/2004 |
Why did the FDA reject Nonprescription status for young women under age 18?
Plan B® meets all of the FDA's requirements for over-the-counter status.
- A woman can and, indeed, always does self-diagnose her need for EC.
- Swallowing two pills does not require medical supervision.
- EC is safe and effective.
Many inside the FDA say politics was involved in the decision to restrict nonprescription status to women under age 18. Opponents of contraception lobbied the FDA against making EC available over-the-counter, especially for young women. Among their claims was that easy availability of EC would increase promiscuity among teens. The non-approval letter, sent to Barr, included instructions for further research that would be needed prior to approval of over-the-counter status for Plan B® for all women.
What Does dual labeling mean? Why Is It a bad idea for teens?
Dual labeling means women age 18 and older can go directly to the drug store and get EC without a prescription. Those under age 18, however, continue to need a prescription. The decision to create a dual label hurts all young women, by creating confusion and unnecessary limitations on access to EC.
Even for older teens, "carding" is a bad idea—one that is likely to prevent many young women from purchasing EC. Clearly, the barriers to getting EC are significant for teens. To ensure that teens have access to EC and can prevent unintended and unintended pregnancy, unrestricted over-the-counter access is critical!
Could Dual Labeling Status Affect Teens' Access to Other Contraceptives?
Currently, condoms and other contraceptives are available to sexually active teens regardless of age. This seasoned public health practice recognizes that there have always been, and probably always will be, sexually active teens. Providing these young people with access to sexual health information and services can help them protect their health and even save their lives. If the FDA approves dual labeling status for EC, a precedent will be set—making it easier for opponents to restrict young people's access to other contraceptives and even to condoms in the misguided belief that such restrictions would keep young people from becoming sexually active. In reality, however, these restrictions further expose some of our most vulnerable teens to unintended pregnancy, early parenthood, and greater risk for HIV and other sexually transmitted infections.
What Can I Do?
Sign the petition demanding that the FDA ensure that all women, regardless of age, have over-the-counter access to EC.
Still want to do more?
- View Advocates' electronic public service announcement (ePSA) and send it on to your friends so they can sign the petition.
- Educate your friends. Send them an e-mail letting them know how to get EC before they need it.
- Join up with other youth activists through the Youth Activist Network.
- Conduct a survey to find out how available EC is in your community. Write a letter to the editor of your local or state newspaper.
- Get others involved. Plan local events! Advocates' Campaign Toolkit has great resources for making these events successful.
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