Saving Plan B from the Zealots

By Ellen Goodman
The Boston Globe
Friday 16 September 2005

Now that we have waved "Bye, Bye, Brownie" to Michael Brown, the hapless head of FEMA, could we turn our sights back to another agency on the skids: the Food and Drug Administration?

If FEMA is an example of a government run on cronyism, the FDA has become a portrait of a government run on ideology. After its blunders over Vioxx and defective heart devices, it has now deliberately tanked the homeland emergency contraceptives.
Days before Katrina hit New Orleans and flooded the news, FDA chief Lester Crawford announced that he was indefinitely postponing the sale of Plan B over the counter. As Susan Wood, the respected head of the FDA's Office of Women's Health, said when she resigned in protest, "This time delay is denial."
I will spare you the long, convoluted history of the morning-after pill and the FDA. Plan B was planted firmly in the common ground in the culture wars. Pregnancy prevention is, after all, abortion prevention. It's something we agree on.
Putting Plan B on the drugstore shelf would mean that women who had unprotected sex or contraceptive failures could easily and quickly prevent pregnancy.
But under pressure from the pro-life fringe that insists against all evidence that emergency contraception is abortion in disguise, the FDA caved. Executing a fandango that Karl Rove would admire, the FDA first boxed the manufacturer into seeking permission for over-the-counter sales only to those 17 or over. Then it rejected the adults-only plan on the grounds that the pills could still fall into the hands of younger teens.
In the furor that followed, what no one dared suggest is that just maybe teenagers should have the easiest, not the hardest access to Plan B. Aren't the youngest precisely those who should be most protected from pregnancy? Or do we still think that motherhood should be the punishment for sex?
A little background. This is a pill proved safe and effective for all ages. There is no evidence that its availability increases sexual activity. But there is a good deal of evidence that teenagers have become the easy target in the struggle over reproductive rights.
Much of the antiabortion action can be summed up in two words: Teenagers First. The abortion case that will come up before soon-to-be chief justice and umpire John Roberts is a New Hampshire law that would impose further restrictions on abortion. It requires parental notification with no exception for a pregnant girl whose health is at risk.
Meanwhile in the Senate, one of the top 10 Republican priorities is a bill that would make it a crime for any adult - aunt, grandmother or sister included - to help a teenager cross state lines to avoid parental notification laws.
In states like Tennessee, Alabama, and Pennsylvania, where teenagers need to ask a judge for the right to decide for themselves, there are increasing numbers of jurists opting out of hearing these cases on moral grounds. So much for mere umpiring.
But back to the elusive common ground. Contraception is also becoming a teenage combat zone. Tom Coburn, the Oklahoma senator who believes in capital punishment for abortion providers, just introduced a bill that would require parental notification before contraceptives are given to minors at federal clinics. Birth control, he believes, "encourages unintended teen pregnancies and abortions" - a scientific notion that qualifies him for a post at the new FDA.
Coburn's misinformation is nothing compared to the abstinence-only disinformation by purveyors who reject even teaching birth control to teenagers. They fear a "mixed message" - abstinence plus contraception - more than a false one.
The Teenagers First plan works because it is so easily cast as a teenage protection plan. What parent doesn't want to put up an emotional umbrella over their child? Wendy Wright of Concerned Women for America has actually described the morning-after pill as "a pedophile's best friend." Say, what?
We've had good news in the past decade, a 10 percent decline in teen pregnancies due mostly to contraception and also to abstinence. Yet some 40 percent of girls get pregnant while they are still teenagers. Meanwhile, 98 percent of parents in one pediatric study said their teens were virgins. You do the math.
If teenagers also need Plan B it's because Plan A - abstinence - fails more often than condoms. Too many teenagers end up pregnant, facing Plan C: abortion or motherhood. In the name of protection, we are leaving teenagers far too vulnerable.
The FDA has given politics a veto over science. They have used the teenage cover story to keep emergency contraception out of easy reach of women of any age. Teenagers first. That's just the beginning.