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Obama Agrees with HHS on Restricting Access to Morning-After Pill

The President was asked today about Kathleen Sebelius’ rejection of an FDA directive to allow the morning-after pill on drugstore shelves without a prescription. And he agrees with his HHS Secretary:

“I did not get involved in the process, this was a decision of Kathleen Sebelius,” Obama said, referring to his Health and Human Services secretary.

“I will say this. As the father of two daughters, it makes sense to apply some common sense,” Obama said.

He said Sebelius “could not be confident a 10 year old or a 11 year old going to a pharmacy would [not] be able to… buy a medication that could have an adverse effect.”

This is just totally non-responsive. There’s no common sense in justifying this with what a 10 or 11 year-old might do unless you also take Tylenol off store shelves, or any other OTC drug that can harm people if taken improperly. In addition, part of the FDA’s testing around this concerned the safety of the drug for adolescents, as Jon Cohn writes.

In ruling to keep Plan B behind the counter, Sebelius cited a very specific concern: The fact that some girls start having sex at very young ages – 13, 12, even 11 – and might not have enough cognitive development to take the drug properly. My understanding is that the concern isn’t simply that very young girls will take the drug on their own, potentially misreading the directions, but that they’ll start to use the pill as a regular form of contraception – potentially getting higher, dangerous levels of hormones.

But the FDA examined this issue, among others. As Maggie Fox of National Journal reported on Wednesday, Teva, the drug’s manufacturer, had provided the FDA with studies on 11- to 16-year-olds. “The FDA based its decision on years of data about adolescent health,” says Stanford University’s Lee Sanders, a pediatrician and leading scholar on health literacy. “That includes research on the specific question of how adolescents will use contraception.”

Every leading medical association recommends stocking the morning-after pill on store shelves, for a variety of important reasons. There’s a time constraint – 72 hours after intercourse – in taking the drug, and the hoops young women have to jump through to get access now are too high. Girls in this position are typically reluctant to get a prescription, and forcing this step increases the chances that they don’t get the help. More unwanted pregnancies and more abortions will result from denying this drug.

By the way, this isn’t only true for younger women, but all of them, as this oral history shows:

1998. “I actually had a doctor’s appointment for the following week, when I was planning to see about starting on the pill for the first time—so of course that was the week my boyfriend and I had a condom mishap. I go to a walk-in clinic [in Canada, where the drug was already available], and a young male doctor listens to the story and prescribes EC—but as he tears the prescription off the pad, he looks at me with utter contempt and says, ‘Next time, try the pill.’ Then he turns and exits without so much as a goodbye.” —Kate Harding

2000: “You couldn’t get Plan B without a prescription back when I needed it for the first time, so it was a pretty stressful experience. Until it wasn’t. I’ll let my 10th grade diary tell you the rest: ‘So [my bf] comes back from the bathroom and tells me the condom broke. He sounds like a little boy, scared, worried, uninformed… I find myself consoling him rather than the other way around. We decide to get the morning-after pill, but I call [clinics], and nobody’s open on Sundays! What is this? A lot of people have sex on Saturdays, how can things not be open?… I called [my best friend] Sarah, and since I trust her mother, she told her mother and she is calling her doctor so that she might get a prescription. God, they should have them at Rite Aid or something, this is horrible waiting… Okay, this is 3 hours later, and I took the pill. Also, my mother now knows I have sex.'” —Nona Willis Aronowitz

Many more stories along the same line at the link. The costs Sebelius and Obama describe, which allegedly outweigh the benefits, don’t make much sense. Plan B One-Step costs $50, not exactly cash that an 11 year-old has on hand. This has more to do with willful blindness over sexual activity, a kind of paternalism (fully expressed by the President), than any sound policy rationale.

The Center for Reproductive Rights is fighting the age limit on prescriptions in court, before the same judge that previously lowered the age for needing a prescription from 18 to 17. They now want to remove all age restrictions, and it may happen. Hopefully this shameful chapter in denying women legal and safe medical options will end.

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David Dayen

David Dayen