Diane Ellsworth
Target Audience: Women, age 18-24.
Purpose: Convince them to have a supply on hand.
Every year, women across the U.S. have approximately 1.7 million unplanned pregnancies and 800,000 abortions each year. Katharine Sheehan, the medical director of Planned Parenthood in San Diego, states that if women were to use emergency contraception or have it on hand, it would reduce the need for abortion by 50 percent (B-7). What is this wonderful pill that can help in emergencies when birth control fails? Plan B (emergency contraception) is a higher dose of the same hormones contained in regular birth control pills. Emergency contraception must be taken within 72 hours of unprotected sex or birth control failure to be effective, and until the laws change giving women the option to buy Plan B over-the-counter, they have to have it prescribed to them by a doctor. So, why not get that prescription written and have it on hand? Better yet, take the initiative, get that prescription filled and have it in your medicine cabinet just in case the worst-case scenario were to happen. It has a shelf life of 48 months, so it won’t expire for four years, and if you don’t end up using it, great! The cost of purchasing Plan B is less than an abortion.
Given that Plan B is available now through a prescription from a doctor, why is it that women aged 18-24 (traditional college age) have the highest rate of unintended pregnancies in the United States and also represent the largest age group who seek abortions? In an article for the College Student Journal, Robin Sawyer states that two different studies (one over a five year trend analysis and the other a national study of college student compliance with contraception) found that similarly 37 percent of students reported not using protection the last time they had intercourse. The first study found that of the women seeking pregnancy tests at student health centers, 37 percent of the women reported using no contraception when they last had intercourse and of these women, 30 percent tested positive for pregnancy. Being unprepared and not using protection isn’t the only reason to have emergency contraception close by. Life, in general, can prove to be harmful even when prevention is taken, shown in the examples below:
Heather Minton couldn’t bring herself to tell anyone that she had just been brutally pinned down and raped at a Friday night party at the University of California, but she did insist that a friend get her out of the party fast and take her to the emergency room. She needed emergency contraception before it was too late and the clinic on campus wouldn’t be able to help her until Monday (Christopher).
Attending college campus parties can put you in a situation that can turn bad, but so can just walking down the street, which is what happened to a 19-year-old undergraduate student at Denver University. After being told to walk in groups of three or four to avoid sexual assault, three women were walking together on campus when a man seized the 19-year-old and sexually assaulted her (Daily Summit News). This would be the “worst case scenario” where you would want to have Plan B on hand. The need to take emergency contraception isn’t always the result of a violent act, but it can be a combination of many situations. For some women, it may be needed because they forgot a dose of their birth control pill, or the heat of the moment quickly changed from romance to despair at the sight of a ripped condom, or they are unprepared by not having birth control or condoms, but find they are “swept away” in a magical moment.
If you were to find yourself in any of the above situations, would you be prepared? Emergency contraception must be taken within 72 hours for it to be 89 percent effective, or better yet, if taken within 24 hours it can be 95 percent effective (Difference). Because the majority of college students are more sexually active on weekends and nearly all doctor offices and clinics are closed on the weekends, it would be best to have emergency contraception on hand in order to not miss this window. Even Planned Parenthood has varied hours of operation with no set hours overall. Each clinic seems to have its own hours, with some clinics open on Saturdays, but some of those Saturdays are only on the first and third Saturday or maybe the second and fourth Saturday of the month. Unless you “plan” your unexpected birth control failure, you may be scrambling to find an open clinic.
Of course, a college student may believe she can rely on the college health center, but all over the country college health centers make it difficult for women to obtain emergency contraception either by not offering it at all or by simply not providing weekend hours. A survey done in 1999 by the Kaiser Family Foundation, examined the availability of emergency contraception in universities and showed that only half of the universities that participated in the survey offered emergency contraception. A similar survey was recently performed in New York. In that survey, 57 percent of the 102 schools surveyed offered emergency contraception on campus, but 41 percent of those schools provided no weekend service. The survey also showed that the universities that do provide emergency contraception have restrictions on who can receive it. Of these, 73 percent stated that students can only obtain Plan B after having unprotected intercourse. Another 27 percent stated that Plan B is restricted to students who have had a second episode of unprotected intercourse during the same menstrual cycle, or have missed one or two doses of regular oral contraceptive. Another 9 percent offer it only if a woman has been sexually assaulted (Hollander 54). In reality, Plan B is not as easy to obtain as some would believe.
Even so, maybe you feel you are proactive and aren’t waiting for the unexpected and the rush to try to find a doctor or open clinic, and the last time you went in for a physical you asked the doctor for a prescription for emergency contraception. Now, can you get it filled? A recent study done in November 2003 by a group of doctors on the availability of emergency contraception through pharmacies in Albuquerque, New Mexico, proves that the answer to that question is not a simple “yes.” New Mexico is one of six states that have a law known as the Collaborative Practice Agreement that allows pharmacists to dispense emergency contraception without a doctor’s prescription. Besides New Mexico, the other states with this agreement are Washington, Hawaii, Alaska, Maine and California. The goal of the study of New Mexico pharmacies was to investigate whether women presenting a prescription for Plan B to pharmacies could get it filled. Out of 89 pharmacies in Albuquerque, Plan B was in stock at only 11 percent of them. Of the pharmacies that did not stock the product, 53 percent reported they could obtain Plan B within 24 hours. The most common reason cited by pharmacy providers for not stocking Plan B was the lack of prescriptions received for it (Espey 918). With a shelf life of 48 months, this is a poor excuse from the pharmacist on why they don’t stock Plan B, but it could also show the low awareness of women in these states of the option to obtain Plan B directly from a pharmacy. The study also showed that of the pharmacies that did not stock Plan B, if the prescription was presented on a weekday, they were more likely to be able to get it within 24 hours versus if it was presented on a weekend.
Plan B |
Pharmacy Visits |
Weekday | Weekend |
In stock |
6 |
|
|
Available within |
35 |
46% |
12% |
Available |
26 |
|
|
Never available |
21 |
|
|
Missing data |
1 |
|
|
(Espey 922)
So women find themselves in a Catch-22. If women don't know about emergency contraception, they won't come in asking for it, and if they don’t ask for it, pharmacies will decide it's not something women want. Women should also be aware that some pharmacists refuse to fill prescriptions for Plan B stating that by doing so, it would compromise their religious beliefs (Chistopher). Also, Wal-Mart, the fifth largest provider of pharmaceuticals, does not stock Plan B stating the policy, “Wal-Mart has made the business decision not to sell Plan B. However, in the interest of serving and meeting the needs of our customers, our pharmacists will refer any request for this product to a pharmacy that does carry it” (Robinson).
Let’s go back to Heather Minton’s story. After her friend drove her to the emergency room so that she could obtain emergency contraception, she was told by the ER nurse that if Heather had not been raped, they would not treat her and suggested they try another ER which was a half-hour drive to another town. Once there, Heather was not sure if they would refuse to treat her also as Heather had not wanted to report the rape, wanting to keep it confidential, and was only trying to get emergency contraception to avoid pregnancy (Christopher). Heather’s uncertainty matches many hospital workers’ uncertainty on the hospital’s policy when it comes to providing emergency contraception. The hospital in Heather’s case, when called three different times, gave three different answers: that they do not offer emergency contraception, that it depends on the physicians on duty because providing emergency contraception is an ethical issue, or that they only offer emergency contraception to women who have been raped (Christopher). Why the confusion? The reason could be that U.S. Catholic hospitals treat one in five people and represent 11 percent of all hospitals in the U.S. (Fast). Even though the standards set by the American Medical Association states “women who have been sexually abused should be counseled about the risk of pregnancy and offered emergency contraception” (Obstructing), many of the doctors at these hospitals refuse as they are directed by the Ethical and Religious Directive for Catholic Health Care Services. Directive 36 states:
If after appropriate testing, there is no evidence that conception has occurred, she may be treated with medications that would prevent ovulation, sperm capacitation or fertilization. It is not permissible, however, to initiate or to recommend treatments that have as their purpose or direct effect the removal, destruction, or interference with the implantation of a fertilized ovum ( Can Emergency).
The directive does not specify how to determine whether conception has occurred, leaving Catholic hospitals to interpret when they may provide emergency contraception (Can Emergency).
Some would argue against the request that all women be proactive and have a filled prescription of Plan B at home in their medicine cabinet when a woman can get it through a prescription from a doctor. The facts are that emergency contraception must be taken within 72 hours for it to be 89 percent effective and sometimes getting a prescription filled within that time frame is arduous because of the office hours that doctors offices and clinics have not being convenient to when Plan B needs to be taken, or because pharmacies don’t always have Plan B in their inventory. It may also be difficult if you are trying to get it from an emergency room because you may find that some emergency rooms won’t supply Plan B at all on moral grounds or only in cases of rape. You must take action and be proactive in asking your doctor for that prescription. Even though the American College of Obstetricians and Gynecologists urge all physicians who care for women of reproductive age to provide advance prescriptions for emergency contraception at every office visit, your doctor may not talk to you about it, until you ask (Schwarz). Alastair Wood, M.D. of Vanderbilt University and advisor to the FDA states, “Women should probably keep emergency contraception in their medicine cabinet just in case it’s ever needed. We don’t tell people to buy a fire extinguisher after the fire started” (Medical 20). Also, if you find yourself in any of the above situations before obtaining the filled prescription of Plan B to have on hand and you don’t know where to turn, the website www.not-2-late.com has a list of participating doctors, by state, who will write prescriptions so that you can get it filled quickly. I ask, all 9,276,187 women in the U.S. between the ages of 20-24, please prepare for the worst case scenario, have a plan, and make that plan, Plan B (Age)!
WORKS CONSULTED
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