After 14 years of controversy and debates that were largely politically driven, the Obama administration announced this week it would no longer fight to keep the age restrictions on the morning-after pill.
In case you haven’t been following the news, let’s review the history of emergency contraception. The FDA first approved Plan B in 1999. The emergency contraceptive method consists of two pills taken 12 hours apart to prevent pregnancy within 72 hours of unprotected sex. A one-pill version, Plan B One-Step, received approval 10 years later in 2009.
Both options initially required a prescription. But since 2006, Plan B has been available over-the-counter without a prescription to women aged 16 years and older. Earlier this year, the age limit was lowered to 15 years, and the Obama administration just conceded this week to lift all age restrictions on the OTC one-pill version.
Plan B has been proven to be safe and effective, with fewer side effects than many other drugs that have been available on the shelves for years. The dispute over Plan B is about sex and reproductive rights, not safety.
Emergency contraception is just that — an emergency method to prevent pregnancy when a condom breaks or no contraceptive method is used during sex. It is higher dose of the birth control pill that prevents ovulation.
Emergency contraceptive pills may also prevent fertilization or implantation by altering the uterine lining, but will not have any effect on an egg that is fertilized and implanted. In other words, contrary to widespread misinformation Plan B is NOT an abortion pill.
I’m always surprised at how few of my patients know about emergency contraception, as well as how many patients are misinformed about the purpose and mechanism of action of Plan B.
If taken within 24 hours of unprotected sex, Plan B is 95% effective at preventing pregnancy, and taken within 72 hours the effectiveness is 89%. Overweight women who have a BMI greater than 25 will have increased risk for pregnancy after taking emergency contraception.
For now, only the brand named Plan B One-Step will be available without a prescription without any age restrictions. The two-pill version, which includes cheaper generic versions, will still require a prescription for girls aged younger than 17 years and will not be available on the shelf.
Plan B should not replace birth control, and patients should be counseled to see a provider to test for sexually transmitted infections after unprotected sex.
Patients need to be aware of their options when it comes to the availability and cost of Plan B and other emergency contraceptives, especially in cases of contraceptive failure or rape. As the laws regulating emergency contraception change, make sure you know the facts and are educating your patients.