Emergency contraception: Why over-the-counter 'Plan B' is a flawed concept


CINCINNATI, July 2004 — Switching the controversial emergency contraceptive known as Plan B to over-the-counter (OTC) status is bad medicine according to a leading medication therapy journal. "Avoiding Pregnancy: 'A Plan' versus Plan B," by Gene Rudd, MD appears in the September issue of The Annals of Pharmacotherapy and can be viewed at The Annals Online's Articles Ahead of Print (www.theannals.com).

On July 22, 2004 Barr Laboratories reapplied to the Food and Drug Administration (FDA) to make Plan B available over-the-counter after their first request was rejected. Yet the FDA's well-founded concerns about the drug's safety in young girls are not the only issue. In his article Rudd presents additional compelling arguments that unsupervised access to Plan B, a higher-dose version of the prescription hormone levonorgestrel, places the health of many U.S. women at risk.

According to Rudd, reproduction-related issues are the leading reason women visit their physicians. Consequently, nonprescription access to Plan B would keep many women out of doctor's offices and away from appropriate, comprehensive care. Furthermore, Rudd continues, the U. S. Centers for Disease Control now recognizes that chastity is the key to stemming the sexually transmitted disease (STD) epidemic among American youths. But the availability of Plan B says "you don't have to be responsible…you have a backup." By providing the illusion of a safety net against pregnancy, Plan B may encourage more risk-taking behaviors such as unprotected sex that increase the spread of STDs. And while proponents claim Plan B will reduce the number of unwanted pregnancies, the drug actually has a failure (pregnancy) rate of 11-25%. Thus it provides incomplete protection and consequently may result in additional pregnancies and abortions, contrary to Plan B advocates' frequent claims.

Finally, Plan B's patient materials claim the chemical agent does not cause an abortion, yet the scientific evidence indicates otherwise. The drug works in part by preventing a developing embryo from attaching to the uterine wall, leaving it to pass out of the mother's body and die. If this is not accurately disclosed to women considering use of the drug, it can have lasting psychological harm when discovered later.

Source: Eurekalert & others

Last reviewed: By John M. Grohol, Psy.D. on 21 Feb 2009
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