By Susan E. Wills
May 1, 2009
The Food and Drug Administration (FDA) recently expanded over-the-counter (OTC) access to the “emergency contraceptive” Plan B to 17-year-old girls and boys. Since 2006 the FDA has allowed adults, 18 and older, to purchase the drug without a prescription.
The reaction of the press to the FDA’s decision has been predictable and dead wrong. Editorials declared it “a long-overdue triumph of science over politics” (Baltimore Sun) and “not only good science but smart policy” (San Jose Mercury News).
The scientific literature, however, shows that FDA’s move was based on wishful thinking, not science. Plan B’s claimed effectiveness has been debunked—both for individuals and populations. And while advocates encourage unnecessary and repeated use, science shows that young women are being put at risk, while the drug’s mode of action and side effects are downplayed.
One of Plan B’s earliest champions, Princeton’s James Trussell, Ph.D., widely promoted claims that it was 89% effective in preventing pregnancy and would reduce abortions in the U.S. by half. But in January 2007, Trussell and others published a review of 23 studies evaluating Plan B effectiveness. They found that “no study has shown that increased access to [Plan B] reduces unintended pregnancy or abortion rates on a population level.” They concluded that individual use of Plan B may reduce pregnancy risk by “more than 23%,” but that efficacy claims of 80% “may overstate actual efficacy, possibly quite substantially.” In short: Plan B works poorly in the individual woman and not at all in large groups of women!
So when are women advised to take this wonder drug? Plan B’s 20-page product insert says that it is meant for “infrequent emergency” use. But Barr, its manufacturer, and others describe an emergency as any “unprotected intercourse or a known or suspected contraceptive failure” (e.g., torn condom) or missing one’s birth control pills for two days. According to Managing Contraception, a woman using a daily progestin-only pill should take Plan B if she is even 3 hours late in taking one pill! All these recommendations disregard the fact that women are naturally infertile 3 out of every 4 weeks of the menstrual cycle and so have no “need” for Plan B 75% of the time.
Pharmacists in many countries report that some young men, as well as girls, are buying Plan B many times a month. The possibility of coercion, abuse of a minor, and cover-up of statutory rape cannot be ignored.
Plan B’s side effects and risks are not trivial. One dose is the equivalent of taking 40 Ovrette contraceptive pills in 12 hours! Use of Plan B can result in bleeding disorders, extreme menstrual cycle irregularities, soaring STD rates, and increased risk of potentially fatal ectopic pregnancies.
There is also evidence that, depending on the timing of Plan B relative to ovulation, the drug may act as an abortifacient by indirectly altering protein levels in the uterine lining so the week- old embryo cannot implant to receive nutrition from his or her mother. Girls and their parents deserve the truth about Plan B—not more deception and wishful thinking.
Susan Wills is assistant director for education and outreach in the USCCB Secretariat of Pro-Life Activities. To learn more about the bishops’ pro-life activities go to www.usccb.org/prolife.