Posted on 5.16.2013 by Lily
Official Plan B One-Step and FDA guidelines still say that the levonorgestrel emergency contraceptive must be taken within 72 hours (3 days) after unprotected sex. Working in reproductive health, it's easy to forget that the standard 120-hour guideline is still technically off-label, since every single other health authority cites it. But even if the 120-hour guideline is the one most often followed in clinics and by sexual health experts, pharmacists dispensing the medication won't instruct off-label use, and patients could figure it's not worth it after reading the drug labeling.
Yes, it's always better to take EC as soon as possible. But a patient should not be discouraged from taking EC after 72 hours because it CAN still be effective for two more days, and it's time that the official FDA instructions reflect that.
Why exactly has the FDA not caught up with standard medical practice on this? Oh right, possibly because they're corrupt, overtly politicized, incompetent drug company panderers who put women's health last.
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Posted on 5.14.2013 by Lily
A new chapter is presently unfolding in the interminable 12+ year struggle to get levonorgestrel-based emergency contraception (EC), commonly known as Plan B or the morning-after pill, sold over-the-counter with no age restriction on retail shelves. The safety of EC cannot be overstated. It has been attributed to NO deaths, NO serious complications, and has NO contraindications besides a specific allergy to levonorgestrel (which nobody has, since it's just a synthetic version of hormones made naturally by your body). It could basically be the safest drug ever to be sold in places like convenience stores, gas stations, and supermarkets. I can't think of a single other OTC medication that boasts the same safety profile - and all of those are sold without age restrictions, despite many being labeled as not for pediatric use.
First, a brief timeline of events in Plan B's sordid history.
-1999: Approved as a prescription-only drug for women of all ages.
-2001-2006: Bush packed the FDA with his cronies over actual scientists, who blocked progress for years, despite their own advisory panel voting 23-4 in favor of OTC status in 2003. (Yeah. We could have been done with this circus 10 years ago.)
-2006: We started taking baby steps forward. First EC went behind-the-counter for women over 18 who could prove their age. (Despite, yet again, the FDA recommending in 2005 that the age limit be lowered to 17.) Behind-the-counter is sort of like over-the-counter in that you don't need a prescription, but it doesn't really improve access very much, because the pill could still only be sold in pharmacies and not retail establishments that sell much more dangerous drugs like aspirin, caffeine, and Tylenol. Under this status, Plan B is less accessible than cigarettes, which are also behind-the-counter, but sold everywhere from supermarkets to gas stations and not subject to pharmacy hours. And so Plan B remained inaccessible to women under 18 without a prescription, and stayed difficult to access for all women.
-2009: The behind-the-counter age restriction was lowered to 17 on U.S. District Judge Edward Korman's orders (more on him below), and a generic version (Next Choice) became available. And that's been the status quo since.
-2011: The FDA, now composed of actual scientists, was poised to allow all levonorgestrel-based emergency contraceptives to be sold OTC with no age restriction. We rejoiced! No more incremental steps forward, no more lowering the age one year at a time while the pill languished behind pharmacy counters, off-limits to women under 17, women who can't prove their age, women who got to the store after the pharmacy was closed. It was really about to happen! ...For a few hours, anyway.
Because Kathleen Sebelius, Secretary of Health and Human Services and longtime pro-choice advocate, bewilderingly betrayed us in an unprecedented move of overruling her own scientists and blocking the policy they were set to implement at long last. Why? She didn't think they had showed that the pill would be safe for 11 and 12-year-olds. Of course, she based this unprecedented and outrageous interference on her years of medical experience and many impressive scientific credentials. Just kidding! She actually had no qualifications whatsoever to make that judgment, and it was really just a political maneuver in our little American game of thrones that, once again, sacrificed women's health. (Hey, we're pretty used to it at this point. Just not from people we thought were our allies.) President Obama, who campaign-promised to return public health policy to science after the horrors of the Bush years, publicly supported her decision. Or was really the one behind it, a year before his re-election. Who knows.
And that's how nothing changed for another year and a half. It is not unreasonable to suggest that thousands upon thousands of women have gotten pregnant unintentionally since Sebelius's intervention because they couldn't access EC in a timely fashion. Roughly 50% of those pregnancies likely ended in abortion.
And that brings us to the present. Well, as of last month, when my current hero Judge Korman - who has been involved in this struggle for years - overturned Sebelius's decision and ordered that all levonorgestrel-based emergency contraceptives be sold OTC with no age restrictions within 30 days. He also told the government just what he thought of their actions in no uncertain terms: they were "arbitrary, capricious and unreasonable" as well as "politically motivated, scientifically unjustified, and contrary to agency precedent."
The government is appealing his ruling, because why admit defeat in their shameful game now? Judge Korman's order was supposed to go into effect this past Friday, though he agreed to delay it until yesterday to allow the government to file their appeal. But! What has the FDA been up to in the meantime? Well, a few weeks ago they approved a policy to lower the age for OTC access from 17 to 15, and to put the medication on pharmacy shelves rather than behind-the-counter. This is happening even if the government wins their appeal against Korman's order to remove the age restriction altogether. So even worst case scenario, we still get a net benefit, right? Another maddening incremental step in this ridiculous 12+ year process, but at least going in the right direction. Right?
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Posted on 11.05.2012 by Admin
This guest post is by Nadia Smiecinska.
With the presidential election just days away, the candidates are working overtime to convince voters that they are the better pick to lead this country through the next four years. Women’s votes become a hot topic in the last months, particularly since women make up just over half of the electorate.
Women appear to favor President Obama’s message, specifically on issues related to reproductive rights. However that is not the entire story. Differing viewpoints on abortion and contraception provide a glimpse of each candidate’s fundamental opinion of what the role of government ought to be in the lives of the American people and who they will fight for.
Obama’s Record on Reproductive Rights
It is no secret that President Obama’s record on women’s rights and, more specifically, reproductive freedoms outshines Governor Romney’s. NARAL Pro-Choice America has a detailed breakdown of each candidate’s actions on choice and President Obama’s unwavering commitment to women making their own decisions without the government dictating morality is commendable. Besides being a consistent defender of Roe v. Wade, President Obama has also made sure that under The Affordable Care Act, insurance policies must cover contraception, counseling and testing for a variety of sexually transmitted diseases, like HPV, and preventative care visits without copay. He also continues to support comprehensive sex education programs, which were cut or significantly defunded under the last Republican administration in favor of abstinence education, and continues to invest in teen pregnancy prevention programs.
Romney’s (Confused) Record on Reproductive Rights
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Despite Romney’s latest, slightly more liberal opinions on choice, which differ from those voiced throughout the campaign trail and now specifically target women in swing states, his views appear confused at best and outright dishonest at worst. When Mitt Romney ran for U.S. Senate in the 1990s and lost -- subsequently successfully winning the governorship in Massachusetts -- he supported a woman’s right to choose and even signed into law a measure “for Massachusetts to apply for a federal Medicaid family-planning waiver to expand services to more low-income women and families.” However, during the same term as governor, he failed to sign a bill that would have allowed rape survivors information and access to the morning-after-pill. In the last decade, as Romney has become a national candidate, seeking the presidency twice, he has continued to move further away from choice. As the Republican Party transitioned ever more to the right, he has done his best to align his own views on everything from reproductive rights to environmental issues with the du jour sentiments of the GOP.
Posted on 10.30.2012 by Chantal
I was really excited to read this post on RH Reality Check. The author, Tracy Weitz, reflects on her experiences at a meeting of the International Federation of Gynecology and Obstretics (FIGO). In doing so, she touches on a topic that has come up for me several times in reflecting on what I see as the political and strategic failures of the pro-choice movement. I find the framework of abortion prevention to be deeply problematic and misguided.
Talk of abortion prevention is not new. Its been part of the conversation for years, especially among supposedly prochoice policy makers, researchers, and NGOs. If we could just reduce the number of abortions, conservatives and the religious establishment would be forced to get off our backs, right? Wrong.
A recent study out of St. Louis seems to have effectively proven what should be obvious to us all by now: access to free contraceptives reduces the rate of unplanned pregnancies, which in turn reduces the number of abortions. (You shocked yet?) The liberal news media is already lauding this as proof that we were right all along. We hold the key to reducing the incidence of abortion! But Tracy Weitz brilliantly points out the flaw in this logic. Since when are we not okay with the number of abortions?
I believe that all women should have access to free (as in ZERO COST) contraception. But not so that they don't have abortions. I believe that women should have access to free (as in ZERO COST) contraception because women have a right to control their fertility and because women deserve to have a variety of options available to them in order to do so, regardless of socioeconomic status. I also believe that abortion must be one of the options that we offer to women as a means of avoiding unplanned or undesired pregnancy. Yes, free birth control. But also yes, free abortion.
Tracy is spot on when she writes that "not pitting pregnancy prevention against abortion rates may seem like a semantic difference, but it is a critically important one for women." In doing so, I agree that we risk increasing the heavy burden of stigma that so many women are already subjected to. In a time when political and legislative opposition to abortion seems to be stronger than ever, I think we also risk forming an unintentional and dangerous alliance with those who seek to stop abortion all together.
According to Weitz, 46 million women worldwide have abortions each year. And I'm okay with that.
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Posted on 10.25.2012 by Lily
This time, it's that pregnancies resulting from rape are God's will. Wait. Rape can lead to pregnancy?! Even legitimate rape?
Anyway, all I can say is that Stephen Colbert is keeping me sane through this election season. Is it November 6 yet?
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