Limiting Choice, Putting Young Women At Risk

(4 pm. – promoted by ek hornbeck)

This was not a good week for women’s reproductive freedom, especially young women of childbearing age under seventeen. The Secretary of Health and Human Services chose to strike down the Food and Drug Administration’s decision to make emergency contraception available without a prescription to people under 17, just as it is now to those who are 17 and older. It is very obvious that Secretary Kathleen Sebelius based her decision, not on the science that Plan B One-Step is safe, but on pure politics to avoid a confrontation with Catholic Bishops and so-called “pro-life” conservatives in an election year.

President Barack Obama’s statement that he did not intervene in the secretary’s decision is barely believable. What was even more insulting was his paternalistic statement regarding women being able to make their own reproductive decisions using his own daughters:

I will say this, as the father of two daughters. I think it is important for us to make sure that we apply some common sense to various rules when it comes to over-the-counter medicine.

And as I understand it, the reason Kathleen made this decision was she could not be confident that a 10-year-old or an 11-year-old go into a drugstore, should be able-alongside bubble gum or batteries-be able to buy a medication that potentially, if not used properly, could end up having an adverse effect.

And I think most parents would probably feel the same way.

No, Mr. President this is not “common sense”, this is a dangerous decision that will put thousands of young women at risk for unwanted pregnancies. As a parent, I know full well that children do not always confide in their parents when they have done something the parents will disapprove. Unlike you, sir, parents can’t watch their children 24/7 and children are not known for making good long term decisions, especially, when they are pressured by their peers.

Girls as young as 10 and 11 are having unprotected sex. As available as condoms are, kids don’t always use or have them and, oh, they do break. There is also the matter of rape and incest. Who do these young women turn to when they are too ashamed to seek help because of the backward attitudes about sex in this country?

For EC to be effective it must be taken within 72 hours of intercourse, the sooner the better. The direction for Plan B are simple and easily understood: Take one pill within 72 hours of unprotected sexual intercourse. Directions that most 10 or 11 year olds can easily understand.

So putting constraints to access by requiring a prescription from a doctor, which may not be either timely or possible, further put the young woman at risk. This is a rule that could adversely affect the rest of their lives, economically, educationally, familial and professionally. This is denying them control over their reproductive lives. As the father of two daughters, you might want to about this more carefully.

The President’s remarks were not just paternalistic but uniformed and sexist. I’ll get to the nonsense he spouted about over the counter drugs.

Let me say this, as a medical professional, there are millions of young women who take birth control, some for health issues, with no adverse side effects. Teenage pregnancy carries increased health risks to both mother and infant, even a higher risk of mortality.

The “morning after” pill has been available to all women in their menarche over the counter in Europe for years with little or no ill effect. Dr. Margaret Hamburg, the F.D.A.’s commissioner, in her statement disagreeing with Sec. Sebelius’ veto, stated the agency’s scientists “determined that the product was safe and effective in adolescent females, that adolescent females understood the product was not for routine use, and that the product would not protect them against sexually transmitted disease.”

Sebelius’ override has been described as “medically inexplicable”:

Sebelius’ decision is “medically inexplicable,” said Dr. Robert Block of the American Academy of Pediatrics, one of a number of major medical groups that contends over-the-counter access to emergency contraception would lower the nation’s high number of unplanned pregnancies.

Pediatricians say the morning-after pill is safe — containing a high dose of the same female hormone that’s in regular birth control pills — especially compared to some existing over-the-counter medicines.

“I don’t think 11-year-olds go into Rite Aid and buy anything,” much less a single pill that costs about $50, added fellow AAP member Dr. Cora Breuner, a professor of pediatric and adolescent medicine at the University of Washington.

Instead, putting the morning-after pill next to the condoms and spermicides would increase access for those of more sexually active ages “who have made a serious error in having unprotected sex and should be able to respond to that kind of lack of judgment in a way that is timely as opposed to having to suffer permanent consequences,” she said.

Sebelius may not have been forthcoming when she said that the drug’s manufacturer had failed to study whether girls as young as 11 years old could safely use Plan B. Teva Pharmaceuticals had funded a study that “tracked 11- to 17-year-olds who came to clinics seeking emergency contraception. Nearly 90 percent of them used Plan B safely and correctly without professional guidance, said Teva Vice President Amy Niemann.”

There are far riskier drugs that are on the shelves of drug stores that are available to teens that can do more harm than a one time use pill that you have to see the pharmacist to get. There are no known drug interactions, yet there are serious warnings about taking Tylenol, aspirin and non-steroidal anti-inflammatory drugs (Ibuprofen, Naprosyn) with a long list of over the counter and prescription drugs. There are diet pills and cough remedies that carry higher risks. A teen driving a car is more dangerous.

For the President to say that he was not involved in the process is laughable on its face. The Executive Branch is controlled by him. All of the cabinet members are answerable to him. No cabinet member would presume to make a decision of this magnitude with the political repercussions without his direct or implicit approval. The buck stops with him.

There is no medical argument that can be made to justify this. It is purely political, pandering to the far right factions that will never vote for Obama even if his were the only name on the ballot. It is feckless, cowardly and a slap in the face to 51% of the population of the United States.