Plan C?

It seems odd to not comment on yesterday’s decision by the administration to veto the FDA’s ruling to allow all girls of childbearing age to purchase Plan B (emergency contraception) over the counter, without a prescription.

Let’s back up. Until now, all adults could buy it without a prescription. Those who are 17 years old could also buy it without a prescription if they could prove their age. If you’re 16 and younger, you need a prescription. There aren’t a lot of medications that fall into this odd category. Pseudoephedrine is one, and that’s cause people were buying it to make crystal meth. Meds to help you quit smoking are another, because theoretically you shouldn’t be able to buy cigarettes until you’re 18 (again, see head under sand). But almost every other medication is either completely over the counter, or by prescription, regardless of age.

My go-to wonk on issues of women’s reproductive health is Sarah Kliff. So I suggest you go read her thoughts on the issue.

Me? From the perspective of a pediatrician, I can tell you that no matter what you think, girls are having sex before they are 18. There are plenty of 16 year olds (some even younger) out there doing it. You can legislate against it, educate against it, and moralize against it, but it’s happening. I think that preventing an unwanted pregnancy from happening in the first place is better for everyone than dealing with whatever choices are made after the fact. That’s what Plan B does, and the FDAs recommendation was to allow girls an easier path to avoid getting pregnant.

The wonk in me understands the competing arguments, and the political issues intertwined with them. Since I have the luxury of not running for office, I’ll tell you that I believe the evidence supports the FDAs decision. But what I find fascinating is that this is the first time ever that the secretary of HHS has overruled the FDA. There have been plenty of controversial decisions, but it pains me that an administration that promised to shield science from politics chose this decision to make a stand.

I’m sure the debate is far from over. I also look forward to hearing more details about the administration’s rationale for this unprecedented move. I have no doubt they will be fielding lots of angry questions.

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