The Obama administration has chosen to keep the status quo on Plan B, overruling the FDA’s science-based decision. This means that girls 16 and younger will continue to need a prescription from a doctor to buy Plan B, while girls and women 17 and older will continue only having access to Plan B through a pharmacist.
Since there’s a 72 hour window for using Plan B, very few kids or even teens will have the wherewithal to arrange for a doctor’s appointment, get a script for Plan B, and order it from a pharmacy in three days time (and if the only pharmacist in town is an evangelical, then forget about it!). The majority of Plan B’s users are adult women — and the pharmacy-only rule can easily be a significant barrier. I take prescription medication, and it has happened that it’s taken days for my work schedule, my pharmacy’s open hours, and the bus schedule to align. It’s very easy for mandatory work and commute hours, and a pharmacy’s open hours, to fully overlap for a couple of days in a row — and when that happens, you can’t get to that pharmacy.1
As I understand it, Plan B is more likely to be effective taken in the first 24 hours than (say) at hour 70. So even a day’s delay can be significant.
Supporting the decision to block Plan B, Obama claimed2 to be worried about 10 and 11 year olds buying their Plan B “alongside bubble gum or batteries.”
…according to the most recent data I could find, of the roughly 758,000 teen pregnancies a year 212 of these involved girls 12 and younger. If you’re getting into a debate about Plan B and 12-year-olds you’re being played for a sucker. The relevant Plan B debate is about 15- and 16-year olds, and people who are bringing up the 0% of teenage pregnancies among 11-year-olds are trying to make paternalistic regulations seem more reasonable. (Which, of course, should not imply that making it more difficult for the infinitesimal number of 12-year-olds who get pregnant to get emergency contraception is anything but a terrible idea.)
The Guttmocher Institute writes:
Sebelius’ focus on 11-year-olds is specious. Fewer than 1% of 11-year-old girls are sexually active, but almost half of girls have had sex by their 17th birthdays, and most of these begin at age 15 or 16. Recent government data from the National Survey of Family Growth suggest that the age restriction on emergency contraception has limited use of the method among this demographic, even as use increased substantially among older teens and young adults. Continuing to restrict access will only increase the number of teens faced with an unintended pregnancy.
Even if we suppose that only 1 in 10,000 adult women who would use Plan B would have trouble getting Plan B in time due to having to get it from a Pharmacist, that’s still an enormous group compared to the incredibly tiny number of 10 and 11 year old girls Obama claims to be concerned about.
Regarding Obama’s “adverse effect” line, Aaron Carroll points out that there are lots of far more dangerous, far cheaper drugs that kids can buy over the counter, which have an adverse effect:
Just looking at kids 5 years of age and under, there were more than 130,000 calls [to poison control centers] for analgesics, 53,000 for vitamins, 48,000 for antihistamines, and 45,000 for cough and cold preparations. And yet, no one seems to be too concerned that these medications could be purchased “alongside bubble gum and batteries”. And, for the record, battery ingestions killed 4 kids in that age group that year.
Even if every single pregnant 10-12 year old takes Plan B and suffers an “adverse effect” — and there’s no evidence at all for that — shouldn’t the hundreds of thousands of children who suffer adverse effects from other OTC medicines be a more urgent priority? Why isn’t the Obama administration calling for Tylenol, which is far more deadly, to be sold to kids only with a prescription?
Well, we all know why. It’s about sex, and more honest defenders of the status quo than Obama admit this. In comments, Robert wrote:
Tylenol doesn’t enable the concealment of behaviors that reasonable parents really ought to know about their children’s participation in.
I don’t want my 14 year old stepdaughter to have sex at this point in her life. If she does have sex, I want her to use contraception and disease prevention, and I hope that she would come to her mother or I about the entire question. But she might not, and I understand that.
But understanding it, I do not want society to collude in her ability to conceal the behavior from her mother or myself. OTC Plan B permits her to engage in risky, unprotected, barrier-free sexual intercourse, and conceal the behavior from people who do have a legitimate parental role in her life and really ought to know about it.
There’s an odd and unjustified line Robert draws here. Why is it that it’s okay for a 14 year old girl to have protected, barriered sex secretly, but when it’s unbarriered sex suddenly things change? It’s true that a 14 year old using a condom is being marginally more responsible, but just because she’s using a condom doesn’t mean that she’s using it correctly (I’d suspect the average 14 year old is less likely to use a condom correctly than an average adult), or that the sexual intercourse is not still “risky.” There are many extremely substantial risks other than pregnancy, after all. What about a 14 year old who has been seduced by a 30 year old — don’t parents need to know about that, even if condoms are used?
So why is it okay that condom use by 14 year olds is “conceal[ed]… from people who do have a legitimate parental role in her life and really ought to know about it”? Don’t the parental rights of people whose 14 year olds use condoms count? By allowing condoms to be bought outside a pharmacy (and — gasp! — from vending machines), isn’t society colluding in the ability of 14 year olds to conceal their behavior from their parents?
But no one would go for treating condoms like Plan B. No politician would dare propose that adult men should only be able to buy condoms from a Pharmacist, in order to protect 200 kids from the horrors of condom use. Because even if, for the sake of argument, we say that it would be better if 14-year-olds didn’t have access to condoms, our society would never sacrifice the needs of adult men to have convenient access to contraceptives. We’d recognize — correctly — that our society includes both children and adults, and we should be extremely hesitant to take rights away from grown-ups.
It’s not enough to say that we should restrict kid’s access to Plan B (or condoms) in order to, in some Bizarro universe, make kids more likely to talk to their parents about their sex lives. Because those kids and their parents aren’t the only ones effected. We need to ask, instead, is it worth inconveniencing hundreds of thousands of grown-ups who need to use Plan B, in exchange for making it marginally more likely that Robert’s 14 year old stepdaughter will talk to her parents?
With condoms, we don’t think it’s worth it. With Plan B, we do.
So why the double-standard? I think there are two things going on here. First of all, our society just doesn’t value ladies’ rights to take care of lady parts as much as we value dude’s rights to take care of dude parts. And second of all, Plan B is relatively new technology, and new means scary and frightening, and people just generally lose their shit and stop thinking logically when there’s scary new technology being discussed. (When I was a kid, there was a lot of concern over the new trend of separate phone lines for kids — wouldn’t that make children more accessible to sexual predators?)
The case for helping minors by restricting Plan B is extremely speculative, to say the least, and the likely number of minors helped would be tiny; that’s not something we should sacrifice the rights of hundreds of thousands of adult women for, any more than we’d sacrifice men’s rights were the position reversed.
As for Plan B and minors, my views are admittedly extreme. I think we should provide it, free, in schools, to any girl under age 18 who requests it, to have it preemptively. So that way, instead of having to go to a store if she has sex without protection, she already has it available in her sock drawer. A study in JAMA found that giving girls Plan B in advance did not increase the odds of them having unprotected sex, but almost doubled the odds of them using Plan B after unprotected sex. Reducing the rates of unwanted teen pregnancy is something that we can and should do. I can’t help but notice that most (although not all) of the support for the Plan B status quo is coming from folks who are “pro-life”; you’d think pro-lifers would be the very first to prioritize preventing unwanted pregnancy over other issues.
- In my experience, this is especially likely to happen on weekends, when many pharmacies keep shorter hours. Good thing no one ever has sex on a Friday night! [↩]
- I suspect President Obama was more worried about seeing attack ads on TV accusing President Obama of enabling 10-year-old girls to have secret sex behind their parent’s back. [↩]
Speaking of Plan B:https://twitter.com/ohtarzie
Abortion doesn’t matter apparently in the Ron Paul debate because plan B’s always available!
I’ve noticed that too… I mean we all know the REAL reason is because they aren’t as much interested in “protecting life” as they are in punishing women for having sex. But you would think they would at least make some small gesture towards making it appear that they actually give a damn about the issue they claim to be all afire with righteous indignation about, no?
Well, in extreme pro-life land, the not-even-implanted-yet zygote is a person, whose life is worth way more than that of the girl or woman carrying it. So it is consistent with an extreme pro-life stance to be against any method of reducing unplanned pregnancies that occurs post-sex.
Thank you for pointing out how this affects adult women and older teenagers and for pointing out the double standard that we would never take away men’s access to contraception to make kids talk to their parents about sex.
I would also point out that if a twelve-year-old does have sex, or is raped, I would much rather have her have access to emergency contraception while she works up the guts to tell her parents. And if she never works up the guts to tell her parents, it’s better that she prevented the pregnancy than to have her still not able to tell her parents, but have them find out when she’s visibly pregnant.
Why is it that it’s okay for a 14 year old girl to have protected, barriered sex secretly, but when it’s unbarriered sex suddenly things change?
I don’t want to drag the previous thread into this thread, but I’ll answer this one.
It’s not OK. It’s less bad when it’s barriered sex. And the reason is not, despite your valid point about 14 year olds’ competence with condom use, that the condom magically is making things better.
The reason in my case is that, if my daughter is having protected sex, then she and/or her boyfriend are (apparently, at least) aware of the risks of STI and pregnancy and making a correct decision that, since they’ve decided to have sex without telling mom, they’re at least going to do it in the way that they’ve been taught is responsible and risk-reducing.
Whereas if they are having unprotected sex, it’s apparent or at least plausible, that they’ve decided to make the squishie sounds AND that they don’t need to worry about STIs or pregnancy. (It may just be that they don’t know because some abstinence-only educator misled them, but since it’s my example and my stepdaughter, I happen to know that she knows.) So they’re making a decision to go against our Stern Moral Teachings, AND to do it in a spectacularly dumb way.
In one case they’re making their own decision about sex, which I don’t like or approve of but which I cannot honestly say is totally beyond their prerogative as independent human beings; I know that they’re going to assert their prerogative one way or the other eventually and it isn’t something that I am going to think society is obliged to keep from happening, or to go to great lengths to make sure I find out about it if it does happen.
In the other case they’re making the same decision, AND they are choosing to do so in a very unsafe and complication-inducing way that they ought to be bright enough to realize is Teh Stoopid. (Nothing personal against anyone here who made the same bad decision as a teen or young adult; Teh Stoopid is the God-given heritage and legacy of every young human being.) I do want society to send up a red flag to let me know, if it finds my kids being exceptionally dumb.
It’s the difference between the sheriff catching my kids hanging out at the abandoned quarry, which is strictly Off Limits, reading poetry to each other and throwing rocks into the deep water, and the sheriff catching my kids at the quarry making and using improvised zip lines to speed across Death Gulch, aka the Jagged 1000-Foot Deep Ravine Filled With 50-Foot Rusty Iron Spikes section of the quarry. They’re disobeying in both cases, but disobedience is natural and inevitable and I can conceive of situations where the sheriff would decide not to tell me about the poetry readings and instead just give the kids a warning, and if I found out about this ten years later I might be OK with his/her decision. I cannot conceive of being OK with the sheriff not telling me “oh by the way, I found your kids courting death”.
Pro-lifers would compel all women, of any age, to carry every zygote to term if they could. Aiding and abetting the futile attempts of middle-aged busybodies to control the sexual behavior of their offspring is just all they can get right now.
Robert, my main complaint about your argument in the other thread is the total lack of cost-benefit analysis that takes into account the state removal of some freedom from hundreds of thousands of adult women as a substantial cost. Do you really think the government should treat 100% of citizens like children in order to protect the minority who are children? Especially when the “protection” for children — as in this case — seems extremely hypothetical and, if it exists, would be very marginal protection? Where’s the cost/benefit analysis?
I think that mistake remains in your new comment.
Re the condom versus Plan B distinction you’re drawing, I can see that there is a difference, but I don’t think that difference is as all-encompassing as you think. It’s less poetry versus a zip line than it is a 26 foot cliffdive versus a 38 foot cliffdive.
Thought experiment: Suppose someone invents a pill that women can take to prevent them from getting pregnant. So it’s much closer to being the poetry-reading than the zip line o’ doom, although there is a tiny bit more risk since unlike a condom, this hypothetical pill wouldn’t prevent STDs. Let’s call it reading poetry while cliff-diving. (Cliff-diving is actually pretty safe, I did it as a kid.)
Do you think that we’d make that pill available OTC, or do you think it would be seen as horribly unreasonable/dangerous for a 14 year old girl to be able to buy the pill for her own use, without consulting an adult? My bet is that people would say that young girls can’t be allowed to decide that, and we should instead try and structure the law to force them to talk to their parents. And I think this would be the case even if our hypothetical pill was (unlike the real-world pill) 100% without side effects.
Yes. The fact that someone thinks it’s perfectly acceptable to demand that the population of adult women give up their rights (unto the whim of pharmacists with a documented tendency to refuse to hand out emergency contraception to people entitled thereto, and with insufficient recourse to safeguard themselves from being deprived entirely of those rights) in order to pay for that person’s slightly improved ability to monitor hir child’s sex life . . . I can’t find words to convey how utterly, abominably selfish that is.
The people who are actually agonized that some young teenager will use it without parental approval can trouble themselves to weave a net that does NOT also trap every adult woman during a very time-sensitive and often traumatic time. It’s their valued result, they can be the ones to pay for it.
There’s at least one obvious work around to the problems of Plan B restrictions: the PRN prescription. Doctors who treat adolescents could just give them a prescription for plan B, to be filled as needed. These girls and women 18 or older (who don’t need the prescription) could go to the pharmacist when it’s convenient for them and pick up the pills. That way, they’re there when needed without the hassle of trying to make an appointment/pick up the pills when the need is acute. As someone already mentioned, the sooner plan B is taken, the more likely it is to prevent pregnancy.
As far as the plan B versus condoms argument, I would argue that plan B and condoms are complementary, not competitive. Sure, you hope that all adolescents will be responsible and take all due precautions before indulging in their natural desire for love and sex, but if they don’t or if their precautions fail, it’s good for them to have a back up. True, plan B doesn’t protect against STDs, but if the choice is between a 17 year old with an STD and a pregnant 17 year old with an STD, the former seems to me to be the better situation.
I feel like a lot of people don’t understand how Plan B works and I find myself compelled to go into boring exposition mode when I see evidence of confusion about it. So…
Plan B works because sperm stay alive in a woman’s system for up to 4-5 days, and most of the time fertilization doesn’t happen immediately. Plan B blocks ovulation from occurring. So if you’re already ovulating at the time you have unprotected sex, Plan B will have no effect. But if you were going to ovulate any time in the next 4-5 days, Plan B will stop that from happening, which will then prevent fertilization. The longer you wait, the more likely ovulation is to occur in the interim, rendering Plan B useless. After 4-5 days, the sperm are no longer viable and it doesn’t matter – you’ve either conceived or you haven’t, and Plan B won’t have an effect either way.
That is why it’s so important to take Plan B as soon as possible. The longer you wait, the more likely you are to ovulate, making pregnancy possible, and Plan B irrelevant. So yes, if you ever think you (or your child) might need it, acquiring some in advance is not a bad idea. That doesn’t excuse making it hard to acquire in the first place, though.
Thank god for Planned Parenthood. They will give kids and adults Plan B if needed, and allow for emergency walk-ins.
This is why I gave money to Planned Parenthood, and will fight like hell to keep Planned Parenthood.
Oh yea, also – the reason for all of these restrictions is because the right wing religious fundamentalists call plan b the abortion pill.
Amp, I take your point entirely. I am a bit schizoid in my arguments here on this topic, because we have a paternalistic government when it comes to medical issues. In Bob’s Designed Universe, there are no barriers to any kind of drug use and you can make, buy, formulate, sell, and use whatever you want and whenever you want, and if parents don’t want their kids to use drug X, whether medical or pharmaceutical, it’s the parent’s job to be the drug police and keep them from doing it.
In our existing world, which is way suckier frankly – in my universe, George Lucas was shot right after he finished editing Return of the Jedi – we do have a drug-controlling regime and people have to jump through all kinds of hoops to get all kinds of things. That being the case, if there is a fascist police state in existence I want it to work my way and not other people’s way, and so I want my preferences to control how the drug police do business.
I take your points regarding the variable risk; I wasn’t trying to say that barrier sex vs. unbarrier sex is completely akin to poetry vs. death racing, just that it isn’t the nature of the sex that concerns me but rather what signal is being sent about how responsible my daughter is acting.
I am not sure I understand your thought experiment about the pregnancy-prevention pill. The pills we have now are not OTC so why would the side-effectless ones be OTC under the current regime? Birth control pills aren’t prescription now because of side effects, they’re prescription now because pretty much everything above the life-altering-effects of aspirin are prescription; i.e., a paternalistic state.
So, Robert, I have to ask, what if the condom breaks? Is it better to have the kid get pregnant and have to tell her parents then, than to be able to get Plan B? She was being responsible, after all.
I don’t want her to get pregnant and have to tell her parents, I want her to tell her parents and get plan B.
Birth control pills aren’t prescription now because of side effects, they’re prescription now because pretty much everything above the life-altering-effects of aspirin are prescription; i.e., a paternalistic state.
Yes and no. The pill is prescription-only because they use the prescription to get women in for their annual exams, but it’s also prescription-only because certain groups of people (smokers, older women with high blood pressure) are at significantly higher risk for the most dangerous side effects (blood clots, potentially fatal) and because it can take some doing to find the right formulation. (The first pill I was on made me bleed for 10 days out of the month. Not fun.)
On the responsibility front, I would note that the girl who buys Plan B is being responsible. Assuming the issue isn’t a broken condom but rather no protection at all, she knows that she made a mistake and is at risk for pregnancy, so she’s doing something about it, something that will cost her more money than is easy to come by and that quite likely will make her physically uncomfortable for a day or two — two things that will probably cause her to be more careful in the future.
I’d be a lot more worried about the girl who doesn’t want to buy Plan B because she either doesn’t know about it or thinks that she doesn’t have to worry about getting pregnant because she did it standing up in a swimming pool or because he swore up and down that he had an accident as a kid that left him infertile.
I mean, I get where you’re coming from, Robert. The more irresponsible they’re being, the more you want some way to intervene and shake some sense into them. I totally get that. But all the public health research points to allowing more access, not less.
Somewhat tangential, but … last night, I saw a series of television ads for the male supplement Extense. Available at Walgreen’s in the vitamin and family planning sections! OTC.
It’s OTC because it doesn’t do anything.
Not that I would know.
And I think we should stop talking about my personal situation and desires, as incredibly fascinating as they are, because there’s a perfectly good thread to carry out that argument/discussion/series of multi-gigabyte lectures in, and they aren’t really germane to this thread, which is about turtle kidnapping.
No, it’s about plan B restrictions hurting adult women, I stand corrected.
I don’t want her to get pregnant and have to tell her parents, I want her to tell her parents and get plan B.
Put yourself back into your teenage brain. Set aside your parent self. You’ve just had sex without any protection. You may or may not get pregnant/get someone else pregnant. You’ve heard there is a pill. Do you tell your parents? Or do you cross your fingers and hope for the best? Honest, now.
Also, I think you must know that there are lots of parents that won’t let her get Plan B because they believe it’s the same as an abortion and some smaller number that will do physical violence to their child over this.
Cross-posted. Sorry. (Only one paragraph was really about you, but you’re right that we’ve largely hashed this out in the other thread.)
I don’t want her to get pregnant and have to tell her parents, I want her to tell her parents and get plan B.
Said it in the other thread and I’ll say it here again: You can’t legislate family relationships.
But if not getting pregnant is contingent on telling her parents, you’re making it contingent not only on having a *good* relationship with her parents (not being abused, not having parents who will throw her out of the house for having had sex at all) but on having the nerve to tell them *and* get to a doctor, within the window that Plan B is effective. I think that’s a lot to ask from a teenager.
You say that like you can definitely have both, *tell her parents* and *not get pregnant.* But for every possibly pregnant girl who has to tell her parents to get Plan B, there will be some who won’t or can’t.
Heck, even if she tells her parents the next day after school, and they take her to the doctor the day after that and get her Plan B on the way home from the doctor’s office, she’s still SOL if she ovulates in that 1-2 days, where she wouldn’t have been if she could’ve just swung by a pharmacy on the way to school and still told her parents the next day, but been able to tell them it was taken care of.
And I’d like to be wiser and to have better skin. An’ a pony.
Grace
Why waste a wish on something you can get on any overstretched horse ranch for $20? $10, if you don’t mind getting it processed into dogfood first.
I’m going for “working FTL starship, actual size”
Why, Kyra, how Libertarian of you. ;)
Grace
Ah, I see that you are the sort who might try to sell oats which have already been through the horse as, “oats, highly processed, with added nutritional amendments”.
If I were offered a choice between that and a pony, I would drop the pony so fast that you could see it doppler-shift with the naked eye.
Grace
Nobody even mentioned that plan B costs $50 a pill.
If I were offered a choice between that and a pony, I would drop the pony so fast that you could see it doppler-shift with the naked eye.
You were offered it implicitly when you got the wish. You spent it on a pony and now you’re stuck with him, no backsies. Wave to the pony-riding wish-waster, loyal crew. Now, set course to Alpha Centauri. Engage!
1. The most common side effect after using Emergency Contraception is that it messes up a woman’s normal menstrual cycle, causing a period to come earlier than normal, irregular bleeding/spotting, or cramping. Since most young teenagers’ menstrual cycles haven’t regulated yet anyway (mine didn’t until I started using birth control pills when I was seventeen, at least), this side effect is a bit negligible, and regardless, isn’t dangerous, just irritating. (And as Dianne said, this might make the teenager more likely to use condoms/a regular birth control method next time.)
2. If the teenager already is pregnant, the hormones in emergency contraception do not harm an existing pregnancy. They’re synthetic progesterone hormones, typically levonorgestrel, and thus are similar to the pregnancy-supporting hormones which pregnant women are already producing. (Note: this does not apply to the emergency contraceptive ella, which is formulated differently.)
This all depends on where you go and what type of insurance you have. A woman on Medicaid can get it for free (at least in my state). Planned Parenthood clinics sometimes will give it for free, or at reduced prices. It is out of many teenagers’ budgets if their only resource is the local pharmacy, though, and I would like to see this change.