The Truth, Mainly - 09/12/2005

When Plan A fails, time for Plan B?
by Leon Satterfield

Have you been following the brouhaha in the Food and Drug Administration? You know—the one about a pill called "Plan B."

It's about sex.

Did that wake you up?

"Plan B" is a pill that prevents pregnancy. It's pretty cleverly called "Plan B" because it's for use when "Plan A"—avoiding sex altogether—doesn't work. The desire to make a little whoopee outvotes (by at least a 2-0 margin) Plan A in an alarming number of cases.

And the morning after Plan A fails so miserably, the lady involved feels a need for Plan B. The gentleman involved is merely confused. "Hah?" he says. "Hah?"

So she has to get out of bed earlier than usual so she can go to her doctor and get him to write her a prescription for Plan B. And that pill, if she takes it within 72 hours of the whoopee-making, prevents her egg from being fertilized by his sperm—in about nine cases out of ten.

You can see the appeal Plan B has, not just for the lady involved but also for the befuddled gentleman. She's got 72 hours to take the pill that prevents fertilization. It's not an abortion pill because in the first 72 hours after the whoopee-making, there's nothing to abort. Just some not-very-smart sperm swimming around in the dark wondering what they're supposed to be doing.

But the problem is that you can't always get in to see your doctor in 72 hours. And the problem is that if your doctor gives you a prescription, the pharmacist may be out for coffee.

So the Food and Drug Administration's experts did a very smart thing: they recommended that Plan B should be an over-the-counter pill rather than a prescription pill.

And that's when FDA Commissioner Lester Crawford began dragging his feet. He said he'd have to think about the recommendation for a couple of months because it's not clear whether teenage girls under 16 could also buy Plan B pills over the counter. And God knows we shouldn't do anything that might result in fewer babies being born to unmarried teenagers.

And that caused Susan Wood, Assistant FDA Commissioner and director of the FDA Office of Women's Health, to resign from her job.

Delaying making Plan B pills available over the counter rather than only by prescription, she said, "is contrary to my core commitment to improving and advancing women's health."

Crawford skirted around established FDA procedures, Ms. Wood said. His "decision was not made in consultation with the normal people who are involved with the decision-making of the agency." In an e-mail to her colleagues, she wrote "I have spent the last 15 years working to ensure that science informs good health-policy decisions. I can no longer serve as staff when scientific and clinical evidence, fully evaluated and recommended by the professional staff here, has been overruled."

The other side, those who support Crawford's decision, say that Plan B pills cause abortions. The pro-Plan B folks argue that instead of causing abortions, the pill actually reduces the number of abortions. Washington Senator Patty Murray is quoted in the Denver Post saying "The people cheering [Crawford's decision]… are redefining abortion."

So I did what I always do when I get contradictory statements. I went to the Internet, the fount of all 21st century knowledge.

And here's what I got from Planned Parenthood of New York City on Emergency Contraception—a category of pills that includes Plan B:

Such pills are "to use in an emergency to try to prevent pregnancy." The pills can "stop a possible pregnancy before it gets started"—within five days after sex.

But if you're already pregnant, forget about it: "they will not end an existing pregnancy….If a woman is already pregnant when she takes Emergency Contraception pills, they will not harm the fetus….Emergency Contraception is contraception, not abortion. It prevents pregnancy before it occurs. Researchers estimate that, if widely used, Emergency Contraception could potentially prevent more than half of all unintended pregnancies and half of all abortions in the U.S. each year."

So much for the argument that Plan B pills cause abortions. And here's my conclusion:

Saying Plan B causes abortions is like saying that penicillin causes venereal disease. Condemning Plan B use is like condemning all sex that takes place during the time of month that a woman is infertile—on the grounds that if it doesn't result in pregnancy, sex is bad.

Don't get me wrong. Having fathered three kids and grandfathered five more, I have nothing against an occasional pregnancy.

But, please, not in 100% of all possible occasions.


Retired English Professor Leon Satterfield writes to salvage clarity from his confusion. His column appears on alternate Mondays. His e-mail address is:

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