Sides are drawn in pill issue
Health, morals go head-to-head with high teen-pregnancy rate
By Martha Irvine
CHICAGO -- A physician who opposes over-the-counter sale of emergency contraception fears that young women would skip regular visits to the gynecologist if they didn't need to see a doctor to get it.
"They're not going to get their pap smears; they're not going to get screened for sexually transmitted disease," said Dr. Gene Rudd, a gynecologist who serves as associate executive director of the Tennessee-based Christian Medical Association.
He also said some young women might not want to use emergency contraception if they knew how it worked.
A stronger dose of regular hormonal contraception, the morning-after pill can prevent pregnancy by delaying a woman's ovulation or keeping sperm from fertilizing an egg.
It also can thin the uterus lining, making it difficult for a fertilized egg to implant. That's a major reason anti-abortion groups -- from the American Life League to the Pro-Life Action League -- are among emergency contraception's main opponents.
While many in the medical field do not share their view, they see interfering with a fertilized egg as abortion.
"Emergency contraception is not true contraception," said Sierra Correa, the 22-year-old vice president of Collegians For Life, a student group that opposes the morning-after pill. "Drug companies have been getting away with calling it contraception by redefining pregnancy to mean implantation" of a fertilized egg.
Some opponents also have argued that easier access to the morning-after pill would make teens more likely to engage in risky sexual behavior -- though some doctors say that research done at the University of Pittsburgh School of Medicine casts doubt on that argument.
The study, published in the April issue of the Journal of Pediatric and Adolescent Gynecology, found that teens who had emergency contraception on hand were not more likely to have unprotected sex. It also concluded that those teens were more likely to use emergency contraception correctly and sooner after sex, when it is most effective.
Such findings have motivated some nonprofits that serve youth to launch information campaigns to let teens know emergency contraception exists.
Officials at one of those nonprofits, Washington, D.C.-based Advocates For Youth, also point to the research of James Trussell, director of Princeton University's Office of Population Research. Trussell has concluded that easy access to emergency contraception could cut by half the number of unintended pregnancies and abortions among U.S. women, ages 15 to 44.
Each year, there are about 3 million unintended pregnancies, and in about 800,000 of those cases the parents are teenagers, according to the federal Centers for Disease Control.
Those statistics were cited last year when the FDA's scientific advisers voted 23-4 in favor of Barr Pharmaceuticals initial proposal to sell Plan B with no age restriction.
Ultimately, however, FDA acting drug chief Dr. Steven Galson overruled the vote because of concerns about teenagers' use of emergency contraception without doctors' guidance and about the long-term effects of its use.
A young woman who has taken the morning-after pill -- and has testified before the FDA to ask for over-the-counter access -- hopes the agency will reconsider.
"The sad thing is," said Vera Brown, a junior at the University of Florida, "teenagers need it the most."