Got Birth Control? Today, Back It Up!

Amy Boldosser

Sales of Plan B have doubled since it became available OTC and surveys show most major pharmacy chains are now stocking it. Yet myths about EC are still prevalent and very real barriers to access remain.

Wednesday, March 25 is Back Up Your Birth Control Day!

Back Up Your Birth Control
is a national campaign to raise awareness of and expand access to
emergency contraception (EC). As
we celebrate the eighth annual BUYBC Day of Action, hundreds of advocates and health
care providers across the country will help spread the message that EC is a
safe and effective way for women to prevent pregnancy after unprotected sex.
This is a crucial time to expand education about EC. In the current economic
climate when women are losing jobs and health
coverage, they need to know how to back up their birth control
(or replace the regular birth control methods they can no longer afford) with
EC more than ever. We hope you’ll join us in raising awareness of what has
often been called "the best kept secret in women’s health" – emergency contraception.

On August 24, 2006, when the FDA approved Plan B for over-the-counter (OTC)
sale without a prescription to women and men ages 18 and older, I was working
to expand access to EC for low-income women and teens in Title X clinics. A
colleague approached me that afternoon and said "well, I guess you’ll be
looking for a new job. Now that EC is available over-the-counter, the access
problem is solved!" How I wish that were true.

From the first BUYBC Day in 2002 to today we can look proudly at Rosie the
Riveter, our BUYBC "poster woman," and say, "You’ve come a long way, baby." Sales
of Plan B have doubled since it became available OTC and surveys show most
major pharmacy chains are now stocking it. Advocacy organizations, departments
of health, campus groups, pharmacist’s associations, and medical providers have
created a wide variety of EC education and outreach campaigns. Yet despite
these efforts and increased availability, myths about EC are still prevalent and
very real barriers to access remain.

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Results of annual surveys of BUYBC participants consistently rank lack of
awareness of EC and of how to access EC as the primary barriers to EC access,
ahead of other barriers like cost or age restrictions. Women can’t be empowered
to back up their birth control and prevent unintended pregnancy if they don’t
know about EC, and have the facts on how it works or where they can access it.

education is needed to address the barriers to EC access by teens, low-income
and immigrant women created by the FDA decision. The
recent court ruling in the Center for Reproductive Rights case against the FDA
will soon expand access to EC OTC to 17 year old women. The ruling also means
that the FDA will need to reconsider the sale of Plan B OTC to women of all ages;
however, no timeline is provided for how soon that might happen. In the
meantime, teens must still obtain a prescription in order to access EC, despite
a lack of any scientific evidence demonstrating EC is unsafe for them.

high cost of EC OTC, usually $40-70, poses a significant barrier to low-income
women, or to those whose budgets are tight right now. Only eight state Medicaid
programs currently cover EC OTC, and efforts to expand this number are being
severely challenged by state budget cuts. The need to show government issued ID
as proof of age is a barrier for undocumented women and men. And the fact that
Plan B is kept behind the pharmacy counter creates a barrier to access outside
regular pharmacy hours, and the potential for pharmacists refusing to dispense
EC. Since EC is most effective the sooner it is taken after unprotected sex,
the delay caused by seeking a prescription, trying to get the money together,
or finding a pharmacy that’s open can significantly increase a woman’s risk of
unintended pregnancy. Education and outreach campaigns, like BUYBC, can help
women identify sources of free or low-cost EC, raise awareness among teens of
their right to access contraception including EC, and help undocumented people
exercise their rights to reproductive healthcare.

must also continue to dispel myths about EC, particularly the misinformation promoted
by anti-choice forces categorizing EC as an abortifacient.
Despite solid scientific evidence which proves that EC works primarily by preventing
ovulation and secondarily preventing fertilization and that EC will not
interrupt or harm an established pregnancy, proposed state laws like the "fetal
" amendment defeated in Colorado and a new law in Texas, and federal
laws such as the Bush era HHS
continue to attempt to classify EC as an abortifacient. Lawmakers
continue to allow carve outs for emergency contraception in Family Planning
Waivers, refusal laws, and by health insurance companies. Even the recent
victory fixing the provision in the 2005
Deficit Reduction Act
, which restored discount birth control pricing for
college and safety net clinics and was a victory for women’s access, doesn’t
impact EC prices since EC was never included in the birth control methods that
qualify for nominal pricing. This means that while we wait to see whether the
drug companies will restore the discounts and for lower cost birth control to
come back to campus next school year, EC will remain an important but
potentially expensive option.

of young people in abstinence-only programs have also been receiving
this misinformation about how EC works. A nationwide survey conducted by the Kaiser
Family Foundation
found that over 25% of teens surveyed believed that EC
causes abortion. This misconception must also be addressed in order to increase
access to EC for rape survivors. Currently only 16
states require emergency rooms (ER) to provide EC to rape survivors even though
timely access to EC is critical to reduce the additional trauma of a pregnancy
due to rape. Women must know they have the right to request EC, or EC
information, and lawmakers in the remaining states must be urged to stop
putting politics before science and make EC in the ER available for all

Now is a crucial time to raise awareness of EC, not just because women need
affordable access to birth control more than ever but also because there is
hope for expanded access on the horizon. President Obama’s stated
to "ensuring that scientific data is never distorted or
concealed to serve a political agenda and that we make scientific decisions
based on facts, not ideology," seems to be a direct rebuff to the political
machinations within the FDA that created the OTC barriers and the politics that
have prevented women from having timely and affordable access to EC for too
long. In addition to the win in the courts, new
staff at FDA could be poised to remove some of these barriers. The possibility
of a generic form of EC becoming available this fall when the patent on Plan B
expires could also improve access for low-income women. Advocates across the
country are continuing to fight for Medicaid coverage for EC OTC, and to ensure
that universal health care plans include coverage for EC.

While advocates work for policy gains, we must continue to raise awareness
about EC and empower women with a second chance to prevent unintended pregnancy.
Please join the activists across the country who are participating in the Back
Up Your Birth Control Day of Action. Visit this link to learn how.

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Reproductive rights are a public health issue. That's a fact.

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