Commentary Contraception

Restricting Plan B Is Bad Politics

Amanda Marcotte

Kathleen Sebelius clearly upheld restrictions on emergency contraception as a naked political move, but it wasn't even smart politics. Young women, a big voting bloc for Democrats, are insulted and will likely be demoralized by this decision. 

See all our coverage of the Administration’s 2011 Emergency Contraception Reversal here.

In March 2009, Barack Obama signed a memo specifically directing the heads of executive departments and agencies to value scientific integrity in their decision-making. To quote the first line of the memo:

Science and the scientific process must inform and guide decisions of my Administration on a wide range of issues, including improvement of public health, protection of the environment, increased efficiency in the use of energy and other resources, mitigation of the threat of climate change, and protection of national security.

By any reasonable measure, Kathleen Sebelius defied this memo with her unprecedented overruling of the FDA’s science-driven process that led to the conclusion that Plan B should be sold over the counter with no age limits. But not only is she not being disciplined by the White House for doing so, she was openly supported by Barack Obama, who claimed that it was “common sense”. To make the whole thing even more ludicrous, the President openly invoked a red herring, scaring Americans with the vanishingly small number of pre-teens who are sexually active, instead of addressing the actual 15- and 16-year-olds who would make up the vast majority of new users of OTC Plan B.

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As has been thoroughly covered at Rewire, the consensus is that this move was strictly political. The Obama administration is pandering to middle-of-the-road voters and even some liberals who believe that teenage girls should be chaste, and should face serious consequences if they decide to have sex against their parents’ wishes. (There is no corresponding concern about boys, which is why there’s no similar debate going on about OTC sales of condoms.) The administration likely sees teenage girls as an ideal sacrificial lamb to pander for votes, since the 16-and-under set won’t be able to vote in November 2012. You can see how easily they came to this conclusion. But that it was a nakedly political decision doesn’t necessarily mean it was a good decision. An entire group of potential voters was forgotten in this calculation: young women that are old enough to vote, who tend to be sensitive to reproductive rights issues and who the Democrats need to get to the polls in large numbers in order to win.

But don’t take my word for it. David Dayen at Firedoglake quoted respected and non-ideological pollster Celinda Lake on the issue:

Democratic pollster Celinda Lake said she could “not even remotely” understand the political calculus of the decision, saying it “alienates the base, causes conflict with women in the base, [is] bad for key groups of women like younger women and unmarried women, and doesn’t win the swing independent women.”

Since the ruling is about teenagers, why would this alienate young women? Well, there’s a number of reasons that the administration should have considered before symbolically spitting in the face of this important voting bloc.

1) The ruling may be about teenagers, but it affects all sexually active women of reproductive age. If the FDA had been allowed to stand by its ruling on Plan B, the drug would have come out from behind the pharmacist’s counter and would sit on the shelves next to condoms and aspirin. This makes it much easier to get for reasons that these cute bunnies are happy to explain:

Tell the FDA to Act on Emergency Contraception from Center for Reproductive Rights on Vimeo.

This would add the number of stores that could stock it, as well, and it would also mean that you could buy it at 24-hour drugstores that don’t have 24-hour pharmacies. Having to endure the paternalistic process of buying Plan B is something young women will now blame on Obama, with good reason.

2) Young women are more likely to empathize with teenagers in need than parents who want excessive control of their daughters. The way some people are carrying on about the supposed horrors of teen sex (most of which is between age-appropriate, consenting partners), you would think that most people have no recollection of what it was like to be a teenager. But young women, as a group, certainly do remember. Just like now, about half of us were having sex by the time we were 17, and mostly we didn’t involve our parents in our decision to become sexually active. We may look at teenagers and think they look like babies, but we still remember that when we were their age, we were smart and responsible enough to drive a car, fill out college applications, go to parties unchaperoned, baby-sit actual children, and manipulate new technologies better than our parents usually could. We know we were perfectly capable of taking a simple, one-dose medication if we had unprotected sex or if a condom broke. We also remember keenly the terror that the very idea of an unintended pregnancy strikes in the hearts of high-schoolers, and our heart goes out to girls who have to endure that fear simply to placate their paranoid elders who have watched too many TV shows about “sexting”. Insulting our younger sisters insults us, and revises our memories of ourselves, making us seem stupider and less mature than we actually were.

3) Young women know a double standard when they see one. Condoms are and, for our purposes, have always been available over the counter with no age restrictions, despite the less than 1 percent of people who have latex allergies (similar to the less than 1 percent of 11-year-olds having sex). If you examine the arguments and the statistics carefully, it’s clear that the objections to Plan B have nothing to do with health and safety, and that it’s only a controversial drug because, unlike condoms, women can take Plan B without a man’s cooperation. It all goes back to female sexuality, and the continued widespread fear and loathing of it. Young women know better than anyone how deeply unfair that is. They’re the ones who most have to endure the sting of words like “slut”, while the men they sleep with endure no such shaming. They know that if they get pregnant, people will insinuate that they’re the ones who failed, not their partners. They know that if they get an abortion, they’re the ones who will be yelled at by protesters and made to endure harassing state regulations like mandatory ultrasounds and waiting periods. They know that if they have a baby outside of marriage, they’ll be the ones shamed for being single mothers, but they also know that if they do get married, they’ll be accused of getting pregnant to “trap” a man. They live in a world that treats them shabbily for being sexual, and they will see clearly how this Plan B decision fits into the larger pattern.

Why did Obama simply overlook young women, even though it’s a group he can’t win re-election without? My theory is that the Democrats are thinking like movie producers. The assumption in the movie industry is that men pick what movies will be seen and women simply tag along, and it looks like Democrats are the same way. Many women can tell you stories of being shamed for being a “single issue voter” when they make reproductive rights a priority, even though people who are motivated to vote based on a single issue like tax policy or a vague promise of “jobs” don’t get slurred with that word. Just like in work, home, school, and church, women are viewed as people who will show up and work hard just because it’s what has to be done, and men are viewed as the ones who you really have to fire up. Because of this, we’re easy to ignore. But as the outcry against the Plan B decision shows, maybe we’re finally getting sick of playing the role of the people who show up and work hard, and get nary a word of thanks for our efforts. 

News Abortion

Anti-Choice Leader to Remove Himself From Medical Board Case in Ohio

Michelle D. Anderson

In a letter to the State of Ohio Medical Board, representatives from nine groups shared comments made by Gonidakis and said he lacked the objectivity required to remain a member of the medical board. The letter’s undersigned said the board should take whatever steps necessary to force Gonidakis’ resignation if he failed to resign.

Anti-choice leader Mike Gonidakis said Monday that he would remove himself from deciding a complaint against a local abortion provider after several groups asked that he resign as president of the State of Ohio Medical Board.

The Associated Press first reported news of Gonidakis’ decision, which came after several pro-choice groups said he should step down from the medical board because he had a conflict of interest in the pending complaint.

The complaint, filed by Dayton Right to Life on August 3, alleged that three abortion providers working at Women’s Med Center in Dayton violated state law and forced an abortion on a patient that was incapable of withdrawing her consent due to a drug overdose.

Ohio Right to Life issued a news release the same day Dayton Right to Life filed its complaint, featuring a quotation from its executive director saying that local pro-choice advocates forfeit “whatever tinge of credibility” it had if it refused to condemn what allegedly happened at Women’s Med Center.

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Gonidakis, the president of Ohio Right to Life, had then forwarded a copy of the news release to ProgressOhio Executive Director Sandy Theis with a note saying, “Sandy…. Will you finally repudiate the industry for which you so proudly support? So much for ‘women’s health’. So sad.”

On Friday, ProgressOhio, along with eight other groupsDoctors for Health Care Solutions, Common Cause Ohio, the Ohio National Organization for Women, Innovation Ohio, the Ohio House Democratic Women’s Caucus, the National Council of Jewish Women, Democratic Voices of Ohio, and Ohio Voice—responded to Gonidakis’ public and private commentary by writing a letter to the medical board asking that he resign.

In the letter, representatives from those groups shared comments made by Gonidakis and said he lacked the objectivity required to remain a member of the medical board. The letter’s undersigned said the board should take whatever steps necessary to force Gonidakis’ resignation if he failed to resign.

Contacted for comment, the medical board did not respond by press time.

The Ohio Medical Board protects the public by licensing and regulating physicians and other health-care professionals in part by reviewing complaints such as the one filed by Dayton Right to Life.

The decision-making body includes three non-physician consumer members and nine physicians who serve five-year terms when fully staffed. Currently, 11 citizens serve on the board.

Gonidakis, appointed in 2012 by Ohio Gov. John Kasich, is a consumer member of the board and lacks medical training.

Theis told Rewire in a telephone interview that the letter’s undersigned did not include groups like NARAL Pro-Choice and Planned Parenthood in its effort to highlight the conflict with Gonidakis.

“We wanted it to be about ethics” and not about abortion politics, Theis explained to Rewire.

Theis said Gonidakis had publicly condemned three licensed doctors from Women’s Med Center without engaging the providers or hearing the facts about the alleged incident.

“He put his point out there on Main Street having only heard the view of Dayton Right to Life,” Theis said. “In court, a judge who does something like that would have been thrown off the bench.”

Arthur Lavin, co-chairman of Doctors for Health Care Solutions, told the Associated Press the medical board should be free from politics.

Theis said ProgressOhio also exercised its right to file a complaint with the Ohio Ethics Commission to have Gonidakis removed because Theis had first-hand knowledge of his ethical wrongdoing.

The 29-page complaint, obtained by Rewire, details Gonidakis’ association with anti-choice groups and includes a copy of the email he sent to Theis.

Common Cause Ohio was the only group that co-signed the letter that is decidedly not pro-choice. A policy analyst from the nonpartisan organization told the Columbus Dispatch that Common Cause was not for or against abortion, but had signed the letter because a clear conflict of interest exists on the state’s medical board.

Commentary Contraception

Hillary Clinton Played a Critical Role in Making Emergency Contraception More Accessible

Susan Wood

Today, women are able to access emergency contraception, a safe, second-chance option for preventing unintended pregnancy in a timely manner without a prescription. Clinton helped make this happen, and I can tell the story from having watched it unfold.

In the midst of election-year talk and debates about political controversies, we often forget examples of candidates’ past leadership. But we must not overlook the ways in which Hillary Clinton demonstrated her commitment to women’s health before she became the Democratic presidential nominee. In early 2008, I wrote the following article for Rewirewhich has been lightly edited—from my perspective as a former official at the U.S. Food and Drug Administration (FDA) about the critical role that Clinton, then a senator, had played in making the emergency contraception method Plan B available over the counter. She demanded that reproductive health benefits and the best available science drive decisions at the FDA, not politics. She challenged the Bush administration and pushed the Democratic-controlled Senate to protect the FDA’s decision making from political interference in order to help women get access to EC.

Since that time, Plan B and other emergency contraception pills have become fully over the counter with no age or ID requirements. Despite all the controversy, women at risk of unintended pregnancy finally can get timely access to another method of contraception if they need it—such as in cases of condom failure or sexual assault. By 2010, according to National Center for Health Statistics data, 11 percent of all sexually experienced women ages 15 to 44 had ever used EC, compared with only 4 percent in 2002. Indeed, nearly one-quarter of all women ages 20 to 24 had used emergency contraception by 2010.

As I stated in 2008, “All those who benefited from this decision should know it may not have happened were it not for Hillary Clinton.”

Now, there are new emergency contraceptive pills (Ella) available by prescription, women have access to insurance coverage of contraception without cost-sharing, and there is progress in making some regular contraceptive pills available over the counter, without prescription. Yet extreme calls for defunding Planned Parenthood, the costs and lack of coverage of over-the-counter EC, and refusals by some pharmacies to stock emergency contraception clearly demonstrate that politicization of science and limits to our access to contraception remain a serious problem.

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Today, women are able to access emergency contraception, a safe, second chance option for preventing unintended pregnancy in a timely manner without a prescription. Sen. Hillary Clinton (D-NY) helped make this happen, and I can tell the story from having watched it unfold.

Although stories about reproductive health and politicization of science have made headlines recently, stories of how these problems are solved are less often told. On August 31, 2005 I resigned my position as assistant commissioner for women’s health at the Food and Drug Administration (FDA) because the agency was not allowed to make its decisions based on the science or in the best interests of the public’s health. While my resignation was widely covered by the media, it would have been a hollow gesture were there not leaders in Congress who stepped in and demanded more accountability from the FDA.

I have been working to improve health care for women and families in the United States for nearly 20 years. In 2000, I became the director of women’s health for the FDA. I was rather quietly doing my job when the debate began in 2003 over whether or not emergency contraception should be provided over the counter (OTC). As a scientist, I knew the facts showed that this medication, which can be used after a rape or other emergency situations, prevents an unwanted pregnancy. It does not cause an abortion, but can help prevent the need for one. But it only works if used within 72 hours, and sooner is even better. Since it is completely safe, and many women find it impossible to get a doctor’s appointment within two to three days, making emergency contraception available to women without a prescription was simply the right thing to do. As an FDA employee, I knew it should have been a routine approval within the agency.

Plan B emergency contraception is just like birth control pills—it is not the “abortion pill,” RU-486, and most people in the United States don’t think access to safe and effective contraception is controversial. Sadly, in Congress and in the White House, there are many people who do oppose birth control. And although this may surprise you, this false “controversy” not only has affected emergency contraception, but also caused the recent dramatic increase in the cost of birth control pills on college campuses, and limited family planning services across the country.  The reality is that having more options for contraception helps each of us make our own decisions in planning our families and preventing unwanted pregnancies. This is something we can all agree on.

Meanwhile, inside the walls of the FDA in 2003 and 2004, the Bush administration continued to throw roadblocks at efforts to approve emergency contraception over the counter. When this struggle became public, I was struck by the leadership that Hillary Clinton displayed. She used the tools of a U.S. senator and fought ardently to preserve the FDA’s independent scientific decision-making authority. Many other senators and congressmen agreed, but she was the one who took the lead, saying she simply wanted the FDA to be able to make decisions based on its public health mission and on the medical evidence.

When it became clear that FDA scientists would continue to be overruled for non-scientific reasons, I resigned in protest in late 2005. I was interviewed by news media for months and traveled around the country hoping that many would stand up and demand that FDA do its job properly. But, although it can help, all the media in the world can’t make Congress or a president do the right thing.

Sen. Clinton made the difference. The FDA suddenly announced it would approve emergency contraception for use without a prescription for women ages 18 and older—one day before FDA officials were to face a determined Sen. Clinton and her colleague Sen. Murray (D-WA) at a Senate hearing in 2006. No one was more surprised than I was. All those who benefited from this decision should know it may not have happened were it not for Hillary Clinton.

Sometimes these success stories get lost in the “horse-race stories” about political campaigns and the exposes of taxpayer-funded bridges to nowhere, and who said what to whom. This story of emergency contraception at the FDA is just one story of many. Sen. Clinton saw a problem that affected people’s lives. She then stood up to the challenge and worked to solve it.

The challenges we face in health care, our economy, global climate change, and issues of war and peace, need to be tackled with experience, skills and the commitment to using the best available science and evidence to make the best possible policy.  This will benefit us all.

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