News Contraception

Fourteen Senators Ask Sebelius for Data Justifying Administration’s Decision Denying Teens Access to Plan B

Jodi Jacobson

Today, 14 Senators, 13 Democrats and one independent, wrote HHS Secretary Kathleen Sebelius asking her to provide them with the scientific evidence and rationale for her decision to deny access to Plan B to teens over the counter

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

An error in this article was corrected at 9:17 pm on Tuesday, December 13th.  The earlier version incorrectly stated 14 Democrats signed the letter to Sebelius. The actual tally is 13 Democrats and one Independent, Senator Bernie Sanders from Vermont.

Last week, both President Obama and Secretary of Health and Human Services Kathleen Sebelius overruled the U.S. Food and Drug Administration (FDA) by refusing to allow emergency contraceptives to be sold over the counter (OTC), despite the FDA’s recommendation to do so. They suggested their decision to deny vulnerable teens access to emergency contraception was based on the lack of evidence on whether young teens would understand how to use the method and whether there might be unknown risks.  These statements came despite a wealth of evidence–ten years worth–supporting OTC access to all females of reproductive age, and despite the fact that untold numbers of OTC drugs have far more dangerous potential side effects than any potential adverse effects of Plan B. 

This was poilitics clear and simple. 

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Today, 14 Senators, 13 Democrats and one independent, have written to Sebelius asking her to provide them with the scientific evidence and rationale for her decision.

The letter is as follows:

The Honorable Kathleen Sebelius

US Department of Health and Human Services

200 Independence Avenue, SW Washington, DC 20201

Dear Secretary Sebelius,

We are writing to express our disappointment with your December 7, 2011 decision to block the Food and Drug Administration’s (FDA) recommendation to make Plan B One-Step available over-the-counter. We feel strongly that FDA regulations should be based on science.  We write to you today to ask that you provide us with the rationale for this decision.

As numerous medical societies and patient advocates have argued, improved access to birth control, including emergency contraception, has been proven to reduce unintended pregnancies.  Nearly half of all pregnancies that occur in the United States each year are unintended. Keeping Plan B behind the counter makes it harder for all women to obtain a safe and effective product they may need to prevent an unintended pregnancy.

We ask that you share with us your specific rationale and the scientific data you relied on for the decision to overrule the FDA recommendation. On behalf of the millions of women we represent, we want to be assured that this and future decisions affecting women’s health will be based on medical and scientific evidence.

The letter was signed by Senators Patty Murray (D-WA), Kirsten Gillibrand (D-NY), Barbara Boxer (D-CA), Richard Blumenthal (D-CT), Daniel Akaka (D-HI), Carl Levin (D-MI), John Kerry (D-MA), Tom Harkin (D-IA), Al Franken (D-MN), Frank Lautenberg (D-NJ), Bernie Sanders (I-VT), Ron Wyden (D-OR), Maria Cantwell (D-WA), and Jeff Merkley (D-OR).

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.

Commentary Abortion

Why Is Obama Afraid to Embrace Reproductive Rights?

Erin Matson

On June 14, the White House will host the United State of Women Summit to "celebrate the progress we've made on behalf of women and girls and to talk about how we're taking action moving forward." Yet abortion is nowhere on the agenda.

On June 14, the White House will host the United State of Women Summit to, as its website explains, “celebrate the progress we’ve made on behalf of women and girls and to talk about how we’re taking action moving forward.” Yet reproductive rights are scarcely included.

Six themes are on the agenda: economic empowerment; educational opportunity; violence against women; entrepreneurship and innovation; leadership and civic engagement; and health and wellness—”looking at health coverage, preventative care, pregnancy and more.” Speakers will discuss a number of topics to “inspire all of us to take action on June 14th and well after.” The audience is to be made up of advocates and leaders hand-selected by the White House.

Prenatal care is highlighted in the programming descriptions. Contraceptive coverage is mentioned as part of the Affordable Care Act. Maternal mortality and HIV prevention is discussed as an issue of global health, although these issues remain urgent within the United States as well, with women of color experiencing unconscionable disparities in care. Yet the word “abortion” is nowhere to be found.

This, despite the fact that in the last five years, states put upwards of 288 new abortion restrictions on the books, which is more than a quarter of the total such laws adopted since Roe v. Wade. It’s not stopping. In the first three months of 2016, states introduced 411 new abortion restrictions. The “pro-life” dream is coming true: Clinics are closing, specific methods of abortion are being banned, and those women who take matters into their own hands are starting to trickle into jails under fetal homicide laws that backers swore wouldn’t be used to prosecute women.

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President Obama is well aware of these issues. He knows that Congress has established a select investigative panel for the purpose of harassing Planned Parenthood, even after the sting videos created by David Daleiden to bring the organization down were thoroughly debunked. He knows that the incendiary rhetoric used by the activists and politicians colluding with Daleiden sadly and predictably erupted into a terrorist act, leading to the murder of three people in a Colorado Springs Planned Parenthood health center late last year. He knows that five men and three women in Supreme Court robes are considering Whole Woman’s Health v. Hellerstedt, a challenge to Texas’ abortion clinic closure law and the biggest abortion access case in a generation.

In this environment, there is no acceptable excuse for leaving abortion out of a policy agenda for women. Abortion is an inextricable part of the struggle for women’s equality, and as I’ve covered for Rewire previously, you simply can’t do feminism—a commitment to the social and political equality of all people, especially women and girls—and set the controversy of abortion off to the side.

The strategy of trying to make things better for women by talking about everything but reproductive rights doesn’t work. Hushing up about abortion has not magically ended the domestic violence crisis, produced the votes for paycheck fairness, or mandated paid family leave. Leaving abortion to the side has certainly failed to help women parent their children in safe and healthy communities, free of state or systemic violence.

And yet the current plan for the United State of Women Summit is silence. As a time for women’s advocates to gather and outline strategies for moving forward, abortion should be included, period. Obama has nothing to lose politically by taking a more robust stand on reproductive rights during the sunset days of his administration. In fact, embracing abortion and sexual health for women would serve to strengthen his legacy toward women and girls.

Since that history-making day in 2009 when he took office, Obama has mistakenly treated reproductive rights as playing second fiddle to the women’s movement, and to his broader legacy toward dignity, equality, and justice for all. Yes, Cecile Richards has visited his White House 42 times and yes, public actions such as including the birth control benefit in the health-care law and refusing to allow shutdown-happy Republicans in Congress to defund Planned Parenthood show a level of access, commitment, and support.

But when this president convenes a big table, even a women’s summit, abortion is lucky to get a folding chair in the back. Women who have sex are placed in a silo on purpose.

If we’re honest about it, abortion is controversial because affirming a woman’s inherent right to dignity, power, and sexual pleasure is the controversy. This is about gender roles, sexuality, and control—especially over people born into bodies of color and families without wealth.

Either we believe that women are people and deserve dignity, or we don’t. There is no such thing as equality for women if the precondition of equality is that women shut their legs. Justice doesn’t come with behavioral preconditions targeting the very people experiencing injustice.

An advocate for reproductive health, rights, or justice could, on a level, sympathize with Obama for not wanting to have his presidency and even his legacy-minded women’s summit flanked by bloody fetus posters and buses full of Troy Newmans. But the threat of a sideshow shouldn’t stand in the way of justice. On other issues, this president and his administration have proven capable of growing and changing, as with Obama’s journey to embrace marriage equality. Or, more recently, consider the administration’s clear and firm stance for equality in the face of outrageous discrimination and lies peddled by the right wing, as when it filed suit against North Carolina’s bathroom discrimination law as Attorney General Loretta Lynch told the transgender community, “We see you.”

Not so with reproductive rights. Even the signature accomplishment of the Affordable Care Act—the birth control benefit—was tarnished by new restrictions on abortion funding, and contraceptive coverage exemptions that continue to grow and fail to placate the opposition. President Obama traded away Washington, D.C.’s right to local abortion funding in 2011. His administration attempted to overrule the Food and Drug Administration’s decision to make emergency contraception available over-the-counter without age restriction, an issue that had to be resolved by force of a court order. To date he has failed to take action to correct a ridiculous interpretation of the Helms Amendment, which bars funding in foreign assistance for abortion “as a method of family planning,” and surely was meant to include customary exceptions for rape, incest, and life endangerment. The president has the sole power to fix this—no congressional action required. An executive order on Helms that stands up for rape victims in war zones and women who can’t live through a pregnancy should be a no-brainer.

In any case, this issue can and should be corrected now. Abortion should not be censored out of Obama’s big party for feminism, nor from feminism in general. A webmaster can add reproductive rights to the United State of Women Summit website, and the programming can be updated. President Obama can, for that matter, sign a life-saving executive order on Helms. And his legacy toward women that he cares so much about will be vastly improved.

CORRECTION: This piece has been updated to reflect the correct number of themes on the agenda at the summit.

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