50 Reasons HHS Should Reverse its Decision on Emergency Contraception

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Commentary Contraception

50 Reasons HHS Should Reverse its Decision on Emergency Contraception

Soraya Chemaly

Here is a $12 billion problem we really can actually go a long way towards eliminating.

Here is a $12 billion problem we really can actually go a long way towards eliminating.

There are 62 million American women of childbearing age, 43 million of whom are “at risk” for unintended pregnancy. Women manage their fertility for an average of 30 years. “At risk”—like an unplanned pregnancy is something that just happens to you, out of your control. NOT. These pregnancies have consequences for all of us. Someone needs to introduce the Purity Bear to the $12 billion dollars worth of consequences. And that’s a conservative estimate.

Most girls and women (some of whom are part of a couple…) don’t get pregnant if they don’t want to when they have access to safe, affordable birth control, including emergency contraception. There are no medical or scientific reasons why girls and women need prescriptions for methods relevant to their needs. Just religious, shame-based ones based on stereotypes, control and fear. We should be scheduling birth control biotechnologies the way we do vaccines and they should not require prescriptions. That or we should start requiring prescriptions for condoms. Exactly how long do you think that option would fly with the Pecker Patrol?

The most obvious and immediate issue is the fact that emergency contraception, Plan B, is not available without a prescription and should be. The longer term issue is why American women are ill-informed about and therefore not using long-acting forms of reversible contraception.

Sex. Abortion. Parenthood. Power.

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It’s been almost exactly a year since, in an unprecedented move, Health and Human Services (HHS) Secretary Kathleen Sebelius, in an act of what some called scientifically unethical “national malpractice,” overruled a Food and Drug Administration recommendation and restricted access to emergency contraception long known to be safe and effective for all females of childbearing age. This was roundly condemned by reproductive health care advocates as a political act, contrary to good public policy, sound scientific reasoning and bad for women and their health.

Unplanned pregnancies pervasively affect us all: PersonallySocietallyEconomically. And I’m not only thinking about the “motherhood penalty,” direct medical costs or obvious expenses related to children. There are clear linkages to increases in other social ills: like crime, lower education levels, higher incidences of domestic abuse, increased pressure on the welfare system and more. Children who result from unplanned pregnancies are far likelier to experience developmental problems, poorer physical and mental health, to struggle in school. These steep costs exponentially exceed the cost of society’s providing easy, affordable access to birth control.

Here are 50 reasons to sign this petition urging Kathleen Sebelius to do the right thing, get us on the right track, and make safe and effective contraception, especially emergency contraception, available to all girls and women and couples who need it, when they need it. 

50 Facts About Unplanned Pregnancies

  1. Rank of the US for unplanned teen pregnancies among developed nations: 1
  2. Rank of the US for abortions globally: Second
  3. Percentage of pregnancies in the US that are unplanned: 49%
  4. Percentage of women by the age of 45 who have experienced an unplanned pregnancy in the US: about 50%
  5. Number of girls or women who can get pregnant: 43 million
  6. Number of boys or men who can get pregnant: 0 million
  7. Age at which a boy or man can independently acquire over the counter birth control that meets his needs and for which he is responsible: Any age, unrestricted access
  8. Average cost to a boy or man: About $1.34 per condom
  9. Average costs of birth control technologies to women: $15.00-50.00 for month of pills, or Handy-dandy calculator for other methods
  10. Average at which a girl in the United States is able to become pregnant: 12.6 years
  11. Average age at which a boy in the United States is able to become pregnant: Never
  12. Age at which a girl can get emergency contraception if the pharmacist doesn’t mislead her: 17
  13. Percentage chance of getting pregnant from one act of sex: 5% to 30% depending on where a woman is in her reproductive cycle
  14. Rank of condoms in terms of efficacy among four categories of contraception: 4th
  15. Reason given by a pharmacist in Tulsa who refused to sell emergency contraception to an adult man : “I don’t feel comfortable with it.”
  16. Number of states with “conscious clause” legislation allowing pharmacists to decline to fill birth control prescriptions because of their religious objections: 12
  17. Percentage of US women in their 20’s whose pregnancies are unintentional: 69%
  18. Rate change in unintended pregnancy for high-income women since 1994: 29% decrease
  19. Rate change in unintended pregnancy for low-income women, or those beneath the poverty line, since 1994: 50% increase
  20. Percentage of unintended pregnancies in the US that end in abortions: approximately 38%
  21. Percentage of US adolescents today who have had sex: 46%
  22. Percentage of all teen births in the developed world that take place in the US: 71%
  23. Likelihood that a teenage who has sex without contraception becomes pregnant within a year: 90%
  24. Percentage decrease in chances of an abortion with birth control use: 46%
  25. Percentage of adolescents in the a recent survey given the wrong age for requirements for emergency contraception by pharmacists: >50%
  26. Percentage of American women currently living in states whose legislatures are hostile to Planned Parenthood: More than 50%
  27. Decline in unwanted pregnancies when free birth control (all kinds) were made availableto teen girls: from 34 per 1,000 teens nationally to 6.3 per 1,000 teens in the study group
  28. Rank of US for maternal mortality in the world: 50th in the world
  29. Rate at which the US maternal mortality has changed in the past 25 years: Doubled
  30. Rate at which African American women die due to maternity related issues compared to women of European descent in the US: 3.2 to 1
  31. Estimated reduction in maternal deaths due to increased contraceptive use: up to 35%
  32. Estimated number of pregnancies and abortions that would have been avoided if 65,000 women participating in a study had had easy, regular access to birth control pills: 1,300 publicly funded pregnancies and 300 abortions
  33. Chances that Emergency Contraception causes an abortion: 0%
  34. Chances that EC, when effective, prevents the need for an abortion: 100%
  35. State in which a rape victim was denied emergency contraception based on pharmacists objections: Oklahoma
  36. Number of women who get pregnant from rape every year: 32,000
  37. Percentage of rape victims who are under the age of 18: 15%
  38. Amount the federal government spent on abstinence programs since 1982:1.5 billion dollars
  39. Percentage of students who got pregnant that drop out of New Yorks public school system: 70%
  40. Percentage of boys who fathered babies who dropped out: Not measured.
  41. Percentage of parents who opted out of a New York City pilot program to provide contraceptives in school: 1-2%
  42. Percentage of teachers who think students should be taught about contraception: 90%
  43. Percentage of teachers in the US who are prohibited from teaching about contraception: 25%
  44. Grade that Florida received on The Population Institutes 2012 state-by-state report card on Reproductive Health and Rights: F (the others receiving an F: AZ, LA, MS, NE, NV, ND, SD, TN)
  45. State in which a 14-year old girl faces life imprisonment because she did not want to tell her mother she was pregnant, delivered a baby in her bathroom and then killed it: Florida
  46. Amount inserted, so to speak, into our current budget for failed Abstinence Only programs: $50 million
  47. Number of states that applied for grants to these programs in 2010: 30 including Puerto Rico
  48. Percentage of US sex education programs that teach that abstinence is the only “birth control” option for unmarried, heterosexual couples: 35%
  49. A stated goal of Republican party leadership: defund Title X Family Planning Legislation
  50. Amount that every $1.00 spent on contraceptive access saves in Medicare expenses: $4.02

Many people still do not understand how Plan B works and think that it causes abortions, which they object to. This drug is safer than Tylenol, as easy to use and understand, and is not an “abortion pill.” You should consider sending this excellent explanatory video, along with a copy of Our Bodies, Ourselves as a holiday gift to your representative in Congress or your state legislature.

Objections seemed to hinge on the horror of young girls buying emergency contraception. I don’t understand this. First, boys can buy condoms and this pill is as easy to comprehend and easier to use than micro-thin latex. Object away if you must in equal measure. Second, concern centered (surreally) on a relatively small group: young girls who need emergency contraception. Being “concerned” at this stage—about an eleven year old seeking, by herself, emergency contraception, too little, too late. Asking her to get parental permission, possibly from the very person who impregnated her, is beyond contemptible and falls into the equally repugnant “lemons into lemonade” basket. It’s a desire to ignore and make worse horrible things happening every day to children. If an 11-year-old is seeking contraception there are many other things to be worried about. This is the point at which she needs not to get pregnantIt’s ridiculous to use this reasoning to deny the overwhelming number of girls and women who are not 11 years old access to emergency contraception.

But, beyond Plan B. Last week the American College of Obstetricians and Gynecologists (ACOG) endorsed over-the-counter birth control pills.

Allow yourselves to dream for a minute, ladies: Imagine not having to pay, with your time and money, for doctors visits to get prescriptions. Waiting for or dealing with a pharmacist, who may or may not have religious or other objections to your private decisions. Imagine being able to walk into a store and buy months worth of your contraception of choice by picking it up on a shelf and taking it to the cash register where some nice person smiles, takes your money, gives you change and puts your cute (or garish) little box in a bag, or you even casually drop it in your pocket, and make your way out.

And, men, day dream for them. Because, well, you know. There are some serious upsides that accrue for you guys. Not to mention just basic fairness. I mean, your boxes are so easy to get and even have the advantage of being thematically organized for maximal pleasure. Heck, you can even customize them.

“Fertility control” is more accurate term because it makes both of these words: “pregnancy intentions,” more relevant and important, and, last but not least, it shifts the focuses where it should be: on the people whose reproduction is at issue. Especially women. Who should be fully in control of their own fertility and are clearly NOT. I say women because a man—as described above—can currently control his fertility by walking into a drug store and buying a condom for $1.34. This is entirely unregulated, unlike women’s fertility. Which is regulated. And, of course, women can buy condoms. Which “reduce chances of pregnancy by 97 percent, [but] in reality fail five times as often because of improper use.” For many women, trusting their futures to a thin tissue of rubber just doesn’t cut it.  If ever there was a public health problem with long-ranging costs that we know how to solve this is IT.

And yet, we don’t. We make women jump through hoop after hoop after expensive, time-sucking, regulated fertility hoop. WHY on earth do we tolerate this from pro-natal legislators? And entertain Bishops who have no place in women’s health care. Ever. At all. Never. Forever and ever. Amen.

Birth control is even more reliable and effective if it is available at no cost. landmark study released in October, involving more than 9,000 women, revealed the totally unsurprising effects of providing free birth control: far fewer unwanted pregnancies and “dramatic reductions” in abortions. This study’s findings are echoed in the terrific fact that our teen pregnancy and abortion rates, while still ridiculously high, have been going down.You would think that these findings would make even the hoariest God-Fearing Patriarchs giddy. But, GFPs actually believe researchers, like voting machines, are colluding with entitled, lying harlots in order to dupe good Christian men and take away their magical powers. This isn’t happening due to the fact that teenage girls are using both hormonal and other forms of long-acting birth control (like IUDs) more effectively not opting to wait to have sex in exchange for the traditional “protections” of marriage.

We need to get birth control pills and emergency contraception into the hands of the people who need it, including teenage girls. These methods are safe and proven to work. But, if we are serious about reducing unplanned pregnancies, we also need to think about forms of birth control that are not popular in the US and not used by American women, many of whom are unaware of their options for reproductive health and fertility management. Many countries already make birth control pills available to girls and women at no or low cost, but, these girls and women also use long-acting, reversible forms of contraception – what the Contraceptive Choice project here calls “LARC Methods.”

The rates of success for some of these methods across the board are staggering, especially when women can choose among options to select what will work best for them. Family planning and birth control are critically important parts of modern life and successful modern economies. This is backlash taken to its most ridiculous and expensive extremes. Join the Reproductive Health Technologies Project and urge Health and Human Services Secretary Kathleen Sebelius to get us on the right track today and put women’s interests back into the women’s health equation.

“Emergency contraception needs to be on the pharmacy shelf between condoms and pregnancy test kits, available to women and couples without delay or hassle,” explains Kirsten Moore president and CEO of RHTP, which has led a coalition advocating for this very action for more than 10 years. “Doctors are leading the way saying that all contraception should move over the counter and be available to women of all ages. Politicians need to follow doctors’ lead and get the politics out of women’s health care once and for all.”