Plan B, with an asterisk

8/29/2006

WITH a teen pregnancy rate that is higher than any other urban county in Ohio and consistently surpasses the national average, Lucas County should be keenly involved in the continuing debate over the so-called morning-after contraceptive.

The pills, sold under the brand name "Plan B," were just approved for over-the-counter sales by the Food and Drug Administration - to adults. Teenaged girls under 18 will still have to see a doctor and obtain the emergency contraceptive by prescription. They will have time to do that because the pill can be taken up to 72 hours after unprotected intercourse.

It was a government compromise to allow some easing of restrictions on the drug, which contains a concentrated dose of the same drug found in many regular birth control pills. The drug has been available only by prescription since 1999. Making nonprescription pills available to women - and men buying for their partners - who are 18 and older, comes after a hard-fought, three-year battle.

While some 41 countries already allow the morning-after contraceptive pill to be sold without prescription, U.S. opponents had successfully blocked greater availability of the drug on grounds that it would increase promiscuity.

It was only by agreeing to restrictions on teenagers that the FDA was able to advance one of the most contentious issues to ever come before the agency. Other limitations on the contraceptive include only selling it from behind the counter at pharmacies and not at convenience stores or gas stations. Pharmacists will also check photo identification.

While Planned Parenthood expressed relief that the FDA had finally ended its foot-dragging on the issue, it said it was "troubled by the scientifically baseless restriction imposed on teenagers."

The drug's manufacturer, Barr Pharmaceuticals Inc., along with lawmakers and women's groups, vows to fight until the pills are available without prescription to all ages. Such an extension could help reduce the distressing number of teen pregnancies in Lucas County.

Plan B can reduce the risk of a pregnancy by up to 89 percent. The FDA says the emergency contraceptive generally acts like regular contraceptives in preventing ovulation or fertilization. It is different from the RU-486 abortion pill in that the contraceptive has no effect if a woman is already pregnant.

So why should there be any age restrictions on Plan B if the point is to prevent unwanted pregnancies from occurring? The answer may seem straightforward, but it isn't.

Proponents of lifting restrictions on girls age 17 and younger rightly argue that their demographic is at especially high risk for unplanned pregnancies. But how young is too young? Should the low-end age limit be set at, say, age 13? Age 14? Not at all?

The FDA's decision ends a long deadlock and makes Plan B available more readily for the first time. By drawing the line at 18, the FDA has also signaled its determination that the government should not appear to be encouraging a sexually active lifestyle for America's adolescents, even if that ship has already sailed.

For now, the compromise is a reasonable step forward.