Statement in Support of Approval of Over-the-Counter Availability of Plan B Emergency Contraceptive
December 16, 2003
Presented by Kim Gandy, President, National Organization for Women, at the U.S. Food and Drug Administration Hearing, Joint Meeting of the Nonprescription Drugs Advisory Committee and Advisory Committee on Reproductive Health Drugs
As its name suggests, this drug is about responding to emergenciesemergencies that are a result of unwanted sex or contraceptive failure. Under these circumstances, urgent treatment within 72 hours is critical. Making Plan B available for over-the-counter sale would significantly reduce the stress and trauma experienced by women in these emergency situations, while preventing thousands of unwanted pregnancies.
Our organization has worked for decades to assist victims of sexual assault, and the needs of women who have been raped are especially critical. Over 300,000 women are raped in the U.S. each year1 and over 32,000 become pregnant as a result.2
While victims of rape receive treatment in hospitals to prevent HIV and sexually transmitted diseases and standards of emergency care established by the American Medical Association (AMA) require that rape survivors be counseled about their risk of pregnancy and offered emergency contraceptionthat is not what is happening in many instances. In far too many cases, women are being denied access to emergency contraception.
Only a handful of states have laws mandating that emergency contraception be available to rape victims. Recent surveys in six states (Minn., Mo., N.Y., Pa., Texas, Wyo.) have shown that few hospitals provide emergency contraception to rape victims.3 Eighty-two percent of Catholic hospitals do not provide emergency contraception even to women who have been raped.4
EC is not only a safe and effective method to prevent unwanted pregnancy, it also can empower women who have been raped with a sense of control and provide an important means to help them to cope with the trauma of sexual assault.
The basic facts about emergency contraception further support its suitability for over the counter distribution. Plan B emergency contraception has all of the characteristics of an over-the-counter drug: it is safe, effective, and simple to use; it is not associated with any serious or harmful side-effects; it is not dangerous to women with particular medical conditions; and does not lead to riskier behavior or less frequent use of other forms of contraception.
The primary barrier to obtaining and effectively using emergency contraception is timing. Emergency contraception is extremely time-sensitive. The sooner it is taken following unprotected or under-protected sexual relations, the more effective it is. If taken within 72 hours, risk of pregnancy is reduced by up to 89 percent.5 Currently, EC is extremely difficult to obtain in a timely mannerbecause women must first obtain a prescription.
A woman faced with a broken condom on a Friday night, whose doctor's office is closed over the weekend, might have to wait until the following Mondaythree days laterto obtain a prescription. Women in rural areas may have to travel great distances to reach the nearest doctor or clinic, making a prescription within 72 hours difficult, if not impossible.
In one survey, even when calls to health providers were made during business hours, only three out of every four attempts to obtain emergency contraception resulted in appointments or telephone prescriptions within 72 hours. Because EC is more effective the earlier it is usedand is most effective within the first 12 hours after unprotected sexual relationsthe obstacles associated with obtaining a prescription for EC pose a serious threat. Women need to have access 24 hours a day, seven days a week.
Nearly 50 percent of pregnancies in the U.S. are unintended, and over half of those pregnancies end in abortion.6 An estimated one half of these unintended pregnancies and abortions could be prevented each year through wider use of EC.7
The American Medical Association (AMA), the American Nurses Association, the American Academy of Pediatrics, the American Public Health Association, the American Academy of Family Physicians, the American College of Obstetricians and Gynecologists, and the Association of Reproductive Health Professionals are all in favor of making emergency contraception available without a prescription.
Thank you for the opportunity to speak today.
1Patricia Tjaden and Nancy Thoennes, "Prevalence, Incidence, and Consequences of Violence Against Women: Findings from the National Violence Against Women Survey," Research in Brief, U.S. Department of Justice, National Institute of Justice, Nov. 1998.
2Melisa M. Holmes, Heidi S. Resnick, Dean G. Kilpatrick, and Connie L. Best, "Rape-Related Pregnancy: Estimates and Descriptive Characteristics from a National Sample of Women," American Journal of Obstetrics and Gynecology, vol. 175, no. 2, August 1996.
3Minnesota NARAL Foundation, Access in Crisis: The Continuing Decline of Hospital-Based Emergency Contraceptive Services in the State of Minnesota, 2000; Missouri NARAL Foundation, The Access Project: An Assessment of Reproductive Health Services in Missouri, 2001; NARAL/NY Foundation, Preventing Pregnancy After Rape: Does Your Hospital Provide Emergency Contraception to Rape Survivors?, 1999; Rebecca Simons, Emergency Contraception for Sexual Assault Survivors: A Survey of Hospital Emergency Rooms in Pennsylvania, Clara Bell Duvall Education Fund, 2000; TARAL, Where Can a Woman Go? A Guide to Reproductive Services, August 2001; Wyoming NARAL, Abortion Access Project, Preliminary Results, 2000; Catholics for a Free Choice, Catholic Health Restrictions Updated, 1999.
4Catholics for a Free Choice, Catholic Health Restrictions Updated, 1999.
5James Trussell et al., The Effectiveness of the Yuzpe Regimen of Emergency Contraception, 28 Family Planning Perspectives, 1996.
6 Stanley Henshaw, "Únintended Pregnancy in the United States," Family Planning Perspectives, vol. 30, no. 1, 1998.
7 James Trussell et al., "Emergency Contraceptive Pills: A Simple Proposal to Reduce Unintended Pregnancies," Family Planning Perspectives, vol. 24, no. 6, 1992.
###For Immediate Release
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