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Emergency Contraception Vetoed Based on Pigs Flying: Plan B Banned for Girls under 17

Posted Dec 12 2011 12:16pm
Last week Health and Human Services Secretary Kathleen Sebelius  overrode the FDA's plan to allow the emergency contraceptive pill  (aka the morning-after-pill, Plan B) to be sold over the counter to girls younger than 17 years old.  Why?  In a statement  the head health honcho (who is neither  doctor or health expert) voiced concern the the pill might harm 11-year old girls who take it.

FYI, it's been available for those 17 and older since 2009. 

At first glance, the HHS Secretary's argument seems reasonable.  Yet on closer inspection it reeks of politics trumping the facts, in this case, the evidence. 

The drug has been extensively tested in adolescent girls younger than 16 and deemed to be both safe and effective according to the FDA.  These studies haven't been made public yet but reportedly assessed both safety and proper use (i.e. do girls understand and follow the directions?).  Apparently the studies didn't include 11 year-olds, an omission that troubled Ms. Sebelius who worried about the 10% of 11 year-olds who are physically capable of "bearing children."

Okay, this isn't Sunday school, Kath, you can say pregnancy.  I wonder if that 10% refers to getting pregnant or having a live birth - not exactly the same phenomenon.  Anywhoooo,  Ms. Sebelius also worried about their "cognitive" and "behavioral" limitations but didn't elaborate.  So I will....

Perhaps not being able to follow the directions.

Alas, it's a single pill.  One pill.  Not a course of ten that must be taken on the lunar eclipse.  Sure, a young girl might not be able to swallow it.  That's a behavioral consideration.  My 11-year old has never swallowed a pill but then again she hasn't faced the prospect of becoming a tween mom.  

Eleven year-olds having sex, unprotected sex? 

Thankfully a pretty rare occurrence according to Lawrence Finer, Director of Domestic Research at the Guttmacher Institute in a recent  letter to the New York Times:
Less than 1 percent of 11-year-old girls are sexually active. On the other hand, almost half of girls have had sex by their 17th birthday, before they are legally able to gain access to the emergency contraceptive over the counter.
Come to think of it eleven year-olds can buy other potentially dangerous drugs over the counter (e.g., acetaminophen) but not one that might prevent them from any number of known adverse health consequences of t(w)een pregnancy and I'm not just talking about the instant celebrity from being cast in MTV's Teen Mom. 

But before you start to freak, some experts don't think it much matters whether the morning-after pill is available.  Studies routinely show women rarely seek out emergency contraceptives
Women often miscalculate their menstrual cycle, or do not understand the risks of unprotected sex. As of now, half of all pregnancies are unplanned, more than 40 percent of children are born to unwed mothers, and 1.2 million abortions are performed every year involving one in every 50 women of reproductive age. Plan to Widen Availability of Morning-After Pill Is Rejected, New York Times, December 7.

So if older women don't seek it out, it's nearly impossible to imagine an 11-year old seeking out the pill on her own.  How many 11 year-olds know about emergency contraception?  I didn't realize it was even available for girls under 18.  Had no idea until recently.  How many 11 year-olds would know about it? Of course taking the pill entails suspecting you might be pregnant too.  

Basically the Obama administration's top health wonk has made a decision based on a seemingly improbable possibility:

An 11 year-old has unprotected sex, suspects she might have gotten pregnant, worries about it, knows about emergency contraceptive, knows she can get the pill over-the-counter, actually gets to a pharmacy, takes the pill and then suffers some harm from the single dose of hormone (e.g., chokes, has allergic reaction, panic attack?).     

It's anyone's guess how often an 11 year-old who's had unprotected sex even suspects she might be pregnant.  There is probably little if any research addressing the chance an 11-year old would even worry about being pregnant.  

Then it's possible some might take the pill who haven't even gotten their periods.  We can worry about that incredibly rare event too. 

Then there's the even rarer scenario that a tween who hasn't even had sex would take the pill... 

By the way the American Academy of Pediatrics also  recommended the pill be available to girls under 17. 

And New York Mayor Michael Bloomberg.  Yeah, a Republican supporting emergency contraceptives.  Speaking of which the Wall Street Journal couldn't help but report the liberals were angry too
Left-leaning women's health advocates seized on the ruling to accuse the Obama administration of allowing politics to interfere with a decision the FDA typically makes based on scientific evidence.  Obama Health Chief Blocks FDA on 'Morning After' Pill, WSJ, December 9  
Oh it's all about the science.  Just the science...
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