Plan B needs a Plan B


Think the fighting’s done over Plan B? You’d better have a Plan B, because it’s far from over. Just because the Food and Drug Administration finally did most of what it should have done years ago — it approved the "morning after" pill for sale without a prescription to women who are at least 18 — doesn’t mean this battle is behind us.

Religious groups and religiously motivated conservatives tried to pressure President Bush to fire the acting FDA commissioner who finally pushed through permission to sell Plan B over the counter without a prescription.

Andrew von Eschenbach has been running the agency without congressional endorsement since last September. The hold on his confirmation by Democratic Sens. Hillary Rodham Clinton of New York and Patty Murray of Washington state has now been lifted, and he should be confirmed not long after Congress returns from its summer recess.

Shortly after the Bush administration took office, a medical advisory panel to the FDA agreed Plan B was safe and should be given to any female who wants it without a prescription, regardless of age.

In swooped the religious right, which apparently believes that life begins before conception, while the medical community, most Americans and even most religious dogma believe that life begins at conception. The drug’s approval was stalled for years.

This is a controversy driven by a minority of zealots who apparently believe that the Spanish Inquisition never should have ended and that any sex at all is bad unless it’s between married couples having sex solely for the purpose of procreation. Their ideology generally stopped evolving somewhere between the fourth-century theologian Augustine and the Middle Ages.

If they choose to live in prehistoric times, no one is trying to stop them. But when other Americans try to live in the contemporary world, they step in and protest, attempting to inflict their rigid ideology on everyone else.

Plan B is a synthetic form of the female hormone progesterone. Progesterone has been used in birth-control pills for decades now and is considered to be among the safest manmade pharmaceuticals. It works either by interrupting ovulation, by preventing fertilization of the egg or by barring a fertilized egg from lodging in the uterus. Science’s definition of conception is when the fertilized egg (or zygote) implants in the uterus.

Even the most devout among us recite church dogma that states that life begins at conception (not before it). Yet religious groups such as the Family Research Council and Concerned Women for America waste a lot of time, money, energy and political capital trying to restrict women’s access to Plan B.

They say it’s unsafe. There’s no reliable medical information to prove that claim has merit. They say it increases teen sex. There’s no reliable data to prove that claim, either. In fact, a 2005 study reported in the journal Obstetrics & Gynecology found no link between the availability of the morning-after pill and sexual activity among teens. Nor did it find the drug to be unsafe for younger women.

Conversely, there are new data emerging suggesting that abstinence-only education, which urges chastity until marriage, leads to a higher incidence of teen pregnancy. Why don’t these groups start lobbying against abstinence-only education instead of against Plan B?

The fight won’t just continue on one side, however. Proponents of unrestricted access still want girls 17 and younger to be able to buy Plan B over the counter and without first seeing a doctor.

The Plan B fight is ironically emblematic of how the United States has become a lagging, not leading, indicator in worldwide access to birth control. Planned Parenthood told media outlets that some 41 countries allow emergency contraceptives to be sold without a prescription, many without age restrictions. Some of America’s own states were out ahead of the nation on this issue. Nine states not controlled by the religious right already allow access by women and girls of any age, without prescription.

Perhaps the fact the atavists lost this fight is a sign of a turnaround. Maybe, just maybe, their era of pre-eminence is fading and America can look forward to an era of cultural leadership once more.

(Bonnie Erbe is a TV host and writes a column for Scripps Howard News Service. E-mail bonnieerbe(at)