B Is for Betrayal

Less than a day after President Barack Obama’s soaring speech on restoring the American middle class, progressives who felt that the administration was finally heading in the right direction stumbled back to reality Wednesday with a baffling decision from Health and Human Services (HHS) Secretary Kathleen Sebelius.

Sebelius overruled the Federal Drug Administration (FDA) on its recommendation to make the contraceptive Plan B—a morning-after pill that reduces the risk of pregnancy after unprotected sex—available over the counter alongside contraceptives like condoms. Even girls younger than 16 would have had access to Plan B under the FDA's recommendation.

In a statement explaining her decision, Sebelius argued that the FDA had not studied the potential impact on girls as young as 11 who could misunderstand the effects of the pill. As a result, she determined it was premature to make the pill available over the counter. "After careful consideration of the FDA summary review," Sebelius said, "I have concluded that the data submitted by Teva [the Plan B drugmaker] do not conclusively establish that Plan B One-Step should be made available over the counter for all girls of reproductive age."

Perhaps cases in which an 11- or 12-year-old girl finds herself in need of a morning-after pill requires the intervention of a doctor and, if sexual abuse or coercion is involved, police. But that wasn't Sebelius's argument. Instead, the HHS secretary questioned the science—despite the fact that the FDA’s commissioner, Dr. Margaret Hamburg, has gone on the record to say that all the experts and studies on Plan B have found the drug to be safe for adolescent women and that teens understood it was not a regular form of birth control and does not protect against sexually transmitted diseases. To be clear, the morning-after pill does present some side effects, including vomiting for some women. But doctors who researched the effects maintain that it is no more dangerous than other widely available medications.

“Acetaminophen can be fatal, but it’s available to everyone,” Dr. Susan Wood, former FDA assistant commissioner, told The New York Times. “So why are contraceptives singled out every single time when they’re actually far safer than what’s already out there?”

Framing the policy around the health of young girls sidesteps the larger issue: The decision restricts contraception access for all sexually active women, not just young girls. If Sebelius were truly concerned about 11-year-olds, she could have suggested age limits for purchasing the medication without a prescription instead of controlling access across all age groups.

Currently, women seeking Plan B can only get it behind the counter if they provide identification proving they are over the age of 17. In places where pharmacies close early or in states with conscience clauses that allow pharmacists to decline to sell Plan B, women can be prevented from getting the medication at all. Although the HHS decision does not place further restrictions on obtaining Plan B, it keeps a system in place that bars young women from obtaining the drug without a prescription and makes it difficult for grown women to act in their own health interests.

"Women must not be forced to jump unnecessary hurdles to obtain safe and effective contraception," said Eleanor Smeal, president of the Feminist Majority, in a statement after the decision was announced. "Men and boys of all ages can obtain condoms easily, without interference from any governmental authority. Women and girls deserve equal treatment and respect, at the minimum."

The battle to make Plan B easily available has been long. The Bush administration approved sale of the drug to women over the age of 18 without a prescription in 2006. When he took office in 2009, President Obama signaled that his administration would make the medication even more accessible by lowering the age to 17. As late as this Tuesday, when Congresswomen Diana DeGette and Louise Slaughter wrote a Huffington Post op-ed heralding an expected decision to make Plan B more available, it seemed new guidelines would soon be in place. To now have what was expected to be a significant step forward checked by a Democratic administration is astonishing. If keeping the restrictions on Plan B in place is an election year political ploy, then it has most assuredly succeeded in stirring up liberal women who feel betrayed.

"Six years ago, we sued the Bush administration for rejecting science and playing politics with women's health by denying emergency contraception for over-the-counter sale," said Nancy Northup, president of the Center for Reproductive Rights, in a statement Wednesday. "We are stunned to see the same behavior from the Obama administration. It is unacceptable that the approval for drugs supporting women's reproductive health is held to a completely different standard."

Refusing to advocate for women, particularly when not just the right to choose abortion but birth control itself is challenged by personhood movements around the country, doesn't score any political points; it merely takes for granted the electorate that hoped for representation.