The Wake

In the back of my mind, I always wonder. The University of Minnesota campus seems relatively safe, but there are times when paranoia and news reports of sex offenders moving in to my neighborhood lurk large in my mind after I pull an extra late night working or hanging out with friends. Will I be safe in my walk home tonight? And if I won’t, is there a way to undo the damage? If I really needed emergency contraceptive, could I get it?The answer is that at the national level it hasn’t become any easier to obtain the pill. The highly controversial emergency contraceptive, also known as the morning-after pill, could become an over-the-counter medication if approved by the Food and Drug Administration; it is now available by prescription only. Commissioner Lester Crawford released a statement that says the FDA has decided to delay making a decision on the drug for at least another 60 days. Barr Pharmaceuticals applied for over-the-counter status in 2003.

Although the FDA concluded in Crawford’s statement that Plan B would be safe as an over-the-counter product for women who are at least 17 years old, they cannot approve the drug because of “unresolved regulatory and policy issues.”

Crawford won Senate approval for his position at the FDA on the condition that he make a final decision on Plan B before Sept. 1, a deadline which has since passed.

Pro-choice women’s groups such as the National Research Council for Women and Families (NRCWF) and National Organization for Women (NOW) regard the FDA’s failure to approve over-the-counter sale of Plan B as a highly politicized stall tactic and not a scientific judgment.

“You feel like you’re reading from Alice in Wonderland,” Susan Dudly, the director of policy research at NRCWF says of Crawford’s statement. “It doesn’t boast faith in the FDA if they make this decision with a political bend. How will this affect other decisions?”

It was enough to prompt the resignation of Susan Wood, the FDA’s director of the Office of Women’s Health. Wood said in an e-mail to her colleagues that she couldn’t serve as staff when scientific and clinical evidence has been overruled.

Wood’s email said that over-the-counter emergency contraception would reduce unintended pregnancies and reduce abortions, and that indefinite delay of its approval “is contrary to my core commitment to improving and advancing women’s health,” the Associated Press reported.

Targets Closer to Home

After all the drama at a national level, efforts by anti-abortion groups in Wisconsin have decided to chip away at the availability of birth control. One pharmacist was sanctioned by the Wisconsin Pharmacy Examining Board for refusing to fill a prescription for traditional birth control pills for a student at UW-Stout.

In late July, the Wisconsin state assembly passed a bill that bans advertising or offering the option of hormonal contraceptives from the University of Wisconsin system. Campus pharmacies are also banned from filling the prescriptions. The bill passed by a margin of eight votes, even scoring a couple nays from Republicans.

This bill succeeds where Virginia legislation failed that attempted a similar ban on all college health centers, public and private. The legislative committee defeated the bill in part because of more than 100 people speaking out against the proposed legislation.

This bill is especially restrictive to emergency contraceptives because they are so time sensitive. Students without access to transportation are restricted from obtaining the contraceptive when it is most effective.

The University of Minnesota, on the other hand, seems yet unaffected by the movement against hormonal contraceptives, and Plan B is available to students in many ways.

“I’ve never heard of anyone having a problem getting [emergency contraceptive],” says Jessie Bills, an intern at the Aurora Center, which offers sexual violence education and advocacy on campus.

Getting the Pil

One of the most common questions to the Aurora Center crisis hotline is where to get Plan B. The easiest place to get the pill is through the Boynton Pharmacy. It’ll cost me about $20 to get the prescription and the pill. But Boynton is only open Monday through Friday from 8:00 a.m. to 4:30 p.m., which could delay access to emergency contraceptive for women who have intercourse or suffer assault on evenings and weekends.

If the Boynton Pharmacy is closed, women can go to the Cub Pharmacy in Roseville, a mere seven miles from campus, but only if they are normally a patient at Boynton and only if Boynton is closed. The cost of the drug at Cub runs between $12 and $16.

By far the cheapest place to get emergency contraception is Hennepin County Medical Center downtown. There the prescription costs $7.40.

A more private method of obtaining emergency contraception is by logging on to a Web site called getthepill.com. The site assures a licensed OB/GYN will review the medical information submitted by women to determine whether it is safe to use the hormone. The “examination” consists of 6 questions to determine that the recipient is both at least 18 and has experienced a normal period within four weeks. Women then obtain a prescription that can be filled at the nearest pharmacy. The cost of increased privacy is higher than other methods around campus, $24.95 plus the cost of the prescription.

How does it work?

Emergency contraceptives like Plan B or Preven are more time-sensitive than other prescription drugs. They must be taken within 24 hours of intercourse to be 95 percent effective and within 72 hours to be 75 percent effective. The second dose must be taken 12 hours later. The pill acts as a method of preventing pregnancy through disrupting fertilization or preventing the implantation of a fertilized egg, rather than as a method of medicated abortion, a distinction that groups like Planned Parenthood try to make clear.

A fact sheet issued by Planned Parenthood says that the ways the two medications work are different; emergency contraceptives prevent implantation of the egg where medicated abortions block the hormones needed to maintain a pregnancy. Medicated abortions are effective up to 63 days after the last menstrual cycle, significantly longer than emergency contraceptives. Medications like Plan B have almost no effect on an already implanted egg.

The most common side effect is queasiness, suffered by about 50 percent of patients. About 20 percent of women vomit as the result of Plan B. The rest of the side effects and risks are similar to regular hormone methods of birth control, since Plan B is really just a higher dose of the hormone levonorgestrel used in birth control methods such as Ortho-Tricyclen.

By no means is emergency contraceptive a surefire bet. The main argument many anti-abortion groups make is that women will become more promiscuous if Plan B is available over the counter. Pro-choice women’s groups say this is contradictory since other forms of regular birth control are much more effective than emergency contraceptives.

As for me, access seems on the brink of going two directions. Like all women on campus, it can either become easier for me to obtain emergency contraceptives if the FDA approves over-the-counter sale or it can become exceedingly difficult if places like the Aurora Center are banned from even disclosing the location of the medication. In that case, the threat isn’t found behind the darkness, but in the daylight of legislation and regulation.