Concerned girls, women, parents and pharmacists are left monitoring the status of ever-changing rules, regulations and developments regarding the Plan B, or “morning-after,” pill.
The Justice Department on Wednesday appealed a federal judge's April ruling ordering that the drug be available over the counter to girls and women of all ages.
Tuesday, the Food and Drug Administration approved over-the-counter sales of the Plan B One-Step pill for girls ages 15 and older.
The Obama administration has favored requiring an older age, 17, and a pharmacist's involvement. The women's group that sued over the age limit said the FDA's action didn't comply with the judge's ruling.
On and on goes the challenge to understand who can obtain the morning-after pill, how they can obtain it and where they can obtain it.
“They do change constantly, don't they?” said Jennifer Chelewski of Kearney, a mother of three young boys, said of the rules. “I think the regulations need to be tightened on how it's sold and who it's sold to.” Chelewski said she views the morning-after pill as destruction of life, although it is an emergency contraceptive and does not cause an abortion.
The drug, levonorgestrel, prevents pregnancy from occurring and will not work if a woman is already pregnant. It should not be confused with RU-486, the abortion pill.
Contraception advocates see a double standard with age limits. No one is carded when buying a condom, but under the FDA's decision, consumers would have to prove their age when buying a pill to prevent pregnancy if that condom breaks.
“This isn't a compromise. This is wrong,” said Cynthia Pearson of the National Women's Health Network.
Others argued it was important for parents and medical professionals to be involved in such decisions involving teens. “This decision undermines the right of parents to make important health decisions for their young daughters,” said Anna Higgins of the Family Research Council.
Meanwhile, Hy-Vee officials this week mulled how the store would respond to the FDA announcement. “We're taking a look at it right now,” spokeswoman Ruth Comer said from West Des Moines. Among other things, Hy-Vee Supermarkets and others that dispense the drug wondered what identification a 15-year-old girl might provide to prove her age.
“It's part of the regulatory process. It's part of the business,” said Comer, who suggested that individual Hy-Vee stores would have latitude in how it's handled.
In some cases, girls and women may struggle to obtain the pill regardless of age. In the metro area, Kohll's Pharmacy & Homecare keeps the pill at two of its eight stores in the area. The pill could be provided by courier in a day or two, said Laurie Dondelinger, a spokeswoman for the drugstore chain. A girl in need of the pill also could be referred to another drugstore, she said.
The drug works best if taken within the first 24 hours of unprotected sex, but it also can cut the chances of pregnancy considerably if taken within 72 hours.
“There just doesn't seem to be a big demand,” Dondelinger said of the pill, which costs about $48 per pill at Kohll's.
Kubat Pharmacy doesn't carry the morning-after pill because it's a pro-life pharmacy chain, a spokeswoman said.
Dr. Jean Amoura, associate professor of obstetrics and gynecology at the University of Nebraska Medical Center, said major national chains, such as Walgreens and Walmart, carry the morning-after pill. But obtaining it in some small towns conceivably could be difficult, Amoura said.
She said she was pleased with the FDA announcement because, in the past, girls and women 17 and older obtained the pill from behind the counter by asking the pharmacist for it, and that was a disincentive for some.
Having it “truly on the shelves” would be “a win for patients,” she said.
As for concerns about the drug's risks, Amoura said it's regarded as highly safe.
The debate over its use has gone on for more than a decade. Selling the morning-after birth control pill right next to condoms, even if limited to buyers 15 or older, would mark a big shift in the long battle over women's reproductive rights.
The FDA's stab at compromise appears to have just made both sides madder.
U.S. District Judge Edward Korman of New York had given the FDA until Monday to lift all age limits on Plan B and a cheaper generic, mandating that emergency contraception be sold just like aspirin. Instead, by requiring that buyers prove their age at the cash register, the FDA decided to treat it something like beer.
The White House said Wednesday of the FDA decision that President Barack Obama “did not weigh in on this decision.”
In its appeal, the Justice Department says that Korman had exceeded his authority and that his decision should be suspended while the appeal is under way.
Also on Wednesday, doctors' groups, led by the American College of Obstetricians and Gynecologists, urged the Obama administration not to let the FDA action be the last word. Any over-the-counter access marks a long-awaited change, but it's not enough, said Dr. Cora Breuner of the American Academy of Pediatrics, which supports nonprescription sale of the morning-after pill for all ages.
“We still have the major issue, which is our teen pregnancy rate is still too high,” Breuner said.
Most 17- to 19-year-olds are sexually active, and 30 percent of 15- and 16-year-olds have had sex, according to a report published last month by the journal Pediatrics.
Danielle Savington, an attorney who lives in Papillion, has two sons, plus a daughter who next month will become a teenager. “So this topic really hits close to home,” Savington said.
Savington said that while she strives to instill confidence in her daughter so she respects herself and her body, they also have talked about the morning-after pill. “I think we have to recognize that there's a need for it.”
Whether that discussion occurs in a home should be up to the parents, she said, and the access decision will be important to many families.
“It makes me sad that it's necessary,” she said.
World-Herald researcher Sheritha Jones contributed to this report, which also includes material from the Associated Press.
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