Easier Access to Plan B: Bad for Black Girls?

Plan B contraceptive displayed at a pharmacy (Justin Sullivan/Getty Images)

(The Root) — If Susannah Baruch were in charge of the nation's biggest chain pharmacy stores, she'd issue orders today. They would read: Make room on store shelves, somewhere between the pregnancy tests and the condoms, for another form of effective, over-the-counter birth control.

"That's exactly where emergency contraception should be, between the condoms and the pregnancy tests," said Baruch, interim president and CEO of the Washington, D.C.-based Reproductive Health Technologies Project. "It really should have been there for years."

On April 5, a New York federal court ordered the U.S. Department of Health and Human Services to lift a nearly 7-year-old rule that banned stores from selling emergency contraception — a medication that can prevent pregnancy up to five days after unprotected sex or a birth-control mishap — to customers under the age of 17 without a prescription. Federal officials must implement the order by the end of this month.

But like almost every issue even remotely connected to reproduction, expanded access to emergency contraception has already become a battleground in the conspiracy-laden (pdf) culture wars around abortion and control of women's fertility. Women's — and even children's — health advocates are cheering the court's ruling as a victory for science over politics and cultural squeamishness about sexually active teens, which could go a long way to reduce unplanned pregnancies in the United States. But anti-abortion groups are also describing the ruling as another assault on the health and fertility of black girls, according to Catherine Davis, a co-founder of the Atlanta-based National Black Prolife Coalition.

In black America, the court's decision to force the federal government to expand access to emergency contraception is particularly important news, said Leslie Kantor, vice president of education for Planned Parenthood Federation of America, based in Washington, D.C.

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Despite a precipitous drop in teen pregnancy since the 1990s, the black teen abortion rate remains significantly higher (pdf) than that of other demographic groups, according to a March analysis released by the Guttmacher Institute, a New York-based reproductive policy think tank and research organization. A full 67 percent of black teen pregnancies ended after an abortion in 2008, the most recent data available.

But those figures don't convince Davis that what black teenagers need is expanded access to emergency contraception.

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"This court's decision frightens me for women all over the spectrum," said Davis, "but it just makes me shudder when I think about what we may be doing to thousands of black girls and the way we are cutting parents out of decisions that are very, very serious."

Emergency contraception — essentially high-dose birth-control pills often called "the morning-after pill" or by one of its brand names, Plan B — works by postponing ovulation, which prevents sperm from coming in contact with and fertilizing an egg. But Davis believes the long-term health implications of giving high-dose birth-control pills to young teens aren't known.

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"We don't know enough about these drugs," she said. "Putting emergency contraception on the shelf beside the cold medicine will tell a lot of people that we do."

The National Institutes of Health has identified a slight increase in the risk of breast cancer among women who use birth control. But in 2011, the U.S. Food and Drug Administration launched a comprehensive review of studies examining the safety of emergency contraception. The nation's drug-safety agency found no evidence of health risks associated with emergency contraception or scientific reason to limit access to those who are 16 or younger.

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The drug-safety agency's findings were so clear that most people watching the issue closely expected the Obama administration to lift the rule banning over-the-counter emergency contraception sales to girls 16 and under. But in December 2011, Health and Human Services Secretary Kathleen Sebelius overruled the FDA's recommendation to make emergency contraception more widely available, saying additional research was needed. About 10 percent of 10- and 11-year-old girls are physically capable of becoming pregnant, Sebelius said at the time. Before making emergency contraception available over the counter, Sebelius wanted to see evidence of the drugs' effects on young girls.

Critics charged that the administration was simply trying to avoid a political battle over contraception and parental rights during the then-ongoing presidential campaign.

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With the election over, the federal court's ruling seems to have restored the role of science in health policy and public access to emergency contraception, reproductive-rights advocates say. 

"We believed all along that the decision to limit access to emergency contraception was a political one, based on issues of comfort with teens having sex and teens having access to emergency contraception," said Baruch. "But we know that there is a lot of unintended pregnancy among teens, particularly black and Latina teens. So for them, this is, without question, a victory."

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Editor's note: This article has been updated to state that Plan B works by postponing ovulation, which prevents sperm from coming in contact with and fertilizing an egg.

Janell Ross is a reporter based in New York who covers political, social and economic issues.

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