The U.S. Food and Drug Administration has deemed Plan B, commonly known as the “morning-after pill,” a safe form of contraception. But as the drug becomes more easily accessible in the coming months, experts warn that it should be used in emergency situations only.
In July 2005, the Massachusetts Legislature broadened access to Plan B and passed a provision to make it available without a prescription, pending approval from the FDA. Last month the FDA approved over-the-counter status for Plan B, which is taken in two-pill doses. Women 17 and younger will still need a prescription to receive the drug, but it will be available over the counter by the end of 2006 to women 18 and older.
“Plan B can safely reduce the risk of pregnancy if taken within five days of unprotected sex,” said Leilani Bowie, a Planned Parenthood spokeswoman. “Barr Pharmaceuticals, the manufacturer of Plan B, stated that they plan to make an over-the-counter version available by the end of this calendar year.”
Bowie said the pill, which sells for $25 to $40, is not an abortive procedure, but it is similar to the birth-control pill.
“It does not work if you are already pregnant and will not harm an existing pregnancy,” she said. “It is approved by the FDA as a form of birth control and works in much the same way as an ordinary birth-control pill.”
Plan B, which contains the hormone levonorgestrel, may stop the release of an egg and may also prevent fertilization. It will not affect an existing pregnancy, according to information posted on Plan B’s official website.
Taking the pills after unprotected sex would drastically reduce the chance of pregnancy, Bowie said.
“Timely access to emergency contraception holds the potential to reduce by up to 50 percent the three million unintended pregnancies that occur each year in the United States,” she said. “The sooner the drug is administered after unprotected intercourse, the better it works, making timely access critically important.”
Planned Parenthood, the state’s leading provider of emergency contraception, already offers Plan B at all its Massachusetts health centers. The drug is available to women who visit a Planned Parenthood location and meet with a doctor on site who can write prescriptions.
Bowie said Planned Parenthood looks forward to providing the pill over the counter in a more private atmosphere.
The pill will be available at pharmacies without a prescription, Bowie said, but pharmacists will have to be trained to administer the drug.
CVS Pharmacy’s monograph for Plan B, which is administered to people who buy the drug, says it is “a progestin hormone that prevents pregnancy by preventing the release of an egg and changing the womb and cervical mucus to make it more difficult for an egg to meet sperm or attach to the wall of the womb.”
Although the pill can be taken up to five days after sex, it works best when taken 72 hours after unprotected sex, the monograph reads. Side effects may include nausea, vomiting, abdominal pain, tiredness, dizziness, changes in vaginal bleeding, breast tenderness, diarrhea or headache.
Meghan Cashin, a University of Massachusetts-Lowell senior, said she has used the morning-after pill in an emergency situation.
“I’m in school, and I knew I had to make a decision,” she said. “If I got pregnant, what would I do? Right away I called the doctor.”
Cashin said Plan B is harder to acquire than most people think.
“The first [pill] is strong,” she said. “I felt really sick because it wears you out. I was nauseous and I kept falling asleep the next day. People say it’s the potency of 10 birth control pills, but it’s much worse.”
Cashin said she was so tired and worn out from the first pill that she did not notice the side effects of the second.
Cashin said she does not recommend the pill to girls who may consider using it as an alternative to condoms or other birth control, and that it should only be used in emergency situations.
“Don’t choose this over regular birth control,” she said. “The side effects are just so bad.”
Cashin said she was hesitant about the decision to make the pill available over-the-counter, saying that people who have never taken the pill will not be expecting its negative effects.
“I think making it more available is going to sound good to people, but once they realize the side effects, they’ll say to themselves ‘I can’t do this every week,'” she said. “There are also emotional side effects. It’s like the precursor to abortion. It’s emotionally draining to think that you could have just had an abortion.”
Stacey Link, a University of Massachusetts-Amherst senior and saleswoman for Athena’s Home Novelties, a company that sells sex toys and condoms, also sees a distinction between using Plan B as a regular form of birth control and using it in an emergency situation.
“It isn’t the act of sex that I condone,” Link said. “It isn’t that I don’t know what it’s like to be caught up in the moment, where reaching for a condom isn’t the first thing that’s on your mind. What I do know is that sex is an adult activity, which requires taking responsibility for any actions you may choose to engage in.
“Should an individual decide to have sex, they should then decide to make their next adult choice using a condom,” Link continued. “As a distributor of Adult Home Novelties, I sell condoms to people who are interested in enjoying their experiences in a safe, responsible, adult-like manner.”
Many girls who have never used the morning-after pill consider it a viable option in emergency situations, but they acknowledge the risks of making it so widely available.
“I’ve never used it, but only because the opportunity never presented itself,” said UMass Lowell senior Alexandra Horelik. “I would use it if I needed to and felt safer.
“I think offering it over the counter could be potentially dangerous, as people might abuse it as a type of birth control and not worry about the consequences of unsafe sex and the exposure to [sexually transmitted diseases],” Horelik added. “But for those who are using it properly, I think it’s great that it’s available to more people who might not be in a position to get an appointment and prescription for it.”
Another alternative, Horelik said, would be for pharmacies to sell the pill without a prescription, but behind the counter, so they can monitor who is buying the drug and offer counseling for first-time users.
Jessica Pittochelli, a senior at Boston University’s Sargent College, said she is not concerned with possible long-term side effects, but she also wouldn’t substitute the pill for safe sex.
“I would use it if I needed to,” she said. “I wouldn’t have a problem using it because it has implications for fertility later in life. I think it’s stupid to substitute it for condoms, though. It’s more expensive, makes you feel sick and doesn’t protect against STDs.”
David McBride, director of Student Health Services at BU, said Student Health Services makes the pill available to BU students.
“We do offer evaluation and prescription for EC [emergency contraceptives],” McBride said in an email. “EC is covered by most insurance carriers, so women can carry the script to any pharmacy to have it filled. After hours, when pharmacies are not open, we do keep a short supply of EC to dispense directly to students.
“We will be developing increased access to EC over the phone,” he continued. ”We also try to give women a prescription for EC to fill and keep on hand when they come for their annual visits. The reason that we offer EC is that we believe that it is important for women to have control over choices regarding reproduction.”
McBride said in most cases, BU students are not denied access to emergency contraception.
“EC is a backup plan,” he said. “We encourage every woman who chooses to be sexually active with a male partner to use a reliable method of birth control, like the oral contraceptive. Condoms do have a habit of failing, so it is important for a woman to take charge of her reproductive health.”