Time for a Plan B

Do you have your morning-after pill?

Last fall, my roommate had sex with a skeleton—not a skeleton, exactly, but a handsome man she met at a costume party hosted by Brazilians. She was dancing at the center of a drunken crowd when he grabbed her from behind with his bony hands and spun her around. Their eyes locked. Subliminal messages were communicated. Please imagine the beating of tribal drums. They soon left together.

Several cocktails and a broken condom later, she was in need of a Plan B. Lucky for her, we had some in the medicine cabinet.

Levonorgestrel, a.k.a. Plan B, is a little white pill (two, actually) made up of the synthetic hormone progestin. That's the same ingredient you'll find in many newer forms of oral birth control, and it's more effective than estrogen at preventing pregnancy. Taken within 24 hours after unprotected sex—one pill ASAP, another 12 hours later—progestin prevents pregnancy in one of three ways: by blocking ovulation, thickening the cervical mucus so that the sperm's path becomes like knee-deep mud, or by making the uterine lining so formidably inhospitable that fertilized eggs can't possibly establish themselves. One dose runs around $25.

Thank the Women's Capital Corporation for Plan B. A private company based in Washington, D.C., WCC helped guide Plan B through the federal government's complex FDA approval process in 1999, making it available—without prescription, even—to women 13 and older via specially certified pharmacists in California, New Mexico, Hawaii, Washington state and Alaska. A pending FDA application could make Plan B available over the counter in all 50 states. I got mine in the city of Orange.

Emergency contraception or morning-after pills like Plan B have been available for almost 30 years. In 1974, A. Albert Yuzpe published the first studies showing that emergency contraception was safe and effective. Back then, doctors dealing with possible pregnancies typically prescribed massive doses of good old monophasic birth-control pills. Some still do. But because that method is "off-label"—i.e., prescribed in a manner that does not follow perfectly the manufacturer's instructions—doctors feared fat malpractice suits if anything went awry. As a result, pharmacological technologies dealing with impulsive skeleton sex long remained a subject of whispered conversation.

Foes of emergency contraception hoped it would stay that way. On its website, the American Life League calls pills like Plan B "chemical abortion" and implores women to ignore the soft semantics of pro-choicers and, instead, to seek "the truth." An article by David C. Reardon on www.afterabortion.org calls Plan B "the best kept (ugly little) secret in America." Many religious groups and state governments are also opposed, and through legislation and lobbying routinely prevent access to the drug.

With that kind of opposition, women are finding it difficult to get their hands on Plan B even where state law makes it available over the counter. In Hawaii, where Plan B is legal, Governor Linda Lingle, a Republican, vetoed a bill that would provide free emergency contraception to victims of sexual assault. And according to a June article in the Los Angeles Times, some Catholic hospitals in California said they simply refuse to offer Plan B.

Strangely, Catholic hospitals in Orange County (St. Jude, St. Joseph and Mission) are more lenient, at least in cases of violent crime. According to Carolyn Carter, a spokesperson for the St. Joseph Health System (parent company for all three hospitals), "As a Catholic health system, we follow the ethical and religious directives for Catholic health-care services. These state that women who are victims of rape or sexual assault can be provided with all treatment necessary to prevent conception." Including emergency contraception like Plan B.

The debate continues between those who want Plan B as readily available as nasal spray and those who think it should be banned as a harbinger of a second Holocaust. Meantime, California girls who find themselves in compromising positions with skeletons (or anyone else) have another form of backup to prevent unplanned pregnancy—sort of like having the Auto Club, a spare tire and a cell phone for emergencies. But until the Bush administration's FDA lightens up, women living in 45 other states simply have to hope they won't be left stranded on the side of the road.

For more info on Plan B and the Women's Capital Corporation, see www.go2planb.com. Local clinics that provide Plan B along with a bevy of other reproductive services are Planned Parenthood (www.ppfa.org) and the Clinic for Women/Clinica Para La Mujer in Santa Ana, (714) 285-9811.

 
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