December 14, 2011

Corrie Westing reports on how the Obama administration is betraying young women with its recent decision on emergency contraception.

AS IF this year hasn't yet seen enough federal and local restrictions on women's reproductive rights, young women just got more bad news regarding their ability to control their own bodies last week.

This time, the Food and Drug Administration (FDA) issued a ruling to ease access to emergency contraception for minors--and President Obama's Health and Human Services Secretary Kathleen Sebelius immediately overturned it.

Though the FDA's extensive research found that emergency contraception is safe for all women of childbearing age, including women under the age of 18, Sebelius invoked her authority to keep it restricted to minors only with a prescription.

Appallingly, Obama declared his support for the restriction by citing his distrust that his own daughters could make an appropriate decision to access emergency contraception if they weren't required to have a prescription for it. He told reporters, "As the father of two daughters, I think it is important for us to make sure that we apply some common sense to various rules when it comes to over-the-counter medicine."

Health and Human Services Secretary Kathleen Sebelius

Apparently, "common sense" is that young women can't decide for themselves whether or not to become pregnant--and that a drug (progestin) that it is practically impossible to overdose on is somehow less safe than ibuprofen or aspirin, which are known to cause severe gastrointestinal and renal damage--even death--if taken in excess.

Half of all pregnancies in the U.S. are unplanned, but for teens, over 8 in 10 pregnancies are unplanned. Increasing access to safe, effective contraception so that women can have control over their fertility is part of any rational strategy to decrease unplanned pregnancy.

Yet "accidents" in contraception are a reality. Condoms break, are used incorrectly or not at all. People miss their pills or don't come back to the clinic for injectable birth control. Victims of sexual assault may be at risk for unplanned--and undesired--pregnancy.

These are very real concerns for U.S. teenagers, nearly half of whom are sexually active. Teens are most likely to use condoms or the pill for contraception--which may be among the easiest to access, but are also not as effective as long-acting reversible contraceptives.

For teens, carrying a pregnancy to term has a much higher risk of producing a low-birth-weight infant, and teen mothers are less likely than those who delay childbearing to go on to college. Furthermore, the U.S. teen pregnancy rate is highest of the developed world.

THE ADVENT of progestin-only emergency contraception, which women can take within 72 hours after unprotected intercourse, provides a safe alternative and works to prevent pregnancy in 89 percent of cases.

The safety and side effect profiles of this medication--often known as "the morning-after pill," or by the trade names Plan B or Next Step--are huge improvements over the previous methods women used, which also contained large amounts of estrogens, and could cause gastrointestinal upset and, in rare cases, blood-clotting problems for women at risk.

Progressives came to expect political decisions trumping science during the Bush years--as when the FDA originally approved emergency contraception for over-the-counter use in 2006, but only for women over the age of 18. The "compromise" that year was that women would still have to request the drug from a pharmacist and prove their age, but minors--who arguably have even less access to clinic or health care offices--would have to find a provider to prescribe the drug.

Advocates of youth and reproductive health rights hoped the Obama administration would remove this barrier to minors' access to emergency contraception. After all, the risks of pregnancy in young women are well documented, and there is no reason to believe that the levels of progestin found in emergency contraception could harm their developing bodies.

Furthermore, the notion that ready availability of emergency contraception will make young women go out and have more unprotected sex is sexist nonsense.

Salon's Rebecca Traister rightly characterized Obama's attitude toward women, specifically young women, as "paternalistic claptrap." While his personal attitude toward women isn't surprising for a U.S. president, as Traister points out, decisions like this beg the question of what good it does for reproductive justice advocates to support him at all.

After all, NARAL Pro-Choice America placed its "trust and confidence in Obama's ability and willingness to fight for a woman's right to choose" when the organization chose to endorse his nomination for presidency in 2008--and then expressed "profound disappointment" with the manifestation of Obama's actual politics with his administration's denial of Plan B.

NARAL President Nancy Keenan argued that the main problem with the administration's decision wasn't the insult to women, but that getting in the way of "young women's access to contraception...is the best way to reduce the need for abortion." In other words, NARAL was making the most conservative possible argument in favor of accessible emergency contraception--that it would reduce abortions.

Any denial of reproductive rights is a disappointment, but not necessarily a surprise in a political climate in which the largest pro-choice organization in the U.S. refuses to take an unapologetic stance for women's right to choose abortion.

Emergency contraception is part of a broad spectrum of means that women need in order to control their fertility. The administration's restrictions only make it easier to further restrict abortion and other family-planning methods. Activists need to make an unapologetic defense of all family-planning methods, including emergency contraception and abortion, if we are going to turn the tide against anti-woman legislation.