Access for All? Reclaiming Women's Contraceptive Options one Pharmacy at a Time

By Pat Reuss, Senior Policy Analyst, and Jan Erickson, Director of Government Relations

Photo courtesy the Office of Senator Hillary Rodham Clinton NOW PAC members and activists delivered thousands of petitions supporting Plan B to Sen. Hillary Roham Clinton (D–N.Y.)

In the wake of the Food and Drug Administration (FDA) decision to allow Plan B emergency contraception (EC) to be sold without a prescription only to women 18 and older, NOW is not optimistic about access to emergency contraception for younger women who are at risk.

Despite the prescription-free status of EC for adult women, we expect that some staff in emergency medical facilities and hospitals, as well as some doctors and pharmacists, will continue to insist that they have the right to refuse to dispense EC and will continue their biased and intolerant treatment of patients based on their age and gender. Young women in need of a prescription to obtain EC can still be denied access by doctors with a political agenda, adult women at the pharmacy counter can still be faced with anti-woman pharmacists, and women of all ages remain at risk of being refused EC at emergency rooms after being raped.

NOW's chapters and grassroots activists will continue our tireless work on this issue to ensure that women expand and safeguard their reproductive options. We will be launching an Emergency Contraception Campaign at the national, state and local level to ensure that girls and women of childbearing age have control over their reproductive destiny. Nothing rings truer than the old NOW rally chant, "Not the Church, not the State—Women will decide our fate."

Nationally, NOW will be working with our Congressional champions to craft and pass legislation that includes but goes beyond the Prevention First Act to remove many barriers facing girls and women in the areas of reproductive health, family planning, and access to contraceptives. We will organize NOW activists to pressure Congress members and candidates to support such legislation. A broad public education campaign will stress the importance of medically accurate, complete information about emergency contraception and will highlight the damaging role that conservative politics play in denying safe, affordable access to this important form of birth control.

The FDA's decision requires that Plan B be stocked by pharmacies behind the counter, "because it cannot be dispensed without a prescription or proof of age." This directive, combined with the age restriction, at once shows the influence of politicians on FDA officials and reveals the decision to be a less-than-half-hearted move towards greater access to EC. In spite of evidence to the contrary, many conservatives assert that easier access to EC will promote promiscuity among young women. Their influence on the FDA likely guided this decision, which runs contrary to the FDA's own panels of experts who deemed EC to be safe for over-the-counter access by all women.

In order to ensure access for all and to accomplish what the FDA, because of right-wing pandering, has been unable to do, any national policy initiative must:

1. Pave the way for NO age restrictions. Congress should ask for a review of the risk management plan and ask that it contain a procedure for removing or phasing out the age limitations as soon as possible.
2. Propose that all federally-supported health care and drug plans include and pay for EC coverage (Medicaid, federal health plans, military, prisons, etc).
3. Specify that EC be covered by all group health insurance plans that cover other prescription medication, as in the Equity in Prescription Contraceptive Coverage Act (particular mention needs to be made since the product will now become non-prescription for the majority of women).
4. Propose that all VAWA-funded rape crisis centers, domestic violence shelters and counselors, as well as emergency rooms providing medical care to rape survivors must provide medically accurate info about EC, make the contraceptive immediately available to the victim and post a list of emergency centers where it is provided.
5. Require the following of pharmacies:
   • EC to be displayed in full view of any customer—not kept under the counter or locked in a glass case.
   • All pharmacies to carry sufficient inventory of EC.
   • Medical privacy, including no personal record-keeping of who purchases EC and no routine request of adult women for photo identification.
   • Education and training of pharmacy owners and their staff to ensure that they have scientifically factual information about Plan B, that proper referral procedures are followed when there is a refusal to fill Plan B prescriptions, that no medical records about filling of the prescription Plan B be kept that reveal personal identities, and that no inappropriate behavior such as lecturing or unprofessional comments should be made to customers.
   • Immediate referral to another pharmacist or another pharmacy and a penalty for not filling and/or returning a prescription to the customer.
6. Suggest a common and inexpensive theft-prevention device which can be used easily and cheaply if pharmacies fear that EC will be subject to shop-lifting if placed on the open shelf.

A national effort to pass federal legislation will be just a part of the larger Emergency Contraception Campaign. NOW chapters will be supplied with an EC access toolkit, complete with political and community-based suggestions for effecting change, stories about how some states have already expanded their EC access, and more. We're counting on NOW activists to be raising awareness on the ground, in their neighborhoods and at their pharmacies, and lobbying their local governments and pharmacy boards. It will take coalitions of activists, legislators, physicians, pharmacists, and other community members to obtain reproductive justice for all.