Statement in Support of Approval of Over-the-Counter Availability of Plan B Emergency Contraceptive

December 16, 2003

Presented by Kim Gandy, President, National Organization for Women, at the U.S. Food and Drug Administration Hearing, Joint Meeting of the Nonprescription Drugs Advisory Committee and Advisory Committee on Reproductive Health Drugs

The F.D.A. advisory panels concerning emergency contraception heard from Kim Gandy, president of the National Organization for Women. Getty Images

As its name suggests, this drug is about responding to emergencies—emergencies that are a result of unwanted sex or contraceptive failure. Under these circumstances, urgent treatment within 72 hours is critical. Making Plan B available for over-the-counter sale would significantly reduce the stress and trauma experienced by women in these emergency situations, while preventing thousands of unwanted pregnancies.

Our organization has worked for decades to assist victims of sexual assault, and the needs of women who have been raped are especially critical. Over 300,000 women are raped in the U.S. each year¹ and over 32,000 become pregnant as a result.²

While victims of rape receive treatment in hospitals to prevent HIV and sexually transmitted diseases and standards of emergency care established by the American Medical Association (AMA) require that rape survivors be counseled about their risk of pregnancy and offered emergency contraception—that is not what is happening in many instances. In far too many cases, women are being denied access to emergency contraception.

Only a handful of states have laws mandating that emergency contraception be available to rape victims. Recent surveys in six states (Minn., Mo., N.Y., Pa., Texas, Wyo.) have shown that few hospitals provide emergency contraception to rape victims.³ Eighty-two percent of Catholic hospitals do not provide emergency contraception even to women who have been raped.⁴

EC is not only a safe and effective method to prevent unwanted pregnancy, it also can empower women who have been raped with a sense of control and provide an important means to help them to cope with the trauma of sexual assault.

The basic facts about emergency contraception further support its suitability for over the counter distribution. Plan B emergency contraception has all of the characteristics of an over-the-counter drug: it is safe, effective, and simple to use; it is not associated with any serious or harmful side-effects; it is not dangerous to women with particular medical conditions; and does not lead to riskier behavior or less frequent use of other forms of contraception.

The primary barrier to obtaining and effectively using emergency contraception is timing. Emergency contraception is extremely time-sensitive. The sooner it is taken following unprotected or under-protected sexual relations, the more effective it is. If taken within 72 hours, risk of pregnancy is reduced by up to 89 percent.⁵ Currently, EC is extremely difficult to obtain in a timely manner—because women must first obtain a prescription.

A woman faced with a broken condom on a Friday night, whose doctor's office is closed over the weekend, might have to wait until the following Monday—three days later—to obtain a prescription. Women in rural areas may have to travel great distances to reach the nearest doctor or clinic, making a prescription within 72 hours difficult, if not impossible.

In one survey, even when calls to health providers were made during business hours, only three out of every four attempts to obtain emergency contraception resulted in appointments or telephone prescriptions within 72 hours. Because EC is more effective the earlier it is used—and is most effective within the first 12 hours after unprotected sexual relations—the obstacles associated with obtaining a prescription for EC pose a serious threat. Women need to have access 24 hours a day, seven days a week.

Nearly 50 percent of pregnancies in the U.S. are unintended, and over half of those pregnancies end in abortion.⁶ An estimated one half of these unintended pregnancies and abortions could be prevented each year through wider use of EC.⁷

The American Medical Association (AMA), the American Nurses Association, the American Academy of Pediatrics, the American Public Health Association, the American Academy of Family Physicians, the American College of Obstetricians and Gynecologists, and the Association of Reproductive Health Professionals are all in favor of making emergency contraception available without a prescription.

Thank you for the opportunity to speak today.

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