- The Washington Times - Tuesday, January 4, 2005

Women’s health care advocates have been urging the federal government to allow easy access to “morning-after” pills as a way to dramatically reduce unintended pregnancies.

However, a study released today undercuts that argument by showing that young sexually active women who were handed packages of “morning-after” pills had pregnancy rates six months later that were virtually the same as women who had to go to drugstores or clinics to get the pills.

“That was definitely a disappointing finding,” said Tina R. Raine, lead researcher of the study of 2,117 women, which appears in today’s Journal of the American Medical Association (JAMA).

A core hypothesis, she said, was that two groups of women with easy access to “emergency contraception” (EC) would have half as many pregnancies as women who had to see a health provider to get the pills. Instead, all three groups of women had pregnancy rates of around 8 percent.

Nevertheless, EC should still be available without a prescription, said Dr. Raine, a professor at the University of California at San Francisco.

That’s because the study also showed that when women had easy access to EC, they used the pills more often, but they didn’t take more sexual risks or get more sexually transmitted diseases (STDs), as some have feared.

Given these findings, “it seems unreasonable to restrict access to EC to clinics,” Dr. Raine and her colleagues wrote.

Concerned Women for America analyst Wendy Wright, an opponent of EC, disagreed.

“Why make [EC] easily available and put women’s health at risk if it doesn’t even reduce what the women fear, which is pregnancy?” she said.

Emergency contraception refers to high-dose birth-control pills taken within 72 hours of unprotected sexual intercourse. The pills, used by 4 percent of women, can interrupt ovulation, fertilization or implantation. All but six states require a prescription to get EC.

Most women’s health advocates believe that half of the nation’s estimated 3.5 million unintended pregnancies could be prevented if EC were widely available, especially to teens and college-age women. They believe the pills are safe and effective, and they have launched campaigns urging the federal Food and Drug Administration (FDA) to allow the nation’s primary EC product, Plan B, owned by Barr Pharmaceuticals Inc., to be sold without a prescription.

Opponents of EC, such as Miss Wright, worry that easy access to EC will encourage irresponsible sexual behavior and STDs.

Studies of EC in Britain show easy access to the pills causes “an increase in STDs and no decrease in the number of abortions,” she said.

In 2003, two FDA advisory panels recommended that the FDA approve Plan B for over-the-counter sales, but in May, the FDA declined, saying it was concerned about teens using the product without medical supervision.

A spokeswoman for Barr Pharmaceuticals yesterday said they have resubmitted Plan B paperwork and are expecting another FDA response this month.

The Raine study, conducted between 2001 and 2003, divided 2,117 sexually active women, aged 15 to 24, into three groups. One group received free packages of Plan B, another group was told how to get Plan B for free at drugstores and a third group was told how to get Plan B by appointment from a health clinic.

A key hypothesis was that, six months later, women in the two groups with the easiest access to EC would have 5 percent pregnancy rates, compared with a 10 percent pregnancy rate expected for women who had to go to a clinic to get Plan B.

But the three groups still got pregnant at about the same rate: Eight percent of the women with Plan B at home became pregnant, as did 7.1 percent of women with “pharmacy access” and 8.7 percent of women with “clinic access.”

This may be because many women with Plan B at home didn’t use it after unprotected sex, Dr. Raine said. Also, some women in the non-clinic groups still went to clinics and this “cross-over may have diminished our ability to demonstrate a difference” in pregnancy rates, she wrote.

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