Maryland Conservatarian

A 42-year-old, happily married mother-of-two, VA-based lawyer recently got pregnant. Sadly, this left her no choice but to get an abortion. Of course, this was all George Bush’s fault.

Dana L. (real name withheld) courageously outlines her dilemma in today’s Washington Post: What Happens When There Is No Plan B? Because this piece somehow manages to blame the Bush administration for the result of her unprotected moment of passion, the Post gives her front page status in Section B.

Apparently, she and her husband got it on one Thursday evening last March without her diaphragm being where it needed to be. I immediately wondered if the President had somehow managed to hide it but, in a rare moment of lucidity, she does not make that claim. Anyway, the next morning, I guess she remembered that sex could lead to pregnancy and so she called her “ob/gyn to get a prescription for Plan B, the emergency contraceptive pill that can prevent a pregnancy -- but only if taken within 72 hours of intercourse.”

Probably not a good time for her to learn:

“…that my doctor did not prescribe Plan B. No reason given. Neither did my internist. The midwifery practice I had used could prescribe it, but not over the phone, and there were no more open appointments for the day.”

Her conclusion?

“But I needed to meet my kids' school bus and, as I was pretty much out of options -- short of soliciting random Virginia doctors out of the phone book -- I figured I'd take my chances and hope for the best.”

This is one efficient lawyer. She makes three phone calls - ob/gyn, internist and midwifery practice – right after getting her kids off to school and it’s already time to go meet the kids’ bus again.

As you can guess, she later learns that she is pregnant…..and was she ever pissed about it. A telling comment:

“I knew that Plan B, which could have prevented it, was supposed to have been available over the counter by now. But I also remembered hearing that conservative politics have held up its approval.”

So Ms. L digs in and learns:

“[I]in May 2004, the FDA top brass overruled the advisory panel and gave the thumbs-down to over-the-counter sales of Plan B…”

(Note to Ms. L – Advisory panels don’t get overruled because, as an advisory panel, they don’t make the rules, they advise…hence the word “Advisory”)

Here is the link to the FDA’s Questions and Answers on Plan B on this very subject. Of course, they’re going to deny political or religious pressure as being part of their decision but they do highlight one point Ms. L kind of brushes over in her tirade: the original application provided that the drug be available OTC for all. I’m not a parent but I’m going to guess most parents don’t want their 14-year old daughters to have access to Plan B absent their knowledge. The sponsor (of the application to go OTC) then submitted a change request:

“…to allow for marketing of Plan B as a prescription-only product for women under 16 years of age and a nonprescription product for women 16 years and older was incomplete and inadequate for a full review. Therefore, FDA concluded that the application was not approvable.”

Ms. L gives short shrift to concerns over expanding availability of this drug; lumping all such doubts together as being conservative and religious-based. But there are some concerns that are common to any drug seeking OTC status, most notably the comprehension by the drug’s user of the associated instructions. As the users will be of the younger, probably less-educated (which partly explains why they’re in the position where they think they need the drug in the first place – sorry, Ms. L) part of the populace, it is important they know the associated risks. Users need to understand also that this is not an everyday birth control pill. To do this they’ll have to read the directions or get advice from a doctor or pharmacist. Also, from the manufacturers own web site (Barr Pharmaceuticals, Inc.):

“A physical examination is not required prior to prescribing Plan B. A follow-up physical or pelvic examination, however, is recommended if thee is any doubt concerning the general health or pregnancy status of any woman after taking Plan B”

...and since doubt about pregnancy status is one of the reasons someone takes the drug....

We also learn Ms. L is “dumbfounded” to discover that doctors and others are allowed to possibly follow their beliefs and not prescribe the drug. Worse, in her eyes, they don’t have to disclose why they won’t prescribe certain drugs. The irony of her dismay at this allowed practice in a column where she won’t use her real name apparently escapes her.

The point of this article is clearly to get us to tsk-tsk the purported politicization of the Plan B OTC proposal by conservatives. As Ms. L concludes:

“But I feel that this administration gave me practically no choice but to have an unwanted abortion because the way it has politicized religion made it well-nigh impossible for me to get emergency contraception that would have prevented the pregnancy in the first place.”

“Well-nigh impossible”? Unless I missed federal laws prohibiting previous inquiry of your physicians and making more than three phone calls in a day to track down the pills, I’m just chalking that up to hyperbole. And any politicization of this matter is clearly matched by those wishing to put “Plan B” on the fast track to your local drug counter (NOW and Emergency Contraception).

I do not wish to make light of Ms. L’s dilemma – I have no doubt it was heartfelt and real. But in taking to the pages of the Washington Post to assign the blame for it to conservative politics, the Bush administration and her non-prescribing doctors, she makes herself a suitable target for mockery for her seeming lack-of-accountability in this matter.