Is Plan B the Best Choice?

Physicians and Students Question the Long Term Affects of Making the “Morning After Pill” More Accessible

"Where was ‘the morning after pill’ when we were young and dating," joked several nurses at the Washington Hospital Center, in Northwest Washington D.C.

The nurses were referring to Plan B (Levonorgestrel), a new form of emergency contraceptive that prevents pregnancy. When taken within 72 hours of unprotected sex, Plan B works by affecting the transport of sperm or eggs in the fallopian tube “preventing fertilization; blocking the surge of hormones that cause ovulation; and thickening the mucus in the uterus making it an inhospitable environment for a fertilized egg to implant.”

Because Plan B prevents pregnancy before it occurs, it is not the same as abortion pills like RU-486, or Mifeprex, which end pregnancy.

A recent push to give women easier access to Plan B comes after a study revealed that easier access to "the morning after pill," translated into less unwanted pregnancies, while posing no apparent risks to women.

The findings rebutted critic’s claims that allowing women to have a stash at home instead of going to the doctor for a prescription would increase the likelihood of the woman engaging in risky and promiscuous sexual behavior.

According to the study, of the 3 million unintended pregnancies occurring each year, half result in abortion. Up to 50 percent of these unintended pregnancies could be prevented with the use of emergency contraception like Plan B.

Carol Johnson, Registered Nurse in the Washington Hospital Center’s Gynecology unit isn’t sold on the idea of easier access.

"The unwanted pregnancy prevention has its benefits, but easier access doesn’t necessarily mean less risk," said Johnson referring to the soaring sexually transmitted disease (STD) rates among youth in predominantly black areas in the country.

"The potentials for abuse are enormous, especially since the easy access also extends to teenagers.”

Currently there are no restrictions placed on obtaining a prescription for the pill except that requests can not exceed three times in one month.

"There are no pregnancy tests given, or testing for STDs, we just go on the patient’s word that the unprotected sex occurred in the last 72 hours," she adds.

Plan B has a 95 percent effective rate when taken within 72 hours of unprotected intercourse and fertility returns within a menstrual cycle or two after consumption. If a woman does become pregnant anyway, it is more likely to be an ectopic or tubal pregnancy since the Plan B makes the uterus a hostile environment for eggs that wind up there.

Diana Thompson, a supervisor in the Women’s Services department at the Washington Hospital Center is concerned with the physical aspects of using the pill.

"The good thing about having to get a prescription is that your doctor can advise you on the medical conditions that would preclude you from taking the pill such as the influence of smoking, blood clots and medicinal interferences," said Thompson. "The doctors could also test you for STDs and vaginal damage in the case of rape. Without this medical guidance, there is the potential for misuse."

And there’s always the question of side effects.  Twenty-five percent of women who have taken Plan B reported severe nausea and vomiting.

Other immediate common side effects reported include abdominal pain (17.6 percent), fatigue (16.9 percent), and headache (16.8 percent). Critics opposed to the sale of Plan B without a prescription, like Thompson and Johnson, said no studies have been done to show whether long-term use of the drug is safe.

Although the FDA has reported no long term side effects of using the drug, Thompson’s questions remain unanswered.

"The pill is to be taken when there was unprotected sex and there is a possibility of being pregnant. How safe is it to take repeatedly when your body doesn’t actually need it? The pill just hasn’t been on the market long enough to know for certain."

"Plan B is a drug, and it’s one that needs to be monitored," said Danielle King a sophomore Physician Assistant at Howard University.

"Because there haven’t been reports of the long term side effects, I don’t think it’s up to standards."

Two of Danielle’s friends have used Plan B. "One was sexually responsible and she just slipped up and the other slips up pretty often, in fact, she would have more unprotected sex if it was more accessible."

Renee Smith, an LVN at the Riverside Medical Clinic in California admits that she would be less paranoid about having unprotected sex if she knew that the morning after pill was waiting in her night stand.

"It’s good that they are trying to make it more accessible" says Renee Smith, LVN at Riverside Medical Clinic in Riverside, California.

"There will be less unwanted pregnancies and fewer abortions."

Smith believes people should only use it as back-up and not as their main source of contraception.

Amber Brawley, a senior at Norfolk State University agrees. But it’s the higher susceptibility to STD’s that concerns her.

"I would use it but only if the protection I was using failed. I won’t have unprotected sex because I don’t want to get an STD."

Kenny Webb, a student at University of the District of Columbia doesn’t see any benefit of the pill except to spread STDs.

"I would feel comfortable having too much unprotected sex with different partners," said Webb.

With the exception of 31 countries and five states, the Plan B emergency contraception is available only by prescription from a clinic or hospital.