What Happens When There Is No Plan B?

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By Dana L.
Sunday, June 4, 2006

The conservative politics of the Bush administration forced me to have an abortion I didn't want. Well, not literally, but let me explain.

I am a 42-year-old happily married mother of two elementary-schoolers. My husband and I both work, and like many couples, we're starved for time together. One Thursday evening this past March, we managed to snag some rare couple time and, in a sudden rush of passion, I failed to insert my diaphragm.

The next morning, after getting my kids off to school, I called my 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. As we're both in our forties, my husband and I had considered our family complete, and we weren't planning to have another child, which is why, as a rule, we use contraception. I wanted to make sure that our momentary lapse didn't result in a pregnancy.

The receptionist, however, informed me 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. The weekend -- and the end of the 72-hour window -- was approaching.

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. After all, I'm 42. Isn't it likely my eggs are overripe, anyway? I thought so, especially since my best friend from college has been experiencing agonizing infertility problems at this age.

Weeks later, the two drugstore pregnancy tests I took told a different story. Positive. I couldn't believe it.

I'm still in good health, but unlike the last time I was pregnant, nearly a decade ago, I'm now taking three medications. One of them, for high cholesterol, is in the Food and Drug Administration's Pregnancy Category X -- meaning it's a drug you shouldn't take if you're expecting or even planning to get pregnant. I worried because the odds of having a high-risk pregnancy or a baby born with serious health issues rise significantly after age 40. And I thought of the emotional upheavals that an unplanned pregnancy would cause our family. My husband and I are involved in all aspects of our children's lives, but even so, we feel we don't get enough time to spend with them as it is.

I felt sick. Although I've always been in favor of abortion rights, this was a choice I had hoped never to have to make myself. When I realized the seriousness of my predicament, I became angry. 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.

My anger propelled me to get to the bottom of the story. It turns out that in December 2003, an FDA advisory committee, whose suggestions the agency usually follows, recommended that the drug be made available over the counter, or without a prescription. Nonetheless, in May 2004, the FDA top brass overruled the advisory panel and gave the thumbs-down to over-the-counter sales of Plan B, requesting more data on how girls younger than 16 could use it safely without a doctor's supervision.

Apparently, one of the concerns is that ready availability of Plan B could lead teenage girls to have premarital sex. Yet this concern -- valid or not -- wound up penalizing an over-the-hill married woman for having sex with her husband. Talk about the law of unintended consequences.

By late August 2005, the slow action over Plan B led the director of the FDA's Office on Women's Health to resign her post. The agency's delay on the drug, she wrote in an e-mail to her colleagues, "runs contrary to my core commitment to improving and advancing women's health." As recently as April 7, Steven Galson, director of the FDA's Center for Drug Evaluation and Research, said that the agency still needed time to work on the issue.

Unfortunately, time was the one thing I didn't have.


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© 2006 The Washington Post Company

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