I'M, UH, I'M CALLING TO SEE how to obtain the, uh, the morning-after pill?"
Man, is this embarrassing. Especially since I'm calling from work, within earshot of colleagues.
"We don't have it," a harried receptionist snaps. She works -- after all -- for a private doctor; she's putting paying patients on hold to talk to me, an unknown woman trying timidly to score an emergency contraceptive hit. "You'd need to get an appointment," she snaps next, and disconnects me.
It is 10:30 on a Tuesday morning and I have been at this for an hour. Fortunately, I do not really need the morning-after pill. Rather, in the interest of research, I'm trying to find out how I would get it if I did. Like most women, I've heard of the pill (pills? pack?) but know next to nothing about it (them?). Recently, however, I saw an item noting that a "second morning-after pill" is about to be marketed, under the inspired name of Plan B. Second morning-after pill? I thought. Was there a first? If so, how might a girl obtain it?
To answer this question, I have put myself in the place of a young woman who has recently had unprotected sex. Perhaps she didn't use birth control; perhaps her partner didn't; perhaps they used a condom but it failed. At any rate, she would desperately like to avoid pregnancy, and can do so if she can take a morning-after pill within 72 hours after the horse got out of the barn.
"Sorry, you'd have to be seen, and I don't have any appointments this week," says another receptionist for another private doctor.
"Do you have health insurance?" says a third.
Granted, the method I'm using now -- scanning the yellow pages under P for physician, then dialing ob-gyns who advertise a commitment to women's health -- probably isn't the best solution. But isn't an emergency a situation where no solution is clearly the best? To be sure, prior to calling the private doctors I tried Planned Parenthood: At the downtown clinic, a receptionist said that the morning-after pill was available, but that a clinician would not be able to see me until tomorrow. Seeing as how the pill is most effective if taken in the first 12 hours, I also tried Mary's Center, an Adams-Morgan clinic, where, I learned, I'd have to undergo a social-worker intake and a full physical first. For something quicker, the helpful nurse suggested I try a morning-after hot line, 1-888-NOT2LATE.
At which point it occurs to me that a resourceful young woman might also turn to the Web. As it happens, a search yields a Web site (www.not-2-late.com) maintained by Princeton University's Office of Population Research, which also runs the telephone hot line. Here my young woman could learn -- for example -- that the morning-after pill is not RU-486, the so-called French abortion pill. Rather, it is a strong and perfectly legal dose of ordinary birth control pills that works before pregnancy occurs, preventing a fertilized egg from implanting itself in the uterus. It might make you nauseous but is otherwise safe: It won't terminate an established pregnancy or harm a fetus. It could, OPR estimates, reduce unintended pregnancies by one-half. The Web site even tells how, using your very own pack of birth control pills, you can make your morning-after cocktail. Too bad my young woman doesn't have her own pack of pills! Too bad no doctor ever urged her to keep one handy! Too bad that drug companies are too craven to include morning-after instructions on the packs of birth control pills they sell! Too bad that the major U.S. drug companies have refused to take the simple step of repackaging a few such pills and selling them as a morning-after kit! Instead -- in a climate hostile to any post-coital contraceptive -- the only companies that do so are tiny Gynetics, which makes and markets Preven but without benefit of a big budget, and tiny Women's Capital Corp., which is just now making Plan B available.
Assuming you can find it. On behalf of my imaginary young woman I dial 1-888-NOT2LATE to find other local morning-after providers. One is Kaiser Permanente, open to members only. One is a private physician whose receptionist refers me to Washington Hospital Center, where I am told I cannot obtain the pill unless I've been raped. Another is Washington Free Clinic, which does dispense the pill, for $20, from 7 p.m. to 9 p.m. The last is Ellen Whitaker, a private physician. Why, I ask her, does this have to be so hard? Why -- when drug companies are flinging Viagra about, not to mention male anti-baldness drugs whose side effects are so serious that pregnant women are urged not to touch them -- is it so tough to obtain this basic birth control? Whitaker points out that the problem is not just drug companies but doctors, who -- in a focus group she did for Preven -- voiced surprising hostility toward it, saying they didn't want constant panicked calls from patients with a little, shall we say, planning problem. Better that my young woman should keep dialing and dialing, getting more and more alarmed, moving ever farther from Plan B and, you could say, ever closer to Plan Ab.
Liza Mundy's e-mail address is email@example.com.