The Obama administration has dealt a blow to women's reproductive rights, in a move that smells of election-season posturing.
Last week, U.S. Health and Human Services Secretary Kathleen Sebelius took the unprecedented step of overruling a recommendation by the Food and Drug Administration in order to restrict access to emergency contraception. The FDA had recommended that EC—a high dose of a synthetic hormone found in birth control pills that can prevent pregnancy if taken within a few days after a woman has unprotected sex—be made available for over-the-counter sale to women and girls of any age. Right now, the pill is available without a prescription for women 17 and older; girls under 17 require a doctor's order.
But shortly before that change could take effect, Sebelius stepped in to block the recommendation, saying that Teva Pharmaceuticals, the company that makes the drug, marketed as Plan B One-Step, has failed to examine whether it is safe for girls as young as 11. FDA Commissioner Margaret Hamburg issued her own statement saying agency scientists had "determined that the product was safe and effective in adolescent females."
While the ban on over-the-counter sale of EC applies directly to girls under 17 only, it will affect any woman who needs the drug. While women over 17 can continue to buy the drug without a prescription, the age restriction means pharmacies will have to keep it behind the counter, forcing even adults who want it to ask for it from pharmacy staff. That, warn activists, creates a barrier that might dissuade some women, who feel too ashamed or intimidated to ask for it.
The battle over emergency contraception has raged for years. Some conservatives liken the pill to abortion, as it can prevent the release of a fertilized egg into the uterus; others argue that its availability will encourage sexual promiscuity. The American Medical Association, the American Congress of Obstetricians and Gynecologists and the American Academy of Pediatrics all endorse the drug's over-the-counter sale.
Under the George W. Bush administration, the FDA initially rejected an application to allow the over-the-counter sale of the drug despite the recommendations of scientists within the agency. In 2006 the administration eased its position, allowing OTC sales for women 18 and over. In 2009, Obama's FDA lowered the age to 17 after a federal court found that the policy established during the Bush administration had been based on political considerations, not scientific evidence.
Sebelius' decision to block the expanded access recommended by the FDA comes as a blow to activists who'd hoped a Democratic president would be more supportive of reproductive rights. In particular, they had been heartened by the newly elected Obama's vow that, under his administration, the government would rely on science-based information in making such decisions. Now many are reading Sebelius' move as an effort by Obama to temper conservative criticism of his administration as he heads into the 2012 election season.
Susan Wood, the FDA's assistant commissioner for women's health during the Bush administration, who resigned from her job in protest of that president's handling of EC, released a statement last week calling Sebelius' move "stunning."
"I had come to believe that the FDA would be allowed to make decisions based on science and the public's health. Sadly, once again, FDA has been overruled and not allowed to do its job," Wood said.
Leslie Tarr Laurie, president of the Valley's Tapestry Health, called Sebelius' decision a major disappointment.
"This was such a betrayal, really, of the commitment to science over politics, and such a betrayal of women's health," Laurie told the Advocate. But sadly, she added, it's not the first sign of the Obama administration's wavering commitment to the issue; she pointed to the president's willingness to bargain with Republicans using funding for Title X, which funds family planning programs.
Laurie urges people upset by Sebelius' decision to call the White House switchboard (202-456-1111) and pass on that message. "We need to make sure it is heard, loud and clear, how important and fundamental access to contraception is, and it can't be a political chit to be traded away," she said.