Five Things to Know About the Morning-After Pill on Its 20th Anniversary

Medication portion of PREVEN Emergency Contraceptive Kit. Photo: Smithsonian Institution

In 1993, the New York Times Magazine posited that the morning-after pill might be “the best-kept contraceptive secret in America.” Even many doctors had no idea there was a fallback contraceptive that could be used shortly after unprotected sex or cases of rape.

In many ways, the morning-after pill had been right in front of U.S. doctors for decades. In terms of chemical composition, it was not much different from standard birth control, using the same main ingredients — synthetic hormones — in higher doses. Moreover, many of their colleagues in Europe and Asia had already been prescribing morning-after pills for years.


In 1998, years of research and advocacy led to the first FDA-approved morning-after pill.


Here, however, the secret was still largely intact. A 1994 study by the Kaiser Family Foundation revealed that two-thirds of American women had never heard of the morning-after pill or other forms of emergency contraception (EC). Less than 1 percent had ever used them.

There was an information shortfall in large part because there was no contraceptive that was approved by the U.S. Food and Drug Administration (FDA) specifically for emergency use. Some providers worked around that absence by using the chemically similar estrogen and progestin medications that were approved for regular birth control. By upping the dosage, they created a suitable morning-after pill on their own. But drug makers couldn’t label or market those birth-control pills for emergency, post-coital use, since they weren’t FDA-approved for that purpose. It also spelled problems for federally funded clinics. Federal dollars couldn’t pay for an off-label medication hack, a makeshift morning-after pill that wasn’t officially approved. Continue reading

Morning-After Pill Still Strong

June 20 marks the fifth anniversary of the U.S. Food and Drug Administration’s (FDA) approval of over-the-counter Plan B One-Step, a type of “morning-after pill” (itself a type of emergency contraception), without age restrictions. The first morning-after pill was approved by the FDA in 1998, but political backlash prevented easy access to it for more than a decade.

In 2011, the FDA was poised to approve over-the-counter access for Plan B for people 17 and older. The Department of Health and Human Services intervened, raising concerns that young girls might not be able to use the drug safely — even though studies have shown that Plan B is safer than taking an aspirin. The Obama administration, however, claimed that younger people still needed a prescription to ensure they understood the proper use of Plan B.


Access to Plan B gives teenagers another chance to avoid unwanted pregnancy.


The wrangling continued. In early April 2013, a federal district court judge dismissed that claim, stating that the Obama administration’s restrictions were a “politically-motivated effort to avoid riling religious groups and others opposed to making birth control available to girls.” On April 30, the FDA announced that the morning-after pill would be available without prescription to users 15 years of age and older.

The fight to expand over-the-counter access for the morning-after pill wasn’t over. Dr. Janet Woodcock, director of the FDA’s Center for Drug Evaluation and Research, stated that “over-the-counter access to emergency contraceptive products has the potential to further decrease the rate of unintended pregnancies in the United States.” It wasn’t until June 2013 — five short years ago this week — that the FDA approved Plan B One-Step for over-the-counter sale without age restrictions, after the Department of Justice dropped its appeal. In February 2014, certain generic morning-after pills were similarly approved.

Today, let’s celebrate this expanded access to the morning-after pill by reviewing what we need to know about this important form of contraception. Continue reading

Best of the Blog: 2017 Edition

It’s been a rough year. Ever since the 45th president was inaugurated in January, we have been pushing back against attempts to overturn the rights of women, LGBTQ folks, immigrants, people of color, and other marginalized populations. Racist and xenophobic voices have been emboldened by an administration that validates their hatred and minimizes their violence. It feels like the progress we’ve been making in advancing reproductive justice, gay rights, trans rights, and voters’ rights has stopped dead in its tracks.

But 2017 was also a year that shook many people out of their complacency — and re-energized longtime activists. January’s Women’s March may have been the largest protest in our nation’s history. Throughout the year, we rose up and shut down Republican attempts to destroy Obamacare, setting the stage for November, when enrollment records were shattered. A year after the gut punch of the 2016 presidential election, women, LGBTQ folks, people of color, and immigrants enjoyed well-earned victories across the nation in the 2017 elections. We need to keep working — staying on this trajectory can turn the tide in the 2018 midterm elections if we take control back from the legislative branch and douse the executive ego with a bucket of ice-cold water.

Our bloggers have been with us every step of the way, whether they are on the front lines of the fight to keep lifesaving laws intact and hold our culture accountable for its multifaceted bigotry, or helping to keep members of the resistance (and everyone else) healthy, informed, and compassionate in this new era.

Rachel kept close track of Republicans’ attempts to destroy the Affordable Care Act throughout the year. Pre-ACA, insurance policies could employ sex-based discrimination, refuse coverage to people with pre-existing conditions, kick people off their plans, and not cover essential services that keep people healthy. Each attempt revealed its creators’ wish list for destroying health care. In 2017, our activism worked, but the fight isn’t over, and we must remain vigilant. Stay tuned throughout 2018!

Matt has been watching the growing, right-wing extremism at the crossroads of racism and misogyny, a subject he covers in his response to the violent events in Charlottesville in August. Matt’s piece explores a political force that has put racial hatred on full display, but also one where misogyny resonates in a culture of disaffected — and often dangerous — men. We need to be intersectional as we fight for justice for everyone who is marginalized by white supremacist extremism.

Amanda observed American Heart Month by sharing the story of the sudden, heartbreaking death of her mother, who lost her life to a heart attack. As you mull over New Years resolutions, consider that heart disease is a top killer in the United States, but you can make lifestyle changes to help prevent it. The best gift for those you hold closest to your heart is to keep your heart healthy and strong, and Planned Parenthood Arizona provides care to help you maintain your heart’s health!

Gene made a slight departure from the blog’s mission to provide good guidance for readers to take care of their sexual health — his favorite post highlighted some of the most ridiculous things you could do for your sexual health. Whether he was lampooning stick-on condom alternatives, labia-sealing tampon alternatives, or egg-shaped rocks made to be inserted into the vagina, Gene took on some of the Internet’s looniest ideas surrounding sexual health and the human body.

Anna has been writing about sexually transmitted infections since 2011, and has become increasingly sensitive to the stigma surrounding these infections — and how people often internalize that stigma. Pairing STDs with fear and guilt has compromised medical care for generations. Folks who worry that the HPV vaccine or pre-exposure prophylaxis encourage promiscuity borrow century-old arguments from opponents of condoms, antibiotics, and other STD prevention methods. We think you’ll learn a ton of fascinating tidbits from this article!

Anne traveled all the way to Washington, DC, to meet lawmakers and represent the one woman out of every three who has had (or will have) an abortion. In a country that is becoming increasingly hostile to reproductive rights, we need people like Anne to put a face on abortion, a legal medical procedure that most of us have colluded to keep taboo. As Anne put it, “We were all darned tired of being characterized by ignorant anti-abortion advocates as shadowy, irresponsible, hypothetical women. We’re real people.”

Serena observed National American Indian Heritage Month by shining a spotlight on the little-known, shameful history of forced sterilization of Native American women. More recently, Native women’s control over their fertility has been further impeded by the Indian Health Service’s inconsistent access to emergency contraception and refusal to provide access to abortion. The ability to control our own bodies is essential to our dignity and self-determination, and it must not be abridged, whether it is interfering with our ability to have children or our ability to prevent or discontinue pregnancy.

Pride paradeCare observed Pride Month by remembering Pride’s roots. For a lot of us, Pride means parades and parties, but these annual celebrations didn’t originate that way — Pride Month commemorates the Stonewall Riots, which erupted 48 years ago. Care explains why the current political climate makes remembering Pride’s roots of the utmost importance. We need to stay vigilant, because when it comes to keeping and expanding the rights of LGBTQ people, and ensuring their safety and dignity, we’re all in this together.

Harvey MilkKelley, Planned Parenthood employee and honorary blogger, celebrated Pride Month by introducing us to Harvey Milk, whose call to LGBTQ people to “come out” led to a seismic societal shift, as hearts and minds were connected through empathy and storytelling. Today, we’re calling on you to take the torch of pioneers like Harvey Milk and keep fighting for LGBTQ rights and reproductive justice — for human dignity, bodily autonomy, and love.

Affirming the Autonomy of Indigenous Women

November is National American Indian Heritage Month. As we celebrate the positive sides of Indigenous Nations’ histories, we must acknowledge that the U.S. government has both robbed Native Americans of their land and, through the policies of the Indian Health Service division of the U.S. Department of Health and Human Services, made it difficult for Indigenous people to access quality health care.

Indian Health Service (IHS) was established in 1955 with the stated goal of improving the health care of Native Americans living on reservations. However, Indigenous women who came into IHS clinics for something as common as vaccinations were often sterilized without their consent. During the 1960s and 1970s, 25 to 50 percent of women who visited IHS clinics (approximately 3,406 women) were sterilized without their knowledge. Methods of sterilization included partial or full hysterectomies, and tubal ligations.


Bodily autonomy is about having the power to decide for oneself whether and when to bear children.


The IHS had a clear objective: population control (aka “genocide”). Census data collected during the 1970s showed that Native Americans had birthrates that were much higher than white communities. According to census data, the average American Indian woman had 3.79 children, while white women had 1.79 children. The 1980 census revealed that the average birthrate for white women was 2.14, while the birthrate for Indigenous women was 1.99. You don’t have to be a math whiz to see that this is a drastic contrast.

Myla Vicenti Carpio, a professor of American Indian studies at Arizona State University, explains: Continue reading

No, the Morning-After Pill Is Not the Abortion Pill

The other week, I was talking to a family member about the threats to contraception access in this country, “thanks” to our new president and his fanatical administration. He thought it was ridiculous that abortion opponents also fight tooth and nail to put obstacles in front of birth control — after all, reliable contraception prevents unintended pregnancies, which itself prevents untold abortions. It seems like a win-win for everyone, regardless of where their opinion on abortion falls.


The morning-after pill prevents pregnancy. The abortion pill ends pregnancy.


Then he said, “Of course, I understand them not wanting tax dollars going toward the morning-after pill, since that causes abortion.”

I had to stop him right there: “Nope.” A bit self-conscious of appearing to be a persnickety know-it-all, I summarized the vast differences between the morning-after pill and the abortion pill — differences that many people, even full supporters of reproductive rights, don’t understand. Opponents of abortion and contraception exploit this misunderstanding, pretending these two pills are one and the same, hoping to elicit “compromise” from “reasonable” people. Compromises that harm real people with real lives and real families. Just as women’s health opponents have been so successful at chipping away at abortion access, so too do they hope to erode access to contraception.

The morning-after pill and the abortion pill are completely different medications, used for different purposes and made up of different ingredients. Let’s look at a quick rundown of the two. Continue reading

Contraception Then and Now

When it comes to contraception, one thing is for sure: We’ve come a long way! And while the future might have even better things in store, like reversible male birth control, superior condoms, or remote-controlled implants, a look into the past reveals that modern contraceptors have a bevy of fantastic options to choose from. Unlike couples who had to forgo contraception or obtain birth control from the black market, nowadays Americans wishing to prevent or postpone pregnancy can select from a variety of legal, effective, and increasingly accessible family-planning methods.


While the history of birth control is fascinating, today’s contraception is the very best.


Let’s look at some old-fashioned birth-control methods and see how they stack up to their modern-day counterparts.

Linen and Guts vs. Latex and Polyurethane Condoms

Most people think of female condoms as new inventions, but the first condom recorded in history was made out of a goat’s bladder and inserted into the vagina — way back in 3000 BC. Ancient civilizations, from the Romans to the Egyptians to the Japanese, made penile sheaths and caps with a variety of materials, including linen, leather, lubricated silk paper, intestines, and tortoise shells. Linen and intestines remained popular through the Renaissance era.

A condom, with user manual, 1813. Photo: Matthias Kabel

Charles Goodyear might be most famous for tires, but his discoveries in vulcanizing rubber also led to the development of rubber condoms in the mid-1800s. Unfortunately, the Comstock Act of 1873 outlawed the manufacture and sale of contraception, and condoms were driven into a shadow economy. In the 1880s, New Yorkers might have been lucky to find black-market condoms made from surplus animal intestines, which were manufactured by Julius Schmid, a German immigrant who otherwise specialized in sausage casings — before his business was shut down by the New York Society for the Suppression of Vice. Condoms weren’t legal in the United States until the Crane ruling of 1918, just in time for the 1920 invention of latex, a form of rubber that was much stronger and more elastic — and with a shelf life of five years vs. rubber’s three months. By the 1920s, Schmid was once again on top of the condom game, peddling brands like Sheik, Ramses, and Sphinx.

Condoms made out of intestines are still on the market, sold as lambskin or “natural” condoms. However, they are not recommended for STD protection: Just as intestines need to allow nutrients to enter the body from digesting food, so too are viruses able to pass through condoms made from intestines. (Sperm, on the other hand, are thought to be too big.) These days, latex is the gold-standard material for condoms, while polyurethane can be used by people with latex allergies. Condoms constructed with these modern materials protect users from unintended pregnancy as well as many sexually transmitted infections, such as HIV and chlamydia. Continue reading

Roe v. Wade: Texas Then and Now

“Mr. Chief Justice, may it please the Court: It’s an old joke, but when a man argues against two beautiful ladies like this, they are going to have the last word.”

Supreme Court, 1973

Supreme Court, 1973

Thus Jay Floyd, Texas assistant attorney general, opened his December 1971 oral argument in Roe v. Wade, as his adversary attorneys Sarah Weddington and Linda Coffee sat nearby (no doubt dumbfounded) after Weddington had presented their argument for women’s abortion rights.

Wisely, the Texas reargument in 1972 opened with no attempt at humor. (When Roe was first argued, the Supreme Court consisted of only seven justices. Because the decision would be so historic, the Supreme Court decided to hear arguments a second time when all nine justices were in place the following year.) Then, on January 22, 1973, the Supreme Court decided that a woman’s right to an abortion was constitutionally protected and the 1854 Texas law at issue was struck down, along with abortion laws in 45 other states. (The Texas gentleman was right: The Texas ladies did have the last word.)


What will the Supreme Court bring us this year? “Don’t Mess with Texas” or “Don’t Mess with Women”?


So, as we approach the 43rd anniversary of Roe v. Wade this Friday, let’s mosey down memory lane. How did we get to that landmark decision, and where might we be going this year with a new Texas case testing abortion rights, Whole Woman’s Health v. Cole?

Throughout history, abortion has been a common practice. At the time of the adoption of the U.S. Constitution in 1787, abortion was legal in all states. Prior to the mid-1800s legal scholars were not proposing abortion laws, nor advocating “personhood” of an unborn child, nor asserting abortion control on medical safety or any other grounds. Continue reading