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

Learning About Alcohol and Drug-Related Birth Defects

The week of May 14 is Alcohol and Drug-Related Birth Defects Awareness Week. According to the National Council on Alcoholism and Drug Dependence:

About 20% of pregnant women smoke cigarettes, 12% drink alcohol and 6% use an illicit drug at least once during pregnancy. These numbers are very alarming. If only people knew the dangers of their decisions, perhaps we would be looking at something more acceptable in those numbers.

So what are some of the dangers posed by these substances to a developing fetus?

Effects of Tobacco Use

According to the Centers for Disease Control and Prevention, the fetus gets less oxygen when the mother smokes. Smoking during pregnancy is a risk factor for low birth weight, preterm birth, placenta problems, miscarriage, and sudden infant death syndrome (SIDS).

Effects of Alcohol Use

I have written about the effects of alcohol use during pregnancy before — in fact, it was the subject for the first article I wrote for this blog.

Alcohol easily passes through the placenta, so when a pregnant woman drinks, so does her fetus. Continue reading

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

Let’s Talk Contraception: Contraceptive Changes on the Horizon

MicrogestinThe Affordable Care Act has undeniably improved women’s ability to receive preventive care that includes contraception. Insured women are now able to have any FDA-approved birth control provided to them at no cost as part of their preventive health care. Access to contraception has been shown time and again to improve the lives of women, their children, and their families by allowing them to plan and space pregnancies, decreasing maternal and infant mortality and also increasing their economic stability.


Some states are taking steps to make birth control less expensive and more convenient to obtain!


The Affordable Care Act has also undeniably opened up a Pandora’s box of contraception-related issues.

The American Congress of Obstetricians and Gynecologists (ACOG) states that “contraception is an essential part of preventive care and all women should have unhindered and affordable access to any FDA approved contraceptive.” In their yearly report, “Access to Contraception,” they advocate 18 recommendations, which include:

  • over-the-counter access to oral contraceptives that is accompanied by insurance coverage or some other cost support
  • payment coverage for 3- to 13-month supplies of birth control to improve contraceptive continuation

In the United States, statistics show that half of all pregnancies are unintended. A recent study has shown that if women who were at risk for unintended pregnancy were able to easily access effective birth control (such as the Pill) at low cost and without a prescription, their rate of unintended pregnancy would decrease significantly. Continue reading

Pro-Choice Friday News Rundown

  • cigaretteSome Republicans are trying to circumvent the Affordable Care Act’s mandate for co-pay-free birth control by pushing for over-the-counter availability of the Pill. Even the American Congress of Obstetricians and Gynecologists thinks this is a horrible idea. Its president states, “Unfortunately, instead of improving access, this bill would actually make more women have to pay for their birth control, and for some women, the cost would be prohibitive.” (Care2)
  • Smoking is damaging, hazardous, and deadly enough on its own. Smoking while on the Pill? Not a good idea. If you’re doing this, please stop. (The Root)
  • Arizona congressional tool Trent Franks says all Democrats who refuse to enact legislation to force women to give birth against their will are doomed to have regrets in their golden years. Insert world’s biggest eye roll here. (Right Wing Watch)
  • Students at one Seattle high school can get IUDs inserted for free! (Grist)
  • A harsh 12-week abortion ban in Arkansas has been blocked by the 8th U.S. Circuit Court of Appeals! Considering 12 weeks is well before a fetus is viable outside the womb, it would have been the strictest in the country. (Think Progress)
  • Are “hookup apps” like Tinder and Grindr behind an increase in sexually transmitted infections? (Time)
  • Race-baiting abortion opponents continue to be disingenuous, tone deaf, ignorant, and just plain The Worst. (RH Reality Check)
  • California is cracking the whip on the lying liars at “crisis pregnancy centers” who intentionally deceive women about abortion. Now if only we could get some federal legislation. (HuffPo)
  • Forced vaginal exams on students? Excuse me??? What the hell kind of shenanigans are going on at Valencia College in Florida? (CNN)
  • Five states worked on abortion restrictions over Memorial Day weekend and no one seemed to notice. (Fusion)
  • Wisconsin Gov. Scott Walker is so embarrassingly stupid I can’t even take it. He referred to mandatory ultrasounds for women seeking abortions (some of which are transvaginal) “a cool thing” and said, “We just knew if we signed that law (requiring ultrasounds), if we provided the information, that more people if they saw that unborn child would make a decision to protect and keep the life of that unborn child.” What? Uh, NO. All available evidence shows that these ultrasounds do nothing to change women’s minds when they do not wish to continue a pregnancy. Women aren’t fools who need to physically see something to realize its significance. You can show them all the fetuses in the universe — if they’re confident in their choice not to give birth, it won’t make a difference. Stop forcing images upon women because you think it’s “cool.” It isn’t. (Talking Points Memo)