Morning-After Pills Even for Young Girls

New York state has decided that morning-after pills will be made available to everyone, with no limits.

Until now, girls under 17 could buy them only with a prescription. The Friday ruling settles the argument that President Barack Obama’s officials have had for a couple of years now.

In December 2011, the Food and Drug Administration recommended selling morning-after pills — which prevent pregnancy for up to five days after sexual intercourse — over-the-counter or without prescription.

Nonetheless, on that same day, the Department of Health and Human Services announced its disagreement. Secretary of Health and Human Services Kathleen Sebelius wrote that she had decided that the pill would be available only by prescription for women under 17. In her opinion, the fact that the pill is not biologically harmful, proven by tests over a long period of time, did not justify over-the-counter sales, because it could still harm young girls psychologically.

“The average age of the onset of menstruation for girls in the United States is 12.4 years. However, about ten percent of girls are physically capable of bearing children by 11.1 years of age. It is common knowledge that there are significant cognitive and behavioral differences between older adolescent girls and the youngest girls of reproductive age. If the application were approved, the product would be available, without prescription, for all girls of reproductive age,” argued Sebelius.

Obama, who himself has two daughters, 11 and 14 years old, sided with Sebelius:

“And as I understand it, the reason Kathleen made this decision was she could not be confident that a 10-year-old or an 11-year-old go into a drugstore, should be able — alongside bubble gum or batteries — be able to buy a medication that potentially, if not used properly, could end up having an adverse effect. And I think most parents would probably feel the same way.”

The matter has aroused particularly strong controversy because morning-after pills were handed out free of charge in 13 schools in New York, including to 14-years-old schoolgirls, without their parents’ knowledge. The New York Department of Education has simply recognized that pregnancy prevention among teenagers is a priority. The schoolgirls are often too shy to talk to their parents or see a doctor for the pill, which is why they get pregnant. A federal judge, Edward Korman, ruled on Friday that Sebelius’ decision was “arbitrary, capricious and unreasonable.” He ordered the Obama administration to abolish all limitations on the availability of morning-after pills.

The pills should be available over-the-counter for all the women and girls, not only in New York but in the whole U.S. Health and Human Services did not issue a decision yesterday on whether it would lodge an appeal, but it just announced that it would analyze the reasoning behind the ruling.

The court also criticized the FDA, which wavered for eight years before issuing its recommendation, immediately undermined by Sebelius. In his ruling, Korman wrote, “Indeed, it could accurately be described as an administrative agency filibuster.”

For years, the American Academy of Pediatrics has taken the view that the barrier in the form of a prescription is harmful. The U.S. still has the highest rate of teenage pregnancies among all developed countries — around 750,000 a year, and a third of them end in abortion. And they happen even though the percentage of teenagers who admit to being sexually active — 40 percent — is lower than in other developed countries.

Following Sebelius’ decision, the American Academy of Pediatrics recommended that pediatricians write up prescriptions for Plan B in advance, in order to ensure that those in need do not have to see a doctor — which requires courage, especially in a stressful situation — but they can go to a drugstore at once. The American Academy of Pediatrics referred to psychology research suggesting that free access to the pill does not influence the psyche of young girls. That is, they do not decide to engage in risky sexual behaviors more frequently.