On February 24th (Thurs.) of 2005, the Community Meeting on Access to Emergency Contraception (EC) was held at the Illinois Disciples Foundation (IDF) in Champaign, Illinois, during the evening. This meeting was sponsored by several women's groups and social service organizations in the area. The mediator of this event was Brooke Anderson, a staff member of Champaign County Health Care Consumers, and its keynote speaker was Destiny Lopez, Director of New York's Emergency Contraception Campaign. There were several other speakers at this event as well, including a woman who had a baby because of her inability to obtain EC in a timely manner. About 150 people attended the community meeting at IDF; there was standing room only for late arrivals. Beverages and desserts were available to the audience during the meeting.

About Emergency Contraception (EC) and Its Local Availability

Speakers Annie Fehrenbacher and Mia Layne described EC to the audience and how to obtain it locally. EC is available as a prescription drug in the United States. The only drug that is currently available for this purpose is called Plan B®, which was approved by the Food & Drug Administration (FDA) in 1999. Plan B consists of specific concentrated doses of a chemical that is found in ordinary birth control pills. If Plan B is taken within 24 hours after contraceptive failure or unprotected sex, it can reduce the risk of pregnancy up to 95%. If Plan B is taken within 72 hours after either of the preceding situations, it can reduce the risk of pregnancy up to 89%.

Plan B is not an aborticide and should not be confused with the drug Mifepristone (formerly known as RU-486). Unlike Mifepristone, which was approved by the FDA for early pregnancy termination in 2000, Plan B works like regular birth control pills to prevent pregnancy before a pregnancy is established. Emergency contraception is typically used when: 1) a condom breaks, 2) two or more birth control pills have been skipped, 3) voluntary sex occurs without contraception, or 4) a woman is forced to have sex (e.g., rape). Women who are already pregnant should not use Plan B, nor should it be used as a substitute for ordinary birth control pills.

Plan B is considered a safe and effective emergency contraceptive. Some women may experience side effects, including nausea, abdominal pain, breast tenderness, or menstrual changes, but these side effects should be temporary as Plan B is taken in only one or two doses. In Champaign County, Illinois, this emergency contraceptive can be obtained through Planned Parenthood, one's family physician, or McKinley Health Center (for students at the University of Illinois). It is available for free at McKinley Health Center, Monday thru Saturday, when the university is in session.

The availability of Plan B at local pharmacies is variable and its price ranges from $18.94 to $35.89. A recent survey of 21 pharmacies in Champaign County revealed 38% of them had this emergency contraceptive in stock, 38% of them did not have it in stock but were willing to order it, while 24% of them refused to carry it. At the time of the survey, the pharmacies with Plan B in stock included CarleRX Express on University, CarleRX Express on Cunningham, Christie Clinic on University, Osco Drug on Green, Osco Drug on Philo, Schnuck's on Vine, Walgreens on Philo, and Walgreens on Springfield. The pharmacies that refuse to carry Plan B include Meijer, Provena Covenant, Target Stores, Wal-Mart in Savoy, and Wal-Mart in Champaign. Unfortunately, ordering an emergency contraceptive that isn't in stock can reduce its effectiveness significantly because of the time delay.

Above are some members of the audience.

Emergency Contraception (EC) and the Bush Administration

Speakers Allison Jones and Emily Sha discussed the need to make EC more widely available in the United States. The product manufacturer of Plan B submitted an application to the FDA to switch its status from prescription-only to over-the-counter. In 2003, a joint panel of the FDA's Reproductive Health Drugs Advisory Committee and Non-Prescription Drugs Advisory Committee voted 23-4 to recommend that the FDA approve the application to make Plan B available over-the-counter. In 2004, the FDA rejected this application and a sent a "non-approvable" letter to the product manufacturer. Critics accuse the FDA, which is under the direction of Bush-appointee Lester Crawford, of playing politics and ignoring the scientific evidence in support of the safety and effectiveness of this drug. Supporters of the FDA-decision believe that making EC available over-the-counter would promote teen-age sexual promiscuity and encourage "pedophiles." However, a recently published study in the Journal of the American Medical Association (JAMA) found little evidence that over-the-counter EC affected teen-age sexual activity in California.

In response to the FDA decision to deny over-the-counter status to Plan B, another speaker, Simon Heller of the Center for Reproductive Rights, has filed a lawsuit in Federal Court in New York on behalf of several EC activists and consumers. The lawsuit states that the FDA has discriminated against women and violated their constitutional rights. This lawsuit seeks to overturn the FDA decision to deny over-the-counter status for Plan B.

Another indication that the Bush Administration is hostile to the availability of EC can be found in the National Protocol for Rape Survivors by the Dept. of Justice, which functions as a guidance to health care providers throughout the United States. This recently released document fails to mention EC as a medical treatment for women who are subjected to rape, which can substantially increase the risk of unintended pregnancy. A national survey has revealed that only 40% of health care providers make EC available to victims of rape – this figure is as low as 6% in some states. Community members are encouraged to contact Diane Stuart, Director of the DOJ Office of Violence Against Women, regarding the omission of EC from the protocol. Her e-mail is diane.stuart@usdoj.gov and her telephone number is (202) 307-6026.

Campaign to Make Emergency Contraception (EC) More Available in the States

Several industrialized and developing nations have already approved over-the-counter EC drugs. While the FDA under the Bush Administration has blocked the availability of EC as an over-the-counter drug, several states in the U.S. have approved legislation that makes Plan B available through a pharmacy without a prescription after consulting with a pharmacist. These states include Alaska, California, Hawaii, Maine, New Mexico, and Washington. Similar bills have been introduced in Illinois and New York that are still pending. Making EC available over-the-counter or through a pharmacy without a prescription avoids the costs and time delays that are often associated with making an appointment with a physician. Some women can't afford the cost of a physician, while others (e.g., those on Medicaid) are forced to wait several months before they can see a physician. Thus, making EC available over-the-counter or through a pharmacy without a physician would make such drugs more widely available in less time than is currently the case.

In Illinois, activists from local women's groups and social service organizations have met with Naomi Jacobsson, the State Representative of Champaign-Urbana and the surrounding area, encouraging her to become a co-sponsor of HB 6577 in the state legislature. Similar to the legislation of the 6 preceding states, HB 6577 would make emergency contraceptives (such as Plan B) available through a pharmacy without a prescription after consulting with a pharmacist. Recently, these activists have received a letter from Rep. Jacobsson, in which she agreed to be a co-sponsor of this bill. Rep. Jacobsson was unable to be present at the Community Meeting on Access to Emergency Contraception because she was attending a legislative session in Springfield, Illinois. Community members are encouraged to contact their state legislators in support of HB 6577, which would make EC more available to women in a timely manner within the state of Illinois.

Above is the keynote speaker, Destiny Lopez.

Discussion of the Keynote Speaker about Emergency Contraception (EC)

The keynote speaker, Destiny Lopez, described various issues that are related to EC and its availability, particularly in New York. She stated that about 25% of private colleges do not provide EC on campus to their students. In addition to the 6 states that allow access to EC through pharmacists, there are 12 states that require hospitals to offer EC to women who have been subjected to rape in emergency rooms. In Congress, there is pending legislation that would provide $10 million for EC education and outreach. Many women are still unfamiliar with EC and can confuse it with an aborticide. In the United States, there are up to 1,000,000 unintended pregnancies per year – the highest of any industrialized nation. About one-half of these unintended pregnancies end in abortion. According to Ms. Lopez, Latino women have the second highest rate of unintended pregnancies, while African-American women have the highest rate. She states that anti-abortionists should support making EC more accessible to women in a timely manner because it can reduce the number of abortions. The Alan Guttmacher Institute estimated that 51,000 abortions were prevented by EC use in 2000, and that the increased use of EC accounted for up to 43% of the total decline in abortions between 1994 and 2000. These numbers would be higher if more women used EC to prevent unintended pregnancies. Unfortunately, the majority of women of reproductive age in the United States do not know about EC.

In New York, it was estimated by the Office of the Comptroller that the state would achieve $450 million per year in savings if EC was more widely available to prevent unwanted pregnancies. In New York City, EC is available for free at STD Health Clinics to residents. Outside of major metropolitan areas, Ms. Lopez suggested that county-wide Public Health Districts could make EC available for free to reduce the incidence of unwanted pregnancies. In New York City, legislation was passed in which pharmacies can be fined $250 if they run out of EC. However, this law was not well-received by the pharmacies.

The keynote speaker described the attitudes of Latinos in New York City to EC and similar reproductive issues. The terminology that is often used by English speakers, such as "pro-choice," "reproductive rights," and "emergency contraception," often don't resonate well with Spanish-speaking Latinos and are poorly understood. Latinos in New York City are primarily of Puerto Rican descent and they receive information about reproductive issues from the Catholic Church (and some evangelical churches to a lesser extent). Although they are often against abortion, Latinos often don't follow the doctrines of church leaders on other reproductive issues and they support Medicaid funding of reproductive health care. In Latino households, it is important to include men in the decision-making process on reproductive issues. Therefore, education and outreach on EC will be more effective if they are directed at members of both genders. Ms. Lopez stated that education and outreach are quite important in making Latinos more aware of EC so that they are more likely to use it and are less likely to confuse EC with abortion.