While politicians and political elites continue to get their knickers in a twist over contraception, it is heartening to see some public health experts who just get it. This small press item recently caught our eye over at the Reproductive Health Technologies Project. For the past two years, the Etter Health Center at Shippensburg University, a small-town Pennsylvania school, has provided access to a vending machine that dispenses Plan B One-Step® (among other health products) to students at a cost of $25. Since Plan B One-Step® usually retails for $50, they get extra kudos for being student-budget friendly.
The news may raise some eyebrows, but let’s recap why we think it’s a really smart move. Plan B One-Step® has been approved by the U.S. Food and Drug Administration (FDA) for over-the-counter use by women ages 17 and older to prevent unintended pregnancy. It can be taken up to 72 hours after birth control failure or unprotected sex, but does not cause termination of a pre-existing pregnancy. The sooner it is used, the more effective it is. Better still, it’s safe.
For several years now, the FDA has allowed women 17 and older to get Plan B One-Step® direct from a pharmacy counter without having to visit a health care provider first. More recently, FDA experts and top decision-makers, in keeping with the evidence and expert advice of medical professionals like the American Academy of Pediatrics and the American Congress of Obstetricians and Gynecologists, concluded the product could be used safely by anyone at risk of an unintended pregnancy, a conclusion that was recently confirmed by experts at an FDA Pediatric Advisory Committee meeting.
Unfortunately, as has happened before, politics (or politicians) trumped science. In December 2011, U.S. Department of Health and Human Services Secretary Sebelius ignored the FDA recommendation to put emergency contraception on shelves and instead decided to keep it behind the pharmacy counter, forcing women who need it to find a pharmacy that’s open, ask for it, and show proof of age. These may seem like small hurdles, until you’re that person in a stressful moment trying to prevent an unintended pregnancy.
Fortunately, health officials at Shippensburg seem to understand that helping young people stay healthy means giving them access to the tools they need to prevent unplanned pregnancy and sexually transmitted diseases. That’s why the vending machine makes sense. These products are safe and don’t require a health care professional to be used correctly. Students are required to provide university identification card to gain access to the health center where the vending machine is located and, according to a university spokesperson, the school does not have any students younger than 17 so the vending machine is in keeping with current FDA labeling.
Why stop with a vending machine? If Plan B One-Step® is safe for use by women of any reproductive age, it only makes sense that there should be more innovative models to facilitate access and help women manage their reproductive health. Researchers at the University of Pittsburgh are investigating how kiosks in clinician waiting rooms can improve access to hormonal contraception. Of course at RHTP, we hope this is just the tip of the iceberg; we’re hoping for a Happy Health Hut somewhere in the near future.
Secretary Sebelius and other politicians have it wrong. Among their misguided concerns are that young women are not capable of making their own health decisions and need adult supervision, and that the availability of contraception increases risky sexual behavior.
Let’s face it. Young people have sex. We are only doing them a service by ensuring that those who need emergency contraception, whatever the reason, get it in a timely manner.
We should encourage schools, health care providers, and other service providers to be pioneers in innovative models of service delivery. Poor access and disparities in access to contraceptives and high rates of unintended pregnancy have persisted into the new era. Twenty-first century challenges require 21st century responses. The status quo is clearly not enough. Let’s move forward in reproductive health service delivery and encourage innovation, because seriously, it’s about time.