Plan B has been available over the counter for 10 years now. Why experts say access is more crucial than ever.
On June 20, 2013, Plan B became available over the counter, helping women avoid point-of-sale barriers to emergency contraception. A lot has changed in reproductive care in the U.S. since then, including the loss of the federal right to abortion care access — that was removed with the reversal of Roe v. Wade last year.
Easy access to Plan B remains, however, and experts say that's been a game-changer.
"Why do we need morning-after contraception? Because we are human," Dr. Mary Jane Minkin, a clinical professor of ob-gyn and reproductive sciences at Yale School of Medicine, tells Yahoo Life. "Almost half of the pregnancies that occur in the U.S. are not planned. People don't always use reliable contraception — they forget to use a condom; the condom breaks; they forget to get their new pack of birth control pills at the pharmacy."
Plan B delays or prevents ovulation after unprotected sex (it does not end a pregnancy that's been implanted), and its usage is fairly common in sexually active women of reproductive age. Data from the National Survey of Family Growth found that, among women aged 22 to 49 who have ever had sex, more than 24% have used emergency contraception at some point. Usage increased with education level — 12.6% of women without a high school diploma or GED have used Plan B, as compared to nearly 28% of those with a bachelor's degree or higher.
"Being able to go into a pharmacy and pick up a very safe and reliable way to prevent an unplanned pregnancy is very important," Minkin continues. "By being over the counter, you don't need to have a medical person's approval, and you don't need to have a pharmacist involved."
Over-the-counter access to Plan B was "a big step for reproductive health," Jamie Alan, an associate professor of pharmacology and toxicology at Michigan State University, tells Yahoo Life.
Plan B is considered a safe medication, Alan says. "This drug has relatively few serious side effects if used correctly," she says. "Nausea is common, but it will resolve." However, the medication doesn't work for everyone. "The major drawback is that, if you are above a certain weight, one dose will not be enough. Many people don’t know that," Alan says. "If you are over 150 pounds, I would recommend talking to your doctor or pharmacist to make sure you are getting the right dose."
Why experts says it's vital that Plan B exists
A lot has changed since Plan B became an option, particularly in the last few years. Reproductive rights in certain states have shrunk: 24 states have banned abortion or are likely to do so, according to the Guttmacher Institute. Ob-gyns have also been criminalized in those states for helping provide reproductive care to women and girls in need, something the American College of Obstetricians and Gynecologists has spoken out about. All of that, Minkin says, makes it vital that an option like Plan B exists.
At the same time, use of long-acting reversible contraception (LARC), such as an IUD or the implant, which have a 99% efficacy rate, has increased. LARC use in American women has skyrocketed, accounting for approximately 1% of contraceptive use in 1995 but 16% in 2019.
Despite Plan B's availability, "There is still work to be done," Megan N. Freeland, director of health communications at Planned Parenthood Federation of America, tells Yahoo Life. She cites research from the Kaiser Family Foundation published last year that shows 1 in 4 women of reproductive age either don't know that emergency contraception pills are available over the counter or haven't heard of emergency contraception. "Of the women who have heard of emergency contraception, around 30% don’t know where to get it," Freeland says.
Why reliable birth control still matters
While Minkin says Plan B is an essential tool for women's reproductive health, she stresses the importance of having reliable birth control in place to avoid the need for emergency contraception. "I am regularly asked if it is safe to use the morning-after pill multiple times, after multiple times of unprotected sex," she says. "It is safe, but we in the medical community can do much better for folks." She recommends looking into a LARC if you find you're regularly relying on Plan B. "We can find a good LARC method for just about everyone, and then you don't have to worry about these issues at all," she says.
Freeland says that access to Plan B is more crucial than ever. "In a post-Roe world, this importance cannot be overstated," she says. "While birth control and emergency contraception are not substitutes for abortion access, being able to get emergency contraception when you need it can go a long way toward having ownership over your own reproductive health, life and future."
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