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HHS Should Appeal Plan B Decision

After nearly a month, the Obama administration's Justice Department finally decided to fight New York Judge Edward Korman's activist Plan B decision. Following Judge Korman's decision, parents across the country, dozens of national organizations, and over 50 Members of Congress called on the administration to appeal the decision in order to protect the rights of parents and ensure the safety of young girls. Even so, a recent decision by the U.S. Food and Drug Administration (FDA) could still put young girls in danger.

The decision to allow all girls of "reproductive" age to purchase Plan B without a prescription was made not by a panel of skilled professionals or by the Health and Human Services Department (HHS), but by a single federal judge who brushed aside serious medical concerns and parental rights in the name of "access." While Americans waited to hear whether or not the Obama administration would appeal the decision, the FDA decided to allow Plan B to be sold right off the shelf without prescription to girls as young as 15. Unfettered access to Plan B, whether available to pre-teens or limited to girls as young as 15, poses serious safety concerns.

Both decisions ignore the potential health risks to young women. Plan B is a single dose of hormones at least four to seven times the dose in birth control pills, and there is limited information on the effects such high doses of hormones would have on young girls. The evidence is also inconclusive on Plan B's mechanism of action, and could include both preventing fertilization of an egg and preventing uterine implantation of an embryo, which would mean acting as an abortifacient drug. Despite what proponents say, it is clearly not the same as taking an aspirin.

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What's more, when HHS secretary Kathleen Sebelius had the choice in 2011 to extend over the counter (OTC) access of Plan B to girls under 17 years of age she declined because of her serious concern that young girls do not understand how to properly use the drug. Proof of adequate drug label comprehension is a requirement for OTC access, as improper use of serious drugs can be dangerous. President Obama, a father of two girls, echoed Sebelius' concerns about potential improper use and praised her decision. Medical professional organizations such as the American College of Pediatricians and the American Association of Pro-Life Obstetricians and Gynecologists also agree.

Advocates of the plan claim that increased access is good for girls. However, in this case, increased "access" is a sure-fire way to discourage girls in desperate need of medical screenings from receiving any medical care or attention. A study out of the United Kingdom in 2010, where Plan B is already available OTC for teens, shows that sexually transmitted infection (STI) rates among teens increased following OTC availability. These new STIs among teens will remain widely untreated because OTC access to contraceptives without a doctor's oversight causes women and girls to avoid necessary medical screenings during which STIs are detected and treated. In the U.S., the Centers for Disease Control (CDC) reported almost 20 million new sexually transmitted infections in 2008 (the latest year for which data is available), with most new cases occurring in young men and women ages 15-25.

Additionally alarming is that Plan B "access" advocates ignore the fact that doctors and parents are often the first line of defense for girls who are being sexually abused. Removing doctors and parents from the equation will make it much easier for predators to conceal sexual abuse and to force the drug's use on minors.

If Plan B is made available on retail store shelves it will be available for sale whether or not the on-site pharmacy is open. The only "safeguard" in place will be the requirement that the cashier check ID before sale. This flimsy protective measure is not acceptable. Secretary Sebelius and the administration should also refuse to accept the new FDA decision in the name of protecting young girls and the rights of parents.

Schools need parental permission to give children aspirin, thus it logically follows that access to a high dose hormonal contraceptive should also require parental permission. Instead of implementing a contraceptive free-for-all among young girls, we should be focusing on ways to encourage communication between parents and teens. Communication and guidance from parents is essential to the proper development and health of children. If implemented, the decisions by Judge Korman and the FDA would both adversely impact the health and wellbeing of teenage girls and would strike a blow to the fundamental rights of parents to direct the upbringing of their children.

Anna Higgins, J.D., is director of the Center for Human Dignity at the Family Research Council.

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