Cat Marnell, xoJane’s health and beauty director, caused quite the stir with her post about Plan B earlier this week. She chalked up New York City’s supposed shortage of Emergency Contraceptive (EC) to the behavior of girls like herself, who use Plan B as their sole method of birth control. But since we know she’s not the only one who sucks at safe sex, and we worry that her post may have confused young women who aren’t in-the-know about contraceptives or Plan B, we decided to get some better information in case this whole scuffle has left you confused.
We got in touch with the folks over at Plan B One-Step (first thing you should know: Plan B moved from two pills to one back in 2009, and now it’s officially called Plan B One-Step), and they put us in touch with Kathleen Besinque, Associate Professor of Clinical Pharmacy, Director of Professional Experience Programs and Office for Teaching and Learning Resources USC School of Pharmacy, to answer some of our lingering questions about how women really use ECs and what’s really safe (because yeah, Cat’s methods…not so much). Here’s what she had to say:
xoJane’s post implies that Plan B One-Step shortages are caused by women who use the drug in place of other forms of contraceptives. Is this correct?
Not true- using EC allows women to reduce the risk of pregnancy after intercourse when needed. Most women are aware that EC is not as effective as other means of birth control and use it as needed. I fill prescriptions for birth control pills and other forms of contraception far more frequently than I am asked for EC.
Is Plan B One-Step recommended as a primary form of birth control?
No but the reason is because it is less effective than other methods. It is not “wrong” or ‘harmful” to use EC but it should be an informed choice. Women can chose not to use birth control at all- however if they do not want to become pregnant – they should chose the most effective method that fits her (and partners) needs- everyone is a little different.
Is the administration of Plan B One-Step regulated by pharmacies?
It is regulated by the FDA. The FDA has regulated that EC be available from behind the counter only to persons (men and women) 17 and older without a prescription and by prescription to women under 17. Any person in the pharmacy (clerks, cashiers, pharmacists) can sell EC to a person 17 or older. No questions or logs are kept on file.
How often is it possible to obtain the drug, and can anyone get it?
A person 17 or older can purchase EC without a prescription as often as they need to. No limits on purchases exist.
My understanding is that several states have conscience clauses allowing pharmacists to refuse to fill a prescription. Can you explain that in layman’s terms?
A pharmacist can refuse to fill a prescription in when in their professional opinion it is unsafe or contains errors.
A pharmacist in many states can also refuse to fill a prescription when they have a moral objection to the therapy (this must be pre-disclosed to employers and a plan to provide the therapy to the patient in place)- but the patient is to be taken care of. In the case of Over The Counter EC- this seldom is an issue since the pharmacist is not the only store employee who can sell the EC. OTC purchases are generally not included in conscious clauses.
What are physician recommendations for the frequency of use of Plan B One-Step? Is it safe to take it three times in a 30-day period?
No evidence exists that suggests it is not safe. While it is possible that repeat use of EC in the same cycle might be less effective- it is not less effective than doing nothing. It is better to use EC as often as it might be needed than to use it only when a women “thinks” she needs it- since often it is difficult to know if she is in her fertile window or not. The safety is not an issue—the total dose of hormone over the month is not harmful or toxic. Since the bigger risk to health is unwanted pregnancy, using EC—even many times in one cycle—is reasonable. Referral for more effective options is suggested but not mandatory.
Every woman should have a Plan A—a safe and reliable form of birth control that they use correctly and consistently is always the goal but that when “oops” moments happen—as they do to everyone—there is Plan B One-Step, a safe and effective method that can help prevent unintended pregnancy when taken within 72 hours (three days) of unprotected sex.