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Second-guessing Plan B

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After years of seeing their painstaking research ignored by political appointees during the George W. Bush administration, federal scientists heaved sighs of relief when newly elected President Obama vowed that science would no longer be countermanded by political ideology. On Wednesday, however, they were given reason to wonder if that was true, as U.S. Health and Human Services Secretary Kathleen Sebelius overruled the U.S. Food and Drug Administration, deciding that teenagers under age 17 would not be given over-the-counter access to the morning-after pill.

Her decision was ironic considering that only a few years ago it was the FDA seeking to restrict minors’ access to the emergency contraceptive pill by requiring a prescription. Timeliness is an important factor with the pill, known by its brand name Plan B One Step; it is most effective at preventing pregnancy when taken within 24 hours after unprotected sex. In 2009, a federal judge ordered the FDA to make the pill available to 17-year-olds without a prescription — adults already didn’t need one — and to reconsider the restrictions on younger girls, considering a body of 40 studies that showed the pill was safe and effective and that adolescents were just as likely as adults to understand how and when to use it.

That’s exactly what the FDA was doing this week when, in a reportedly unprecedented action, Sebelius overturned its decision. The reason she gave was that although the new rule would have made the drug available to girls of any age, the manufacturer had not included in its studies girls as young as 11, about 10% of whom can become pregnant.

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Her official stance, which bears little scrutiny, has led reproductive-rights groups to allege that the decision was politically motivated — perhaps by fear within the Obama administration of being attacked during the presidential campaign for encouraging young girls to have unprotected sex without their parents’ knowledge.

FDA Commissioner Margaret Hamburg says that her agency did, in fact, take into account use by very young girls. But Sebelius waited until the eleventh hour to make her decision, rather than asking the FDA for more data earlier in its deliberations. And even if she felt there was not enough data on the use of the drug by 11-year-olds, she could have asked the FDA to consider limiting access to girls 12 or older.

Children might misuse many nonprescription medications, but we don’t whisk all those drugs behind the counter. In fact, Sebelius’ argument against easier access to the pill is one of the best arguments for it. As much as we don’t want to see sexual activity among young girls, repeated studies have shown that the availability of Plan B does not make women or girls more likely to have unprotected sex, promiscuous sex or, in fact, any kind of sex. Young girls who are, however unwisely, having unprotected sex especially need access to safe methods of preventing pregnancy.

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