Felicia Stewart, 63; Doctor Pushed for ‘Morning-After Pill’ Contraceptive

Long before the “morning-after pill” was ever packaged or marketed, Dr. Felicia Hance Stewart had become its national spokeswoman.

For years, the gynecologist pushed for the creation of an emergency contraceptive pill that a woman could use after unprotected sex. Convinced by her passion, medical professionals joined the effort and eventually brought the drug known as Plan B to the U.S. market.

It was one of many ways that the 63-year-old Stewart, who died April 13 of lung cancer at her home in San Carlos, Calif., influenced the lives and futures of women here and abroad.

“The advocacy effort which she helped spark in the U.S. helped ensure that products would eventually become available in ... countries around the world,” said Sharon Camp of the Alan Guttmacher Institute, who credits Stewart for inspiring her work that brought Plan B to the commercial market.

Around the country, a community of reproductive-health advocates praised Stewart as the wise woman of their tight-knit group, a fearless, creative thinker who provided an example and spurred others to action.

“She was an articulate spokesperson for reproductive health and reproductive rights,” said James Trussell, a professor of economics and public affairs and director of the Office of Population Research at Princeton University. “She inspired a generation of young women clinicians, researchers and activists to strive to be like her.”

Stewart was born March 14, 1943, in Washington, D.C., to Lena and Harold Hance. She graduated from University High School in Los Angeles, UC Berkeley and, in 1969, Harvard University’s Medical School.

On April 11, 1970, abortion was legalized in New York, and Stewart soon went to work at one of the first health clinics in the city that provided the procedure. Later, she received training in obstetrics and gynecology at UC San Francisco, where she met Gary Stewart, whom she later married and shared a practice with.

Two decades of work as a clinician provided her with the experiences that would shape her views on the need for emergency contraceptives.

“She, unlike many of us, dealt with women who had been raped or had a condom break or otherwise had a contraceptive emergency,” Camp said.

Before the creation of Plan B, Stewart offered her patients a form of emergency contraceptive. She prescribed birth control pills in a higher than normal dose, which worked in much the same way as a morning-after pill.

But Stewart was convinced that availability and awareness would increase with a product designed and marketed for the purpose of preventing unintended pregnancies after sex.

Stewart countered objections that the availability of the pill would cause women to become lax in their insistence that men use condoms, or that women would use the pill in excess.

“Look, people’s lives are people’s lives, and some of them can’t cope or be as organized as some of us might like,” she told a New York Times reporter in 1993. “But it’s only in the area of sex that we get involved in the ethics of promoting risk taking, the idea that we should withhold information or devices because we don’t want people to need them.

“Would you make the same argument about cholesterol drugs? Saying, if we give people a drug that will reduce cholesterol, they won’t be as likely to exercise and eat properly like they really should?”

By the early 1990s, Stewart was speaking at conferences and writing on what she called “the best-kept secret” by doctors, but pharmaceutical companies were not interested, Camp said. The issue was controversial and the potential profit seemed slim, given that the young and poor women most likely to need the pill had little money to buy it.

But Camp and many others who heard her were convinced. In the end, it took a private-public sector partnership -- and Camp’s creation of a pharmaceutical company -- to get the pill on the market. It won FDA approval in 1990 and is now available by prescription. Stewart supported efforts to make the drug available over the counter, but that idea has faced opposition and stalled, Camp said.

In addition to her work in promoting the morning-after pill, Stewart was a leader in an effort to train nurse midwives and nurse practitioners to perform medical or drug-induced abortions.

From 1994 to 1996, she served as deputy assistant secretary for population affairs for the U.S. Department of Health and Human Services, where she helped create domestic and international policies on family planning and population issues.

Her advocacy while there helped California develop “one of the biggest and most successful family planning programs in the nation and the world,” said Dr. Philip D. Darney of San Francisco General Hospital.

Stewart also worked with the Center for Reproductive Health Research & Policy and the Bixby Center for Reproductive Health Research & Policy, both in San Francisco. She also directed the Reproductive Health Program at the Henry J. Kaiser Family Foundation in Menlo Park, Calif.

She praised the efforts of teenagers to educate one another about sexual responsibility and encouraged men to take a more active role in choosing and using contraception.

“There are 3.5 million unintended pregnancies every year, and in pretty nearly every one of them, there was a guy involved,” she quipped in a 1997 Los Angeles Times article.

Stewart is survived by her children, Matthew and Kathryn Stewart; her stepchildren, Tamara Barlow of Sacramento and Michael and Wayne Stewart of Utah; eight grandchildren; and her parents.

A memorial service is tentatively being scheduled for sometime in May.