Board Rebuffed in Its Effort to Ban Morning-After Pill

A health agency effectively denied a request from San Bernardino County on Thursday to end the distribution of morning-after contraceptive pills at county health clinics, a move expected to draw the Bush administration into a volatile debate over women’s rights.

In a terse one-page letter to Fred Aguiar, chairman of the San Bernardino County Board of Supervisors, the California Family Health Council said the county did not demonstrate the “exceptional circumstances” necessary to grant the pill-ban request--the first of its kind in California.

“Ultimately, I would really hope that they would carefully consider their request based on the information they have--or the lack thereof,” said Margie Fites Seigle, chief executive of the Health Council, the Los Angeles-based nonprofit group that distributes federal family planning money.

“There was not sufficient information there [to justify a ban],” said Seigle, who wrote the letter. “The question is: Can they provide it?” Until it can, San Bernardino County must continue distributing the pill, she said.

If the Health Council formally rejects the county’s request, which now appears likely, the request is expected to wind its way to the U.S. Department of Health and Human Services.

That would set the stage for an important test of the Bush administration, which has blocked funding for overseas family planning groups that perform abortions and strongly supports local government control.

Women’s rights supporters suspect that’s the target audience of the San Bernardino County supervisors--most of whom contend that the morning-after pill is akin to abortion.

“I’m very concerned that once this gets to that level, it will be granted,” said Jon Dunn, president and chief executive of Planned Parenthood of Orange and San Bernardino counties. “This would give our president his first opportunity to allow [local governments] to limit the scope of family planning services. I think he has demonstrated his willingness to do that, and I think it would set a very dangerous precedent.”

Health and Human Services representatives could not be reached Thursday.

Aguiar did not return phone calls seeking comment, but he sent Seigle a note later Thursday arguing that the county “has provided sufficient information to support a decision.”

“It is respectfully requested that you inform the county of that decision at your earliest convenience,” Aguiar’s letter said.

In April, a conservative majority on the San Bernardino County board decided to seek a ban on the pills. Unlike the controversial RU-486, which expels a fetus, morning-after pills are heavy doses of birth control drugs that prevent a fertilized egg from being implanted.

The medical community considers the morning-after pill a valuable method of reducing unplanned pregnancies; supporters say the pill will prevent 1.7 million pregnancies this year, and, subsequently, 800,000 abortions.

Indeed, though the Clinton administration just made morning-after pills available in 1999, they are already considered so accepted that the new president of the American College of Obstetricians and Gynecologists asked doctors last week to give women advance prescriptions for the pills during routine gynecologic visits.

Some conservative groups, however, view the pills as a form of abortion--and, therefore, they believe the government should not pay for them. That, coupled with a concern that the pills are periodically given to minors, prompted San Bernardino County to request a ban on distribution of the pill in county-run health clinics.

An analysis of county health records showed that the vast majority of the 643 pills distributed by the county in 2000 were not given to teens, but to poor adult women without insurance or access to family-planning counseling.

Women’s rights groups and many health care professionals have called the request dangerous and shortsighted. Ultimately, they say, it could result in a higher number of abortions, presumably not the goal of the politicians pushing for the ban.

The county is essentially asking for permission to skirt federal law, which requires that government agencies receiving family planning grant money use some of it to dispense morning-after pills--unless they have a waiver.

To receive the waiver, federal law dictates the county must prove that “exceptional circumstances” exist, especially since the county has provided the pills in the past. The county must also provide “epidemiologic, clinical and other supportive data to justify the request.”

Documents the county provided to the Health Council spelled out a variety of concerns. They argued, among other things, that high doses of estrogen can have painful side effects, that some women may be hypersensitive to the pills and that the long-term effects of the pills may not be known.

But a chief concern was whether the pills should be considered a form of abortion--whether the pill “should appropriately be considered pregnancy prevention, termination of emergency contraception,” Aguiar wrote on April 6.

“[Our] motivation is based upon a desire to protect children in our County and to uphold community standards, preserve local control and to defend parental rights,” he wrote.

But the argument did not hold water under under federal law, the Health Council ruled.

“Maybe there’s information that I’m not aware of,” Seigle said. “If they have it, please bring it forward.”