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Emergency Contraception Without a Prescription
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by By Cliff Terry | 2006

Good health policy is also a good environmental policy

SB 297 and HB 828 would allow women to buy emergency contraceptive (EC) pills without a prescription.

EC pills, often called morning-after pills, are ordinary birth control pills taken in special doses after unprotected intercourse (the condom breaks, say, or intercourse was not planned) to reduce the risk of pregnancy by up to 95%. They are not abortion pills.

Half of the 6 million annual pregnancies in the U.S. are unintended. EC holds the potential to reduce unintended pregnancies by half, so it could also cut in half Maryland’s abortion rate of 3 in every 10 pregnancies.

But emergency contraceptive pills are effective only within 72 hours after intercourse. Moreover, their effectiveness decreases by 50% with every 12 hours of delay even within those 72 hours. So women must be able to get them as soon as possible and on the spur of the moment, because that’s the way the need arises. It may be impossible to get a physician’s prescription quickly enough, especially on a weekend or holiday.

The American Medical Association and the American College of Obstetricians and Gynecologists support making EC pills available to women without a prescription. Several states have allowed this for years.

Advisory committees for the U.S. Food and Drug Administration voted overwhelmingly that the pills are safe enough to sell nationwide without prescription, but under right-wing political pressure the FDA kept postponing a decision. That decision now appears to have become a “no” by inaction.

Here are some of the objections people have expressed to sale of EC without prescription, with responses:

1. In some cases the pills may work by
preventing implantation of a fertilized egg in the uterus, and some churches that oppose abortion call that abortion. In medical terms, however, it is not abortion because a woman is not pregnant until after implantation.


2. Some say EC will encourage promiscuity. But some say that about any contraception.


3.  Some are leery about very young girls taking the pills without medical supervision. But the pills are far safer than either alternative—childbirth or abortion. Moreover, they could not be sold except after a screening by a pharmacist trained in a state-approved program, following a protocol developed by the state, and providing an instruction sheet written by the state.


4.  EC does not protect against sexually transmitted diseases. But most other contraceptives don’t either. Pharmacists will make sure purchasers understand that.


5. Some fear women will rely on EC as their regular contraception. But the pharmacist will warn them it is not effective enough for that. Also, about a quarter of users have unpleasant (but not dangerous) side effects, like nausea, which would discourage frequent use.


What makes EC a Sierra Club issue? Environmental concerns are only one of the reasons easy access to EC is important, but they are an important reason. All those unintended pregnancies contribute, of course, to continuing population growth. As you know, growth contributes directly to sprawl, road congestion, air pollution, extinction of species, and degradation of all of our natural environment.

For lots more information about emergency contraception, see . For information about this bill, contact Cliff Terry,, or 410-944-9477.

Please call your senator, especially if on the Education, Health, and Environmental Affairs Committee (though it’s possible that committee will vote before you receive this, since the hearing was Feb. 15). And please call your delegates, especially if on the Health and Government Operations Committ

> 2006 Table of Contents


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