Text 20636, 164 rader
Skriven 2006-06-04 19:53:52 av Alan Hess
Ärende: Plan B lack of availability
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washingtonpost.com

What Happens When There Is No Plan B?

By Dana L.
Sunday, June 4, 2006; B01

The conservative politics of the Bush administration forced me to have an
abortion I didn't want. Well, not literally, but let me explain.

I am a 42-year-old happily married mother of two elementary-schoolers. My
husband and I both work, and like many couples, we're starved for time
together. One Thursday evening this past March, we managed to snag some rare
couple time and, in a sudden rush of passion, I failed to insert my diaphragm.

The next morning, after getting my kids off to school, I called my ob/gyn to
get a prescription for Plan B, the emergency contraceptive pill that can
prevent a pregnancy -- but only if taken within 72 hours of intercourse. As
we're both in our forties, my husband and I had considered our family complete,
and we weren't planning to have another child, which is why, as a rule, we use
contraception. I wanted to make sure that our momentary lapse didn't result in
a pregnancy.

The receptionist, however, informed me that my doctor did not prescribe Plan B.
No reason given. Neither did my internist. The midwifery practice I had used
could prescribe it, but not over the phone, and there were no more open
appointments for the day. The weekend -- and the end of the 72-hour window --
was approaching.

But I needed to meet my kids' school bus and, as I was pretty much out of
options -- short of soliciting random Virginia doctors out of the phone book --
I figured I'd take my chances and hope for the best. After all, I'm 42. Isn't
it likely my eggs are overripe, anyway? I thought so, especially since my best
friend from college has been experiencing agonizing infertility problems at
this age.

Weeks later, the two drugstore pregnancy tests I took told a different story.
Positive. I couldn't believe it.

I'm still in good health, but unlike the last time I was pregnant, nearly a
decade ago, I'm now taking three medications. One of them, for high
cholesterol, is in the Food and Drug Administration's Pregnancy Category X --
meaning it's a drug you shouldn't take if you're expecting or even planning to
get pregnant. I worried because the odds of having a high-risk pregnancy or a
baby born with serious health issues rise significantly after age 40. And I
thought of the emotional upheavals that an unplanned pregnancy would cause our
family. My husband and I are involved in all aspects of our children's lives,
but even so, we feel we don't get enough time to spend with them as it is.

I felt sick. Although I've always been in favor of abortion rights, this was a
choice I had hoped never to have to make myself. When I realized the
seriousness of my predicament, I became angry. I knew that Plan B, which could
have prevented it, was supposed to have been available over the counter by now.
But I also remembered hearing that conservative politics have held up its
approval.

My anger propelled me to get to the bottom of the story. It turns out that in
December 2003, an FDA advisory committee, whose suggestions the agency usually
follows, recommended that the drug be made available over the counter, or
without a prescription. Nonetheless, in May 2004, the FDA top brass overruled
the advisory panel and gave the thumbs-down to over-the-counter sales of Plan
B, requesting more data on how girls younger than 16 could use it safely
without a doctor's supervision.

Apparently, one of the concerns is that ready availability of Plan B could lead
teenage girls to have premarital sex. Yet this concern -- valid or not -- wound
up penalizing an over-the-hill married woman for having sex with her husband.
Talk about the law of unintended consequences.

By late August 2005, the slow action over Plan B led the director of the FDA's
Office on Women's Health to resign her post. The agency's delay on the drug,
she wrote in an e-mail to her colleagues, "runs contrary to my core commitment
to improving and advancing women's health." As recently as April 7, Steven
Galson, director of the FDA's Center for Drug Evaluation and Research, said
that the agency still needed time to work on the issue.

Unfortunately, time was the one thing I didn't have.

Meanwhile, I hadn't even been able to get Plan B with a prescription that
Friday, because in Virginia, health-care practitioners apparently are allowed
to refuse to prescribe any drug that goes against their beliefs. Although I had
heard of pharmacists refusing to fill prescriptions for birth control on
religious grounds, I was dumbfounded to find that doctors could do the same
thing.

Moreover, they aren't even required to tell the patient why they won't provide
the drug. Nor do they have to provide a list of alternative sources. I had
asked the ob-gyn's receptionist if politics was the reason the doctor wouldn't
prescribe Plan B for me. She refused to answer or offer any reason, no matter
how much I pressed her. By the time I got on the phone with my internist's
office and found that he would not fill a Plan B prescription either, I figured
it was a waste of time to fight with the office staff. To this day, I don't
know why my doctors wouldn't prescribe Plan B -- whether it was because of
moral opposition to contraception or out of fear of political protesters or
just because they preferred not to go there.

In any event, they were also partly responsible for why I was stuck that
Friday, and why I was ultimately forced to confront the decision to terminate
my third pregnancy.

After making the decision with my husband, I was plunged into an even murkier
world -- that of finding an abortion provider. If information on Plan B was
hard to come by, and practitioners were evasive on emergency contraception,
trying to get information on how to abort a pregnancy in 2006 is an even more
Byzantine experience.

On the Internet, most of what I found was political in nature or otherwise
unhelpful: pictures of what your baby looks like in the womb from week one, and
so on.

Calling doctors, I felt like a pariah when I asked whether they provided
termination services. Finally, I decided to check the Planned Parenthood Web
site to see whether its clinics performed abortions. They did, but I learned
that if I had the abortion in Virginia, the procedure would take two days
because of a mandatory 24-hour waiting period, which requires that you go in
first for a day of counseling and then wait a day to think things over before
returning to have the abortion. Because of work and the children, I couldn't
afford two days off, so I opted to have the procedure done on a Saturday in
downtown D.C. while my husband took the kids to the Smithsonian.

The hidden world of abortion services soon became even more subterranean. I
called Planned Parenthood two days in advance to confirm the appointment. The
receptionist politely informed me that the organization never confirms
appointments, for "security reasons," and that I would have to just show up.

I arrived shortly before 10 a.m. in a bleak downpour, trusting that someone had
recorded my appointment. I shuffled to the front door through a phalanx of
umbrellaed protesters, who chanted loudly about Jesus and chided me not to go
into that house of abortion.

All the while, I was thinking that if religion hadn't been allowed to seep into
American politics the way it has, I wouldn't even be there. This all could have
been stopped way before this baby was conceived if they had just let me have
that damn pill.

After passing through the metal detector inside the building, I entered the
Planned Parenthood waiting room; it was like the waiting room for a budget
airline -- crammed full of people, of all races, and getting busier by the
moment. I was by far the oldest person there (other than one girl's mom). The
wait seemed endless. No one looked happy. We were told that the lone doctor was
stuck in Cherry Blossom Parade traffic.

He finally arrived, an hour and a half late.

The procedure itself took about five minutes. I finally walked out of the
building at 4:30, 6 1/2 hours after I had arrived.

It was a decision I am sorry I had to make. It was awful, painful, sickening.
But I feel that this administration gave me practically no choice but to have
an unwanted abortion because the way it has politicized religion made it
well-nigh impossible for me to get emergency contraception that would have
prevented the pregnancy in the first place.

And to think that, all these years after Roe v. Wade became the law of the
land, this is what our children have to look forward to as they approach their
reproductive years.

Dana L. is a lawyer and writer living in Virginia. Out of concern for her
family's privacy, she requested that her last name not be published.

+ 2006 The Washington Post Company

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