The XX Factor

The Morning-After Pill Is Finally Available to Girls Under 17. Why Did It Take So Long?

Free at last

Photo by Joe Raedle/Getty Images

Today, a federal judge ruled that the U.S. government must make emergency contraceptives available over the counter to all women and girls, no prescription or ID check necessary. In his decision, U.S. District Judge Edward R. Korman concluded that the pill causes no serious side effects, does not induce abortions, and will soon be “one of the safest drugs sold over-the-counter.” So why did it take 14 years to make the morning-after pill available like condoms are?

Plan B was the first U.S. contraceptive marketed to prevent pregnancies in the hours after unprotected sex, broken condoms, or sexual assault. When it hit American drugstores in 1999, it was available to every woman with a doctor’s prescription in hand. But since the pill is most effective when taken within 24 hours of sex—its efficacy depletes every hour after intercourse—that meant that Plan B was technically available to all women but practically useless to most of them. (Imagine scheduling an appointment with a doctor every time you realized you needed a condom.) Women who weren’t able to secure a doctor’s visit and drugstore run before sperm reached egg were still looking at Plan C: abortion.

Activists have been hounding the government to free up the drug ever since. In 2006, the Food and Drug Administration made the pill available for women 18 and older without a prescription; in 2009, a judge forced the FDA to make it available to 17-year-olds, too. Most teenage girls were out of luck. (Imagine asking your parents to schedule an appointment with a doctor every time you realized you needed a condom.) And even adults were still required to approach their neighborhood pharmacist, present an ID, and risk public shaming in requesting the medication.

Why did a 16-year-old need a doctor’s opinion to secure medication an 18-year-old can get freely over the counter? And why did the U.S. feel the need to clamp down on a drug that was already freely available in 63 other countries, including the United Kingdom, Ghana, and France? In 2005, National Women’s Liberation filed a lawsuit alleging that the decision was purely political and not at all medical. “The Bush administration pressured FDA review staff to enact an age limit on the pill for political reasons,” the NWL argued. A court agreed that the FDA “acted in bad faith and in response to political pressure,” strayed from its “normal procedures,” mounted “repeated and unreasonable delays” to freeing the drug, and ordered the pill be made available to 17-year-olds, too. By 2011, President Bush was out of office, and the FDA was poised to eliminate age restriction on the pill entirely. In a surprise move, Health and Human Services blocked the FDA’s decision, and a new president approved. The Obama administration “could not be confident that a 10-year-old or an 11-year-old [who goes] into a drugstore, should be able—alongside bubble gum or batteries—be able to buy a medication that potentially, if not used properly, could end up having an adverse effect,” Obama said at the time.

Of course, bubblegum  can have an adverse effect when “not used properly,” but stealing candy from babies isn’t a very strategic move for a president gearing up for re-election. Curtailing the reproductive rights of teenage girls—no matter what the scientific and medical record says—is far more politically advantageous. Reproductive health has always been a point of political posturing. But one of the more interesting lessons of the 14-year fight over Plan B is how seamlessly political obstruction translated from a conservative administration to an ostensibly progressive one—President Bush’s move appealed to his base, and President Obama’s move appealed to Bush’s base, too. By the time NWL filed this latest suit—and won—Obama was already cleared for another four years. Within a month, the United States will finally offer medicine to women and girls because it makes medical sense. “National Women’s Liberation believes that any female old enough to get pregnant is old enough to decide that she doesn’t want to be pregnant,” said Stephanie Seguin, a plaintiff in the case. “This decision to grant immediate access to the Morning-After Pill is a huge step forward in the fight for women and girls to be able to control the course of their lives.”