Access to Contraceptive Urged
The culture war over emergency contraceptives has heated up on several fronts in recent weeks, with battles fought in pharmacies, state legislatures, political campaigns and Congress.
On Tuesday, advocates for sexual assault victims called on Connecticut lawmakers to require that all Connecticut hospitals – including the state’s four Roman Catholic hospitals – provide emergency contraception to rape victims.
Wal-Mart, the nation’s largest retailer, has cited business reasons for not carrying Plan B – an emergency contraceptive that in most cases can prevent pregnancy if taken within 72 hours of sexual intercourse – in its pharmacies, but critics say the company is responding to pressure from conservative groups.
In Connecticut, Comptroller Nancy Wyman and New Haven Mayor and gubernatorial candidate John DeStefano Jr. have called on all pharmacies to make the drug available. Attorney General Richard Blumenthal promised Friday to issue a legal opinion about whether pharmacies such as Wal-Mart must carry Plan B.
Massachusetts and Illinois have already ordered all pharmacies in those states to stock Plan B.
In Washington, meanwhile, lawmakers such as Rep. Rosa DeLauro, D-3rd District, have urged the U.S. Food and Drug Administration to adopt recommendations made by its own advisory committee more than two years ago and make Plan B available without a prescription.
Democrats say the FDA bowed to pressure from conservative groups in delaying approval of over-the-counter emergency contraceptives.
“There is no reasonable medical evidence to support the FDA’s delay, only an ideological agenda that undermines science and the public health,” DeLauro said Tuesday. “The FDA must not allow ideology to supersede public health.”
Pregnancy can be prevented after sexual intercourse by administration of high doses of birth control hormones over a couple of days. Many doctors prescribe birth control pills as emergency contraception. Plan B is specifically marketed as a “morning-after pill” but like many birth control pills it is made of a hormone that interrupts ovulation. In some cases, the contraceptive can prevent a fertilized egg from implanting in the uterine wall. The success rate of Plan B is 89 percent when taken within three days of intercourse, according to its maker, Barr Pharmaceuticals Inc. of Woodcliff Lake, N.J.
The contraceptive is different from the drug RU-486, which can induce miscarriages in the early stages of pregnancy.
While Plan B has been available by prescription in pharmacies since 1999, it has never been a particularly big seller for Barr, which does not report sales figures because it is not a significant part of the company’s revenue. Still, about 1.3 million prescriptions for Plan B were written in the last fiscal year, the company said.
Distribution of Plan B, however, has been vehemently opposed by some religious leaders who believe the contraceptive will encourage promiscuity and by the Catholic Church, which says the effect of the drug sometimes mimics an abortion.
A law that would require hospitals to dispense emergency contraceptives would conflict with Catholic teachings that life begins at the moment of conception, said the Rev. John Gatzak, director of communications for the Archdiocese of Hartford, speaking for administrators at three Catholic hospitals in the diocese – St. Francis Hospital and Medical Center in Hartford, St. Mary’s Hospital in Waterbury and the Hospital of St. Raphael in New Haven.
Catholic hospitals in Connecticut already have a protocol when dealing with rape victims. They will give a sexual assault victim Plan B – but only if tests reveal she is not pregnant or ovulating. If a woman is ovulating, conception might have occurred and because emergency contraception can prevent the implantation of a fertilized egg, administering the drug would be equivalent to abortion, Gatzak said.
“The church is standing by its belief that human life is sacred,” Gatzak said.
The policy in Catholic hospitals is to inform rape victims where they can receive emergency contraception if they are pregnant or ovulating, Gatzak said
“They will give it to women only if they don’t need it,” said Frances Kissling, president of Catholics for a Free Choice, which supports abortion rights and distribution of the drug to rape victims. “The opposition is not based on numbers or need, but it is an ideological crusade to ensure a woman does not have the option.”
California, New Mexico, New York, Washington, Massachusetts and New Jersey have laws that require hospitals to offer the drug to rape victims. South Carolina requires that the state pay for the drug, Kissling said.
In about 80 percent of Connecticut hospitals, a woman will routinely be offered emergency contraception, said Laura Cordes, director of policy and advocacy at Connecticut Sexual Assault Services, which provided health care and counseling to 400 rape victims in the 2004-05 fiscal year and has lobbied for the legislation. However, 20 percent of the hospitals, including a few non-Catholic hospitals, do not regularly offer emergency contraception, she said.
“Hospitals that do not offer emergency contraception to rape victims elevate survivors’ emotional distress,” Cordes said.
While the culture war over Plan B may resound in other parts of the country, there is broad bipartisan support in Connecticut to require all Connecticut hospitals to offer emergency contraception, said Sen. Gayle S. Slossberg, D-Milford, vice chairwoman of the legislature’s public health committee. The committee plans to hold public hearings on the bill soon.
“We want to [ensure the] best medical care for rape victims,” Slossberg said.
This article originally appeared in the 22 Febraury 2006 edition of the Hartford Courant.