When Plan A fails

Where only first names appear, names have been changed to protect the identities of sources.

Things don't always go as planned. Last year, despite regularly using contraceptives to prevent pregnancy, one missed pill and one broken condom left Jessica, a senior, in need of a backup. "It was unsettling," she says. It was a Friday night and the clinics were closed for the weekend, leaving Jessica terrified for the next three days.

That Monday, she made a trip to the local health clinic, where a brief exchange with the doctor left her with two small pills. "All it took was five minutes of conversation, but I felt significantly relieved," she says.

Jessica was prescribed Emergency Contraceptive Pills (ECPs). This treatment is given in a series of pills and is most effective the sooner it begins. At the Teen Connection clinic in Takoma Park and at Planned Parenthoods across the state of Maryland, ECPs are freely available to all women under the age of 18. In fact, more than 80 percent of Planned Parenthood health care clients receive services to prevent unintended pregnancy, and an estimated 594,000 unintended pregnancies are averted by Planned Parenthood contraceptive services each year.

While ECPs are most frequently used in cases of unprotected sex, a handful of sexually active Blazers are taking the extra precaution to prevent pregnancy when their primary, or even secondary, form of contraception fails.

"The thought was terrifying"

Last winter, Amy, a senior, found herself in a situation similar to Jessica's. She had been taking birth control irregularly, and the condom she and her boyfriend used broke. Although the odds were in her favor, she decided she could not afford the risk of pregnancy. "The thought was terrifying," says Amy. "There's no way I'd have a child now." She, too, went to her local clinic, where she was immediately prescribed Plan B.

In other cases, bad judgment and a lack of protection can leave teenagers vulnerable to and worried about pregnancy. The summer after 10th grade, Susan, a senior, had unprotected sex with her boyfriend after returning home from vacation. Immediately afterwards, she realized the possible consequences of her actions and called Planned Parenthood to get a Plan B prescription. "I know it was irresponsible and it sounds stupid, but sex is something you get caught up in," explains Susan.

Like most other teenagers, she decided not to involve her parents. "If I'm responsible enough to have sex, I'm responsible enough to take care of myself," she says.
Although Jessica, Susan and Amy have all used Plan B a second time as a backup to other contraceptives, they agree that the experience gave them a reality check. "There's so much sexual activity in high school, and in some ways it seems so casual," says Susan. "This made me realize sex is serious."

Time for Plan B

When Susan arrived at Planned Parenthood, she was still in a state of shock. "I sat there looking at other people and I didn't understand how I got myself in that situation," she explains. Although she felt uncomfortable in such an unfamiliar environment, Susan realized she wasn't alone. "Everyone is represented. Old, young and people of all races," she says. "Sex affects everyone."

John Nugent, the CEO and president of Planned Parenthood of Maryland, says the organization has been providing reproductive health care for women and men of all ages for 75 years. "We provide value-neutral counseling, which means we don't inflict our values on someone. We try and determine what solution is best for them," says Nugent.

He emphasizes that women do not have to come into the clinic to receive Plan B and that no physical exam is necessary. "Because of the short period of time to prevent pregnancy, time is crucial," insists Nugent.

Instead, women can call a toll-free number, which is available on a 24-hour basis. The phone representatives will call in a prescription and refer callers to a pharmacy that offers Plan B. "It's a matter of picking up the medication," says Nugent.

After her experiences with ECPs, Jessica encourages all girls to ask for Plan B if they have any doubts. "Don't be afraid of the stigma associated with the pill," she says. "Don't be afraid of being judged."

Plan B politics

While oral contraceptives have been used for the past four decades and ECPs have been used safely since 1999, the FDA is still debating whether to make Plan B over-the-counter (OTC). Most recently, the FDA postponed a final decision for the second time this year, sparking a heated debate among Plan B advocates and within the FDA itself. Plan B supporters are outraged because they believe the FDA's verdict was politically based. According to Nugent, "All the scientific data indicates that this is a safe product — the FDA turned it down, not because of science, but because of politics."

Most critics, however, fear that not only will women misuse the drug, but that it will also increase sexual activity among teenage girls. Considering that more than 30 percent of American women do not know enough about ECPs to effectively use them, according to Planned Parenthood, the misuse and abuse of the drug is inevitable.

For this reason, Amy believes going to a clinic is an important part of obtaining ECPs. Talking to a doctor first is a good way to prevent people from taking advantage of its availability and using it too often, she says.

Although Jessica strongly supports making Plan B available OTC, she also admits that there are benefits to going to a clinic. "I think it would have been more nerve-wrenching if I had to buy it from a pharmacist," she says. "I think going to a clinic and talking to someone makes the situation a lot more comfortable."

Hannah Klaus, the executive director of Teen STAR, a sexual education program for adolescents, discourages the use of contraceptives like Plan B because she feels that they are too unreliable. "Sexual relations are very precious, and contraceptives are giving people a false sense of security," says Klaus. "It's not a cure-all."

Critics also believe that availability of Plan B might result in increased promiscuity. But according to Planned Parenthood, new studies negate this claim, finding that, while increased access to ECPs does increase the likelihood of use, this access does not alter sexual behavior or the risk for contracting STDs.

Ultimately, Susan, Jessica and Amy feel no remorse over being sexually active and still choose to use contraception. "I don't regret my choice to have sex," says Susan. "I regret my choice to be irresponsible."