Doctors assess impact of morning-after pill going OTC

Many physicians support more widespread access to emergency contraception, but others say it's abortion, or it may not be safe.

By Victoria Stagg Elliott, AMNews staff. Jan. 19, 2004.

Reproductive rights advocates, many physicians and several medical groups are celebrating the fact that Plan B, also known as emergency contraception or the morning-after pill, soon might be available without a prescription.

"Let's face facts: Accidents happen," said Vivian M. Dickerson, MD, president-elect of the American College of Obstetricians and Gynecologists, explaining that the change would help reduce unwanted pregnancies and abortions in this country.

The concept, of course, is not new. Since the 1960s, concentrated doses of birth control pills have been prescribed off label for use after unprotected intercourse, primarily for sexual assault victims. But the Food and Drug Administration officially approved use on a prescription basis with Preven (a levonorgestrel and estradiol compound distributed by Gynetics Inc.) in September 1998, and with Plan B in July 1999.

Last month, two Food and Drug Administration advisory panels endorsed switching Plan B to over-the-counter status. The FDA is not required to follow this advice, though it is expected to do so.

Plan B, or levonorgestrel, is a progestin-only emergency contraceptive distributed by the Women's Capital Corp., headquartered in Washington, D.C.

The American Medical Association, the American Academy of Family Physicians, ACOG and the American Academy of Pediatrics support OTC availability as a way for women to access the medication within the 72-hour time window required for it to be effective. ACOG even took the interim step in 2001 of recommending that women be offered advance prescriptions.