Plan B, One Year Later

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It's been nearly a year since the controversial emergency contraceptive "Plan B" became an over the counter drug. OB/GYN Dr. Valerie Rice talks about the drug's impact on reproduction and women's health over the last year.

FARAI CHIDEYA, host:

I'm Farai Chideya. And this is NEWS & NOTES.

Tomorrow the emergency contraceptive known as the morning-after pill will have been sold over the counter for exactly one year. The Food and Drug Administration had postponed its ruling on whether there could be over-the-counter sales again and again.

Doctor Valerie Montgomery Rice is Dean of the School of Medicine at Meharry Medical College, where she's also senior vice president for health affairs. She joins us now to look back at that controversy over the morning-after pill, also known as Plan B and to look at the current set of contraceptive options for women. Dr. Rice, thanks for coming on.

Dr VALERIE MONTGOMERY RICE (Dean, Meharry Medical College): Thank you for having me.

CHIDEYA: So, I remember there were some misconceptions about the morning-after pill and whether or not it was a so-called abortion pill, like Mifepristone. Is that kind of misconception still out there?

Dr. RICE: I think there may be some confusion still in the mind of some of the individuals, but we now know, based on good data and the work that was done by the companies who sponsored this, is that what we believe is happening is that it is ovulation is probably inhibited and that the normal menstrual cycle is altered, which would delay ovulation. And so, we don't believe that what you are really seeing is a embryo that is somewhat aborted. We believe that the mechanism is based on ovulation really being inhibited and a delay in ovulation, which, of course, you can't get fertilization and therefore, you won't have this quote, unquote, "chemical abortion" that people talk about.

CHIDEYA: So, are there any side effects with this pill?

Dr. RICE: With any birth control pills, some people do have some nausea, occasionally vomiting, but you - remember, this is a dose that is given 12 hours apart, and typically, most of the patients, particularly when they are used in the progestin-only type of morning-after pill, which Plan B is, then you don't see significant nausea at all.

CHIDEYA: Progestin is one of the different hormones that are used in some birth control pills. Just very briefly, tell us why this pill has that particular hormone.

Dr. RICE: Well, I think that when you look at the side effect profile, the number of people who had, like, the nausea, the vomiting, et cetera, as compared to some of the other progestins that were maybe considered, this one had the lowest side effect profile because, remember, we're trying to utilize something that's going to be effective and, of course, have the greatest safety profile for women.

CHIDEYA: So whether minors could get their hands on the drug was one of the key points of debate on whether to make available over the counter - has that issue been resolved?

Dr. RICE: I believe so. I did sit on the FDA panel during this time and was at the, of course, participated in the hearings, et cetera, and you know, the concerns were whether or not this would be a "licensed," quote, unquote for minors to participate in more sexual activity, et cetera. And my response to that has always been that people make decisions about whether or not to have intercourse based on, really, multiple factors. But one of the key factors is the information that they get at home. And so I did not agree that this would be a licensed. But the controversy was still there, whether or not if we placed it away from behind the counter then - and put it on the shelf like other over-the-counter medications, whether we would see an increase use, and I'm not clear that the data has shown that at all. That you're seeing an increase use by teens, et cetera.

I think I want to make sure that we clarify this. Plan B is an emergency type of contraceptive, and none of us would advocate that be the standard form of contraception that a person would use a lot, okay? No one would advocate that. We would advocate that people get on a more standard regimen of contraceptive. We have multiple options for women for long-term contraceptives that are reversible. So, I want to make sure that by no means that people walk away with this thinking that any of us would advocate that this is the standard means by which a woman will protect herself from pregnancy. This is what we recommend and the time when a condom breaks, or there has been a loss of your birth control pills and you have intercourse and you are concerned, that would be the situation that you will use this in. So I want to make sure that that is clear.

CHIDEYA: Well, Dr. Valerie Montgomery Rice, thank you for coming on.

Dr. RICE: All right. Thank you for having me.

CHIDEYA: Dr. Valerie Montgomery Rice is an obstetrician and gynecologist. She joined us by phone from Meharry Medical College in Nashville where she's dean of the school of medicine and senior vice president for health affairs.

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